The impact of responses to high rates of malnutrition during armed conflict is frequently measured in terms of the number or proportion of malnourished children or mortality rates at one point in time. While this gives an indication of a programme's impact, it does not highlight the number of times that children may become malnourished throughout the duration of the conflict. This means that the emphasis is placed on short term, quick solutions rather than solutions that aim to reduce malnutrition both in the short and long term. For instance, the same children who attended the feeding centres in Lower Bong and Upper Margibi, Liberia, in 1995 attended the feeding programmes in 1991 and 1993. Alternative methods of impact assessment need to be developed that measure both the impact of armed conflict and the effects of relief responses on sustainable livelihoods and child nutrition.
The most important measure to prevent the negative impact of armed conflict on nutritional situations of children is, no doubt, the prevention and resolution of conflict. Of course, this is more easily said than done. It is important that when a conflict occurs, steps be taken to strengthen community structures and family caring practices. Steps are needed to improve access to health care and household food security to help protect the nutritional status of the population, reduce the number malnourished children, and lower the frequency of children becoming malnourished, especially in prolonged conflicts.
The prolonged nature of most of the internal conflicts occurring in the world requires that a long-term developmental approach be taken both for the response during the conflicts and the reconstruction afterwards. All relief measures should link emergency, relief, rehabilitation and development objectives and activities. Methods need to be developed to measure impact and effectiveness of different types of responses in each situation or stage of the conflict. For example, a recent evaluation of the livestock programme in southern Sudan compared the cost of providing 400g of food aid/day for one year to 21,000 people at US$1,000/MT to the cost of increasing the food base of the same number of people through the livestock programme. The evaluation estimated that the livestock programme has a cost-benefit ratio in comparison to food aid of 1:15 (OLS, 1995a).
Many of the relief actions that seek to prevent people from becoming destitute through interventions in all areas (e.g. provision of water, livestock, agricultural assistance, health and education services), also protect nutritional status and could be considered as developmental. They are also fundamental to protecting against rapid increases in mortality and malnutrition in crisis situations (Ibid).