Exposure to conflict and child health outcomes: evidence from a large multi-country study

Abstract

Background Previous research has consistently found evidence of poor health outcomes among children living in conflict areas. However, the methodological focus of these studies has largely been on case studies, chart or registry reviews, qualitative studies, and single country studies. This reflects the need for a comprehensive multi-country analysis of the associations between conflicts and child health over a longer period. This study analyses the adverse impact of exposure to different types of conflicts from in utero to five years of age, on several child health measures across a large group of countries. Our analysis pools data from multiple countries and time-points, to provide robust evidence on the relationship between conflict and child health. Methods Geo-referenced data on various forms of conflict are combined with the Demographic Health Survey dataset, to construct a large unique database of 590,488 pre-school age children across 52 developing countries over the period 1997 to 2018. Our analysis exploits the within-country differences in children’s exposure to conflict from in utero to age five, to estimate its association with health outcomes. Our multivariate regression models estimate the links between conflict exposure and child health outcomes, measured using child nutrition outcomes (height-for-age and weight-for-age z-scores) and immunization status. Results and conclusions Empirical estimates show that even after controlling for a large array of socio-economic and demographic characteristics and location fixed effects, conflict exposure is negatively associated with child nutrition and immunization, across all our measures of conflict. These findings are robust across a range of specifications, alternative measures of conflict and sub-samples.

Area level indirect exposure to extended conflicts and early childhood anthropometric outcomes in India: a repeat cross-sectional analysis

“…Data on protracted conflicts was obtained from the Uppsala Conflict Data Program (UCDP), which collates data on geo-referenced conflict events, the actors involved, time, location, and reported deaths from secondary sources [ 48 ].This data source has been used for studies measuring exposure to conflict as a determinant of children’s and women’s health by different studies in LMICs [ 26 , 43 – 45 , 49 ]. Importantly, UCDP only includes violent events causing >= 25 deaths annually [ 48 ].…”

Access to Human Health Benefits of Forests in Rural Low and Middle-Income Countries: A Literature Review and Conceptual Framework

“…Significant advances have been made in strengthening the evidence on the impacts of conflicts (e.g., civil wars, civil conflicts) on nutrition-related outcomes [78]. Contributing to these advances is the ability of conflict-health scholars to apply rigorous quasi-experimental study designs to publicly available large survey datasets, such as the Demographic and Health Surveys (DHS) data administered by the U.S. Agency for International Development (USAID) (e.g., [79][80][81][82][83][84][85][86][87][88][89]). There are few studies attempting to apply rigorous quasiexperimental designs to the DHS data to examine the impacts of forest-related interventions on health-related outcomes [27,29,31,90].…”