Health Workforce Reallocation in the Aftermath of Conflict: Evidence from Colombia

Abstract

Healthcare workers are in great deficit worldwide, especially in rural and vulnerable areas of developing countries. By leveraging a permanent ceasefire that ended over five decades of armed conflict between the Colombian government and the FARC insurgency, we study the extent to which conflict termination affected the health workforce gap between areas more exposed to FARC violence and other places. Based on individual-level administrative records of all healthcare workers in Colombia and a difference-in-differences strategy, we find that the ceasefire caused a differential 11.4% decrease in the share of employed healthcare workers per 1,000 people in places more exposed to FARC violence relative to the rest of the country. We find a stronger decrease among healthcare workers with less human capital levels and open-ended labor contracts. We show that this effect is likely explained by lifting mobility restrictions in previously violent areas, and document that, because the net reduction in healthcare workers increased the within-municipality share of (more productive) physicians, it did not translate into a deterioration of mortality rates or healthcare service provision.