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Fear, accessibility, and legitimacy: An examination of the effects of political violence on health security in Pakistan

Author

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  • Amira Jadoon

    (8531US Military Academy at West Point, USA)

  • Hina Khalid

    (2434888Information Technology University, Pakistan)

Abstract

How does political violence affect public health risks? While past research provides useful insights, it remains unclear how the effect of violence on health risks varies by perpetrator identity, target, and the intensity of attacks. We argue that indiscriminate attacks by militants will discourage civilians from accessing healthcare services. In contrast, clashes between militants and governments are likely to induce state actors to augment healthcare provision, while reinforced state control may facilitate civilians’ access. We test our arguments by employing multilevel modeling using subnational data on political violence events within Pakistan between 2005 and 2011, and immunization rates for under-5 infectious diseases.

Suggested Citation

  • Amira Jadoon & Hina Khalid, 2023. "Fear, accessibility, and legitimacy: An examination of the effects of political violence on health security in Pakistan," Conflict Management and Peace Science, Peace Science Society (International), vol. 40(2), pages 207-235, March.
  • Handle: RePEc:sae:compsc:v:40:y:2023:i:2:p:207-235
    DOI: 10.1177/07388942221094006
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    References listed on IDEAS

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    1. Sexton, Renard, 2016. "Aid as a Tool against Insurgency: Evidence from Contested and Controlled Territory in Afghanistan," American Political Science Review, Cambridge University Press, vol. 110(4), pages 731-749, November.
    2. Khanna, Gaurav & Zimmermann, Laura, 2017. "Guns and butter? Fighting violence with the promise of development," Journal of Development Economics, Elsevier, vol. 124(C), pages 120-141.
    3. Eli Berman & Joseph H. Felter & Jacob N. Shapiro & Erin Troland, 2013. "Modest, Secure, and Informed: Successful Development in Conflict Zones," American Economic Review, American Economic Association, vol. 103(3), pages 512-517, May.
    4. Amira Jadoon, 2019. "Playing dirty to survive: the vulnerability of civilian targets within U.S. military aid recipient states," Small Wars and Insurgencies, Taylor & Francis Journals, vol. 30(3), pages 587-614, April.
    5. Stewart, Megan A., 2018. "Civil War as State-Making: Strategic Governance in Civil War," International Organization, Cambridge University Press, vol. 72(1), pages 205-226, January.
    6. Peter Hilsenrath, 2005. "Health Policy As Counter-Terrorism: Health Services And The Palestinians," Defence and Peace Economics, Taylor & Francis Journals, vol. 16(5), pages 365-374.
    7. Ana Arjona, 2014. "Wartime Institutions: A Research Agenda," HiCN Working Papers 169, Households in Conflict Network.
    8. Benjamin Crost & Joseph Felter & Patrick Johnston, 2014. "Aid under Fire: Development Projects and Civil Conflict," American Economic Review, American Economic Association, vol. 104(6), pages 1833-1856, June.
    9. Ali Hamid E., 2011. "Military Expenditures and Human Development: Guns and Butter Arguments Revisited: A Case Study from Egypt," Peace Economics, Peace Science, and Public Policy, De Gruyter, vol. 17(1), pages 1-21, September.
    10. Giacaman, Rita & Wick, Laura & Abdul-Rahim, Hanan & Wick, Livia, 2005. "The politics of childbirth in the context of conflict: policies or de facto practices?," Health Policy, Elsevier, vol. 72(2), pages 129-139, May.
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