O'Hare Bernadette A M, Southall David P
Department of Paediatrics, University Hospital of Wales, Cardiff, Heath Park, Cardiff CF14 4XN.
J R Soc Med. 2007 Dec;100(12):564-70. doi: 10.1177/0141076807100012015.
To compare the rates of under-5 mortality, malnutrition, maternal mortality and other factors which influence health in countries with and without recent conflict. To compare central government expenditure on defence, education and health in countries with and without recent conflict. To summarize the amount spent on SALW and the main legal suppliers to countries in Sub-Saharan African countries (SSA), and to summarize licensed production of Small Arms and Light Weapons (SALW) in these countries.
We compared the under-5 mortality rate in 2004 and the adjusted maternal mortality ratio in SSA which have and have not experienced recent armed conflict (post-1990). We also compared the percentage of children who are underweight in both sets of countries, and expenditure on defence, health and education.
Demographic data and central government expenditure details (1994-2004) were taken from UNICEF's The State of the World's Children 2006 report.
Under-5 mortality, adjusted maternal mortality, and government expenditure.
21 countries have and 21 countries have not experienced recent conflict in this dataset of 42 countries in SSA. Median under-5 mortality in countries with recent conflict is 197/1000 live births, versus 137/1000 live births in countries without recent conflict. In countries which have experienced recent conflict, a median of 27% of under-5s were moderately underweight, versus 22% in countries without recent conflict. The median adjusted maternal mortality in countries with recent conflict was 1000/100,000 births versus 690/100,000 births in countries without recent conflict. Median reported maternal mortality ratio is also significantly higher in countries with recent conflict. Expenditure on health and education is significantly lower and expenditure on defence significantly higher if there has been recent conflict.
There appears to be an association between recent conflict and higher rates of under-5 mortality, malnutrition and maternal mortality. Governments spend more on defence and less on health and education if there has been a recent conflict. SALW are the main weapon used and France and the UK appear to be the two main suppliers of SALW to SSA.
比较近期有冲突和无冲突国家的五岁以下儿童死亡率、营养不良情况、孕产妇死亡率以及其他影响健康的因素。比较近期有冲突和无冲突国家中央政府在国防、教育和卫生方面的支出。汇总撒哈拉以南非洲国家（SSA）在小武器和轻武器方面的支出以及主要合法供应国，并汇总这些国家小武器和轻武器的许可生产情况。
我们比较了2004年SSA中经历过和未经历过近期武装冲突（1990年后）国家的五岁以下儿童死亡率以及调整后的孕产妇死亡率。我们还比较了两组国家中体重不足儿童的百分比，以及国防、卫生和教育方面的支出。
人口数据和中央政府支出明细（1994 - 2004年）取自联合国儿童基金会《2006年世界儿童状况》报告。
五岁以下儿童死亡率、调整后的孕产妇死亡率和政府支出。
在这个包含42个SSA国家的数据集中，21个国家经历过近期冲突，21个国家未经历过近期冲突。近期有冲突国家的五岁以下儿童死亡率中位数为每1000例活产197例，而近期无冲突国家为每1000例活产137例。在经历过近期冲突的国家，五岁以下儿童中中度体重不足的中位数比例为27%，而在无近期冲突的国家为22%。近期有冲突国家调整后的孕产妇死亡率中位数为每10万例分娩1000例，而近期无冲突国家为每10万例分娩690例。报告的孕产妇死亡率中位数在近期有冲突的国家也显著更高。如果近期发生过冲突，卫生和教育方面的支出显著更低，而国防方面的支出显著更高。
近期冲突与较高的五岁以下儿童死亡率、营养不良率和孕产妇死亡率之间似乎存在关联。如果近期发生过冲突，政府在国防上的支出更多，而在卫生和教育上的支出更少。小武器和轻武器是主要使用的武器，法国和英国似乎是向SSA供应小武器和轻武器的两个主要国家。
