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Armed conflicts, which primarily occur in low- and middle-income countries, have profound consequences for the health of affected populations, among them a decrease in the utilization of maternal health care services. The quantitative relationship between armed conflict and maternal health care utilization has received limited attention in the public health literature. We evaluate this relationship for a particular type of health care service, antenatal care, in Nepal. Using count regression techniques, household survey data and sub-national conflict data, we find a negative correlation between the number of antenatal care visits and incidents of conflict-related violence within a respondent's village development committee. Specifically, we find that under high-intensity conflict conditions women receive between 0.3 and 1.5 fewer antenatal care check-ups. These findings imply that maternal health care utilization is partially determined by characteristics of the social environment (e.g. political instability) and suggest health care providers need to revise maternal health strategies in conflict-affected areas. Strategies may include decentralization of services, maintaining neutrality among factions, strengthening community-based health services and developing mobile clinics.

Watershed protection, and associated water quality improvements, has received considerable attention as a means for mitigating health risks and avoiding expenditures at drinking water treatment plants (DWTPs). This study reviews the literature linking source water quality to DWTP expenditures. For each study, we report information on the modeling approach, data structure, definition of treatment costs and water quality, and statistical methods. We then extract elasticities indicating the percentage change in drinking water treatment costs resulting from a 1% change in water quality. Forty-six elasticities are obtained for various water quality parameters, such as turbidity, total organic carbon (TOC), nitrogen, sediment loading, and phosphorus loading. An additional 29 elasticities are obtained for land use classification (e.g., forest, agricultural, urban), which often proxy source water quality. Findings indicate relatively large ranges in the estimated elasticities of most parameters and land use classifications. However, average elasticities are smaller and ranges typically narrower for studies that incorporated control variables consistent with economic theory in their models. We discuss the implications of these findings for a DWTP's incentive to engage in source water protection and highlight gaps in the literature.

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