Terrorism and Child Mortality: Evidence from Africa

How does terrorism affect child mortality? We use geo-coded data on terrorism and highly spatially disaggregated data on child mortality to study the relationship between both variables for 52 African countries between 2000 and 2017 at the 0.5×0.5 degree grid-cell level. A two-way fixed-effects approach indicates that higher levels of terrorist activity correlate with higher levels of child mortality risk. Our estimates suggest that moderate increases in the terrorism index are linked to several thousand additional deaths of children under the age of five per year. Employing instrumental-variable and panel event-study approaches, we also provide causal evidence that terrorism increases the risk of death for children under the age of five. Effect sizes associated with these causal estimates are several times larger than those from the more conservative two-way fixed-effects approach. Finally, interrogating our data, we show that the direct effects of terrorism (e.g., in terms of its lethality and destruction of public health infrastructure) tend to be very small. This, in turn, suggests that increases in child mortality primarily emerge through the behavioral response of economic agents (e.g., parents, doctors, medical staff, aid workers and policymakers) to terrorism. Indeed, we provide evidence that higher levels of terrorist activity unfavorably correlate with several proximate causes of child mortality.