Implications of armed conflict for maternal and child health

Detalhes bibliográficos
Autor(a) principal: Jawad, Mohammed
Data de Publicação: 2021
Outros Autores: Hone, Thomas, Vamos, Eszter P., Cetorelli, Valeria, Millett, Christopher
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/132284
Resumo: Publisher Copyright: © 2021 Jawad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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spelling Implications of armed conflict for maternal and child healtha regression analysis of data from 181 countries for 2000–2019Medicine(all)SDG 3 - Good Health and Well-beingSDG 16 - Peace, Justice and Strong InstitutionsPublisher Copyright: © 2021 Jawad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background Armed conflicts have major indirect health impacts in addition to the direct harms from violence. They create enduring political instability, destabilise health systems, and foster negative socioeconomic and environmental conditions—all of which constrain efforts to reduce maternal and child mortality. The detrimental impacts of conflict on global maternal and child health are not robustly quantified. This study assesses the association between conflict and maternal and child health globally. Methods and findings Data for 181 countries (2000–2019) from the Uppsala Conflict Data Program and World Bank were analysed using panel regression models. Primary outcomes were maternal, under-5, infant, and neonatal mortality rates. Secondary outcomes were delivery by a skilled birth attendant and diphtheria, pertussis, and tetanus (DPT) and measles vaccination coverage. Models were adjusted for 10 confounders, country and year fixed effects, and conflict lagged by 1 year. Further lagged associations up to 10 years post-conflict were tested. The number of excess deaths due to conflict was estimated. Out of 3,718 country–year observations, 522 (14.0%) had minor conflicts and 148 (4.0%) had wars. In adjusted models, conflicts classified as wars were associated with an increase in maternal mortality of 36.9 maternal deaths per 100,000 live births (95% CI 1.9–72.0; 0.3 million excess deaths [95% CI 0.2 million–0.4 million] over the study period), an increase in infant mortality of 2.8 per 1,000 live births (95% CI 0.1–5.5; 2.0 million excess deaths [95% CI 1.6 million–2.5 million]), a decrease in DPT vaccination coverage of 4.9% (95% CI 1.5%–8.3%), and a decrease in measles vaccination coverage of 7.3% (95% CI 2.7%–11.8%). The long-term impacts of war were demonstrated by associated increases in maternal mortality observed for up to 7 years, in under-5 mortality for 3–5 years, in infant mortality for up to 8 years, in DPT vaccination coverage for up to 3 years, and in measles vaccination coverage for up to 2 years. No evidence of association between armed conflict and neonatal mortality or delivery by a skilled birth attendant was found. Study limitationsAU include: Pleasecheckthattheeditstothesentence the ecological study design, }Studylimita which may mask sub-national variation in conflict intensity, and the quality of the underlying data. Conclusions Our analysis indicates that armed conflict is associated with substantial and persistent excess maternal and child deaths globally, and with reductions in key measures that indicate reduced availability of organised healthcare. These findings highlight the importance of protecting women and children from the indirect harms of conflict, including those relating to health system deterioration and worsening socioeconomic conditions.Escola Nacional de Saúde Pública (ENSP)Comprehensive Health Research Centre (CHRC) - Pólo ENSPRUNJawad, MohammedHone, ThomasVamos, Eszter P.Cetorelli, ValeriaMillett, Christopher2022-02-04T23:24:16Z2021-092021-09-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/132284eng1549-1277PURE: 36580276https://doi.org/10.1371/journal.pmed.1003810info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:10:57Zoai:run.unl.pt:10362/132284Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:47:24.876794Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Implications of armed conflict for maternal and child health
a regression analysis of data from 181 countries for 2000–2019
title Implications of armed conflict for maternal and child health
spellingShingle Implications of armed conflict for maternal and child health
Jawad, Mohammed
Medicine(all)
SDG 3 - Good Health and Well-being
SDG 16 - Peace, Justice and Strong Institutions
title_short Implications of armed conflict for maternal and child health
title_full Implications of armed conflict for maternal and child health
title_fullStr Implications of armed conflict for maternal and child health
title_full_unstemmed Implications of armed conflict for maternal and child health
title_sort Implications of armed conflict for maternal and child health
author Jawad, Mohammed
author_facet Jawad, Mohammed
Hone, Thomas
Vamos, Eszter P.
Cetorelli, Valeria
Millett, Christopher
author_role author
author2 Hone, Thomas
Vamos, Eszter P.
Cetorelli, Valeria
Millett, Christopher
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Escola Nacional de Saúde Pública (ENSP)
Comprehensive Health Research Centre (CHRC) - Pólo ENSP
RUN
dc.contributor.author.fl_str_mv Jawad, Mohammed
Hone, Thomas
Vamos, Eszter P.
Cetorelli, Valeria
Millett, Christopher
dc.subject.por.fl_str_mv Medicine(all)
SDG 3 - Good Health and Well-being
SDG 16 - Peace, Justice and Strong Institutions
topic Medicine(all)
SDG 3 - Good Health and Well-being
SDG 16 - Peace, Justice and Strong Institutions
description Publisher Copyright: © 2021 Jawad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
publishDate 2021
dc.date.none.fl_str_mv 2021-09
2021-09-01T00:00:00Z
2022-02-04T23:24:16Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/132284
url http://hdl.handle.net/10362/132284
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 1549-1277
PURE: 36580276
https://doi.org/10.1371/journal.pmed.1003810
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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