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Armed violent conflict and healthcare-seeking behavior for maternal and child health in sub-Saharan Africa: A systematic review

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  • Gbadebo Collins Adeyanju
  • Pia Schrage
  • Rabiu Ibrahim Jalo
  • Liliana Abreu
  • Max Schaub

Abstract

Background: Over 630 million women and children worldwide have been displaced by conflict or live dangerously close to conflict zones. While the adverse effects of physical destruction on healthcare delivery are relatively well understood, the effects on healthcare-seeking behavior remain underexplored, particularly in sub-Saharan Africa. This study aims to better understand the interconnections and knowledge gaps between exposure to armed violent conflicts and healthcare-seeking behaviors for maternal and child health in sub-Saharan Africa. Methods: Five key electronic databases (PubMed, Scopus, Web of Science, PsycNET, and African Journals Online) were searched for peer-reviewed publications between 2000 and 2022. The review was designed according to PRISMA-P statement and the protocol was registered with PROSPERO database. The methodological quality and risks of bias were appraised using GRADE. A data extraction instrument was modelled along the Cochrane Handbook for Systematic Reviews and the Centre for Reviews and Dissemination of Systematic Reviews. Result: The search results yielded 1,148 publications. Only twenty-one studies met the eligibility criteria, reporting healthcare-seeking behaviors for maternal and child health. Of the twenty-one studies, seventeen (81.0%) reported maternal health behaviors such as antenatal care, skilled birth attendance, postnatal care services, and family planning. Nine studies (42.8%) observed behaviors for child health such as vaccination uptake, case management for pneumonia, diarrhea, malnutrition, and cough. While conflict exposure is generally associated with less favorable healthcare-seeking behaviors, some of the studies found improved health outcomes. Marital status, male partner attitudes, education, income and poverty levels were associated with healthcare-seeking behavior. Conclusion: There is a need for multifaceted interventions to mitigate the impact of armed violent conflict on healthcare-seeking behavior, given its overall negative effects on child and maternal healthcare utilization. While armed violent conflict disproportionately affects children’s health compared to maternal health, it is noteworthy that exposure to such conflicts may inadvertently also lead to positive outcomes. Prospero registration number: CRD42023484004.

Suggested Citation

  • Gbadebo Collins Adeyanju & Pia Schrage & Rabiu Ibrahim Jalo & Liliana Abreu & Max Schaub, 2025. "Armed violent conflict and healthcare-seeking behavior for maternal and child health in sub-Saharan Africa: A systematic review," PLOS ONE, Public Library of Science, vol. 20(2), pages 1-27, February.
    • Handle: RePEc:plo:pone00:0317094
    DOI: 10.1371/journal.pone.0317094
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    References listed on IDEAS

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    1. Daniel Meierrieks & Max Schaub, 2024. "Terrorism and child mortality," Health Economics, John Wiley & Sons, Ltd., vol. 33(1), pages 21-40, January.
    2. Daniel Meierrieks & Max Schaub, 2024. "Terrorism and child mortality," Health Economics, John Wiley & Sons, Ltd., vol. 33(1), pages 21-40, January.
    3. Mohammed Jawad & Thomas Hone & Eszter P Vamos & Valeria Cetorelli & Christopher Millett, 2021. "Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000–2019," PLOS Medicine, Public Library of Science, vol. 18(9), pages 1-18, September.
    4. Ziegler, Bianca R. & Kansanga, Moses & Sano, Yuji & Kangmennaang, Joseph & Kpienbaareh, Daniel & Luginaah, Isaac, 2020. "Antenatal care utilization in the fragile and conflict-affected context of the Democratic Republic of the Congo," Social Science & Medicine, Elsevier, vol. 262(C).
    5. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    6. Mansour, Hani & Rees, Daniel I., 2012. "Armed conflict and birth weight: Evidence from the al-Aqsa Intifada," Journal of Development Economics, Elsevier, vol. 99(1), pages 190-199.
    7. Ghobarah, H.A.Hazem Adam & Huth, Paul & Russett, Bruce, 2004. "The post-war public health effects of civil conflict," Social Science & Medicine, Elsevier, vol. 59(4), pages 869-884, August.
    8. Jean-Louis Arcand & Aude-Sophie Rodella-Boitreaud & Matthias Rieger, 2015. "The Impact of Land Mines on Child Health: Evidence from Angola," Economic Development and Cultural Change, University of Chicago Press, vol. 63(2), pages 249-279.
    9. Kirschner, Shanna A. & Finaret, Amelia B., 2021. "Conflict and health: Building on the role of infrastructure," World Development, Elsevier, vol. 146(C).
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