Mixed-methods approach to describing violence and mortality among Malian refugees and host populations: a cross-sectional and participatory study in the Bassiknou district, Mauritania
Study design
Retrospective mixed-methods study
Context
Since 2012, Mauritania has hosted Malian refugees, with renewed displacement since 2023 concentrated in Bassikounou department. Many refugees have fled violence and find themselves in precarious living conditions in host villages. This mixed-methods study was carried out to assess the context of violence and mortality among Malian refugees, while exploring the experiences and living conditions of refugees and host communities.
Our role
- Coordination
Methodology
A retrospective survey employing two-stage cluster sampling (126 clusters) was conducted using satellite imagery of refugee and host shelters in Bassikounou (excluding Mbera camp). Families within selected clusters were included. Mortality data spanned 17 months (August 2023–January 2025). A peer-led qualitative approach contextualized violence dynamics.
Results
• Mortality: Refugee crude mortality rate (0.33/10,000/day) was twice that of the host population (0.17/10,000/day). Violence caused 58.3% of refugee deaths, with two-thirds occurring in Mali.
• Violence: 5.9% of refugees said they had experienced violence versus 0.5% of hosts. Firearm- and knife-related violence occurred exclusively among refugees in Mali.
• Population estimate: excluding Mbera camp, there are around 29,739 refugees, 692 returnees and 94,898 residents in the area hosting refugees in Bassikounou.
• Context: Refugees described extreme violence - massacres, looting and intimidation - experienced before or during exile, which caused deep collective trauma, with the precarious conditions of exile exacerbating the mental load.
Discussion
Malian refugees faced disproportionate mortality and violence, underscoring insecurity in Mali. Refugee deaths are predominantly linked to violence in origin areas. Despite risks, many refugees express intent to return. Findings emphasize urgent advocacy for civilian protection and targeted interventions addressing the consequences of violence suffered, to respond to psychosocial, health and economic needs.
