Armed Conflict and Maternal Health Care Utilization: Evidence from the Boko Haram Insurgency in Nigeria

doi:10.1016/j.socscimed.2019.02.055

Publication:
Armed Conflict and Maternal Health Care Utilization: Evidence from the Boko Haram Insurgency in Nigeria

dc.contributor.author	Ekhator-Mobayode, Uche Eseosa
dc.contributor.author	Chukwuma, Adanna
dc.date.accessioned	2021-05-13T20:56:17Z
dc.date.available	2021-05-13T20:56:17Z
dc.date.issued	2019-04
dc.description.abstract	Retention in maternal health care is essential to decreasing preventable mortality. By reducing access to care, armed conflicts such as the Boko Haram Insurgency (BHI), contribute to the high maternal mortality rates in Nigeria. While there is a rich literature describing the mechanisms through which conflict affects health care access, studies that estimate the impact of conflict on maternal health care use are sparse and report mixed findings. In this study, we examine the impact of the BHI on maternal care access in Nigeria. We spatially match 52,675 birth records from the Nigeria Demographic and Health Survey (NDHS) with attack locations in the Armed Conflict Location and Event Dataset (ACLED). We define BH conflict area as NDHS clusters with at least five attacks within 3000, 5000 and 10,000 m of BH activity during the study period and employ difference-in-differences methods to examine the effect of the BHI on antenatal care visits, delivery at the health center and delivery by a skilled professional. We find that the BHI reduced the probability of any antenatal care visits, delivery at a health center, and delivery by a skilled health professional. The negative effects of the BHI on maternal health care access extended beyond the Northeastern region, that is the current focus of humanitarian programs. Systematic efforts to identify and address the mechanisms underlying reductions in maternal health care use due to the BHI, and to target the affected populations, are essential to improving maternal health in Nigeria.	en
dc.identifier.citation	Social Science and Medicine
dc.identifier.doi	10.1596/35576
dc.identifier.issn	0277-9536
dc.identifier.uri	https://hdl.handle.net/10986/35576
dc.publisher	Elsevier
dc.rights	CC BY-NC-ND 3.0 IGO
dc.rights.holder	World Bank
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/3.0/igo
dc.subject	CONFLICT
dc.subject	MATERNAL HEALTH
dc.subject	VIOLENCE
dc.subject	TERRORISM
dc.subject	HEALTH CARE USE
dc.title	Armed Conflict and Maternal Health Care Utilization	en
dc.title.subtitle	Evidence from the Boko Haram Insurgency in Nigeria	en
dc.type	Journal Article	en
dc.type	Article de journal	fr
dc.type	Artículo de revista	es
dspace.entity.type	Publication
okr.associatedcontent	https://www.sciencedirect.com/science/article/pii/S0277953619301285 Journal website (version of record)	en
okr.date.disclosure	2022-03-03
okr.date.doiregistration	2025-05-06T11:08:15.976617Z
okr.doctype	Publications & Research::Journal Article
okr.doctype	Publications & Research
okr.externalcontent	External Content
okr.identifier.doi	10.1016/j.socscimed.2019.02.055
okr.identifier.report	161820
okr.journal.nbpages	104-12
okr.language.supported	en
okr.peerreview	Academic Peer Review
okr.region.administrative	Africa
okr.region.administrative	Africa Western and Central (AFW)
okr.region.country	Nigeria
okr.topic	Conflict and Development::Armed Conflict
okr.topic	Conflict and Development::Conflict and Fragile States
okr.topic	Health, Nutrition and Population::Early Child and Children's Health
okr.topic	Health, Nutrition and Population::Health Service Management and Delivery
okr.topic	Health, Nutrition and Population::Reproductive Health
okr.unit	Health, Nutrition and Population Global Practice
okr.volume	226
relation.isAuthorOfPublication	41aa479e-8677-5046-8dc0-ceca0dc1aa7f
relation.isAuthorOfPublication.latestForDiscovery	41aa479e-8677-5046-8dc0-ceca0dc1aa7f