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

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 whic...

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Main Authors:	Chukwuma, Adanna, Ekhator-Mobayode, Uche Eseosa
Format:	Journal Article
Published:	Elsevier 2021
Subjects:	CONFLICT MATERNAL HEALTH VIOLENCE TERRORISM HEALTH CARE USE
Online Access:	http://hdl.handle.net/10986/35576

id	okr-10986-35576
recordtype	oai_dc
spelling	okr-10986-355762021-07-20T18:45:33Z Armed Conflict and Maternal Health Care Utilization : Evidence from the Boko Haram Insurgency in Nigeria Chukwuma, Adanna Ekhator-Mobayode, Uche Eseosa CONFLICT MATERNAL HEALTH VIOLENCE TERRORISM HEALTH CARE USE 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. 2021-05-13T20:56:17Z 2021-05-13T20:56:17Z 2019-04 Journal Article Social Science and Medicine 0277-9536 http://hdl.handle.net/10986/35576 CC BY-NC-ND 3.0 IGO http://creativecommons.org/licenses/by-nc-nd/3.0/igo World Bank Elsevier Publications & Research :: Journal Article Publications & Research Africa Africa Western and Central (AFW) Nigeria
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
topic	CONFLICT MATERNAL HEALTH VIOLENCE TERRORISM HEALTH CARE USE
spellingShingle	CONFLICT MATERNAL HEALTH VIOLENCE TERRORISM HEALTH CARE USE Chukwuma, Adanna Ekhator-Mobayode, Uche Eseosa Armed Conflict and Maternal Health Care Utilization : Evidence from the Boko Haram Insurgency in Nigeria
geographic_facet	Africa Africa Western and Central (AFW) Nigeria
description	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.
format	Journal Article
author	Chukwuma, Adanna Ekhator-Mobayode, Uche Eseosa
author_facet	Chukwuma, Adanna Ekhator-Mobayode, Uche Eseosa
author_sort	Chukwuma, Adanna
title	Armed Conflict and Maternal Health Care Utilization : Evidence from the Boko Haram Insurgency in Nigeria
title_short	Armed Conflict and Maternal Health Care Utilization : Evidence from the Boko Haram Insurgency in Nigeria
title_full	Armed Conflict and Maternal Health Care Utilization : Evidence from the Boko Haram Insurgency in Nigeria
title_fullStr	Armed Conflict and Maternal Health Care Utilization : Evidence from the Boko Haram Insurgency in Nigeria
title_full_unstemmed	Armed Conflict and Maternal Health Care Utilization : Evidence from the Boko Haram Insurgency in Nigeria
title_sort	armed conflict and maternal health care utilization : evidence from the boko haram insurgency in nigeria
publisher	Elsevier
publishDate	2021
url	http://hdl.handle.net/10986/35576
_version_	1764483363142369280

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

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