Goli Srinivas, Mavisakalyan Astghik, Rammohan Anu, Vu Loan
Australia India Institute, University of Western Australia, Perth, Australia.
Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Mumbai, India.
Confl Health. 2022 Oct 10;16(1):52. doi: 10.1186/s13031-022-00483-9.
Previous research has consistently found evidence of poor health outcomes among children living in conflict areas. However, the methodological focus of these studies has largely been on case studies, chart or registry reviews, qualitative studies, and single country studies. This reflects the need for a comprehensive multi-country analysis of the associations between conflicts and child health over a longer period. This study analyses the adverse impact of exposure to different types of conflicts from in utero to five years of age, on several child health measures across a large group of countries. Our analysis pools data from multiple countries and time-points, to provide robust evidence on the relationship between conflict and child health.
Geo-referenced data on various forms of conflict are combined with the Demographic Health Survey dataset, to construct a large unique database of 590,488 pre-school age children across 52 developing countries over the period 1997 to 2018. Our analysis exploits the within-country differences in children's exposure to conflict from in utero to age five, to estimate its association with health outcomes. Our multivariate regression models estimate the links between conflict exposure and child health outcomes, measured using child nutrition outcomes (height-for-age and weight-for-age z-scores) and immunization status.
Empirical estimates show that even after controlling for a large array of socio-economic and demographic characteristics and location fixed effects, conflict exposure is negatively associated with child nutrition and immunization, across all our measures of conflict. These findings are robust across a range of specifications, alternative measures of conflict and sub-samples.
先前的研究一直发现生活在冲突地区的儿童健康状况不佳的证据。然而,这些研究的方法重点主要是案例研究、图表或登记册审查、定性研究和单一国家研究。这反映出需要对冲突与儿童健康之间的关联进行更长期的全面多国分析。本研究分析了从子宫内到五岁期间接触不同类型冲突对一大组国家的多项儿童健康指标的不利影响。我们的分析汇总了来自多个国家和时间点的数据,以提供关于冲突与儿童健康之间关系的有力证据。
将各种形式冲突的地理参考数据与人口健康调查数据集相结合,构建了一个包含1997年至2018年期间52个发展中国家590,488名学龄前儿童的大型独特数据库。我们的分析利用了各国儿童从子宫内到五岁期间接触冲突的差异,以估计其与健康结果的关联。我们的多元回归模型估计了冲突暴露与儿童健康结果之间的联系,儿童健康结果通过儿童营养指标(身高别年龄和体重别年龄z分数)和免疫状况来衡量。
实证估计表明,即使在控制了一系列社会经济和人口特征以及地点固定效应之后,在我们所有的冲突衡量指标中,冲突暴露与儿童营养和免疫均呈负相关。这些发现在一系列规格、冲突替代指标和子样本中都是稳健的。