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War and Gender Inequalities in Health: The Impact of Armed Conflict on Fertility and Maternal Mortality

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  • Henrik Urdal
  • Chi Primus Che

Abstract

Recent studies have found significant excess mortality in women during and immediately after armed conflicts. This article directly assesses one of the most likely explanations, namely that war negatively affects reproductive health. Armed conflicts may contribute to sustain high fertility levels through increased social insecurity, loss of reproductive health services, and lower female education. Further, war's deteriorating impact on health infrastructure is expected to increase the relative risk that women die from complications associated with pregnancy and childbirth. These claims are tested in a global time-series cross-national study from 1970 through 2005. Three major findings are reported. First, armed conflicts are associated with higher overall fertility in low-income countries only. Second, maternal mortality rates are elevated, albeit moderately, in conflict countries. Third, conflicts in neighboring countries are associated with lower maternal mortality, possibly indicating that health interventions among refugee and host populations are relatively successful. While addressing one of the least successful UN Millennium Development Goals, this study also responds to the UN Security Council Resolution 1325, in which Article 16 specifically calls for the “Secretary-General to carry out a study on the impact of armed conflict on women and girls.”

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  • Henrik Urdal & Chi Primus Che, 2013. "War and Gender Inequalities in Health: The Impact of Armed Conflict on Fertility and Maternal Mortality," International Interactions, Taylor & Francis Journals, vol. 39(4), pages 489-510, September.
    • Handle: RePEc:taf:ginixx:v:39:y:2013:i:4:p:489-510
    DOI: 10.1080/03050629.2013.805133
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    2. Prem, M & Guerra, M. E. & Rodríguez, P & Vargas, J. F., 2020. "The Peace Baby Boom: Evidence from Colombia’s peace agreement with the FARC," Documentos de Trabajo 18430, Universidad del Rosario.
    3. Brian C. Thiede & Matthew Hancock & Ahmed Kodouda & James Piazza, 2020. "Exposure to Armed Conflict and Fertility in Sub-Saharan Africa," Demography, Springer;Population Association of America (PAA), vol. 57(6), pages 2113-2141, December.
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    5. Krieger, Tim & Renner, Laura, 2020. "Polygyny, inequality, and social unrest," Discussion Paper Series 2020-02, University of Freiburg, Wilfried Guth Endowed Chair for Constitutional Political Economy and Competition Policy.
    6. Bove, Vincenzo & Di Salvatore, Jessica & Elia, Leandro & Nisticò, Roberto, 2024. "Mothers at peace: International peacebuilding and post-conflict fertility," Journal of Development Economics, Elsevier, vol. 167(C).
    7. Michelle L. O’Brien, 2021. "The Consequences of the Tajikistani Civil War for Abortion and Miscarriage," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 40(5), pages 1061-1084, October.
    8. Muhammad Badiuzzaman & Syed Mansoob Murshed, 2016. "Impact of post-conflict development interventions on maternal healthcare utilization," WIDER Working Paper Series 082, World Institute for Development Economic Research (UNU-WIDER).
    9. Philip Verwimp & Davide Osti & Gudrun Østby, 2020. "Forced Displacement, Migration, and Fertility in Burundi," Population and Development Review, The Population Council, Inc., vol. 46(2), pages 287-319, June.
    10. Tatsuki Inoue amd Erika Igarashi, 2023. "The far-reaching effects of bombing on fertility in mid-20th century Japan," Papers 2306.05770, arXiv.org, revised Oct 2023.
    11. Mai Wardeh & Rui Cunha Marques, 2021. "Sustainability in Refugee Camps: A Systematic Review and Meta-Analysis," Sustainability, MDPI, vol. 13(14), pages 1-24, July.
    12. Kirschner, Shanna A. & Finaret, Amelia B., 2021. "Conflict and health: Building on the role of infrastructure," World Development, Elsevier, vol. 146(C).
    13. Kati Kraehnert & Tilman Brück & Michele Di Maio & Roberto Nisticò, 2019. "The Effects of Conflict on Fertility: Evidence From the Genocide in Rwanda," Demography, Springer;Population Association of America (PAA), vol. 56(3), pages 935-968, June.
    14. M. Shafi Bhat & Amir Ali Khan & Mohmad Akbar & Sumira Mir, 2023. "Disaster-development interface and its impact on emerging vulnerability scenario in Ladakh region of northwestern Himalayas," Journal of Environmental Studies and Sciences, Springer;Association of Environmental Studies and Sciences, vol. 13(2), pages 253-270, June.
    15. Louise Olsson & Theodora-Ismene Gizelis, 2013. "An Introduction to UNSCR 1325," International Interactions, Taylor & Francis Journals, vol. 39(4), pages 425-434, September.
    16. Prem, M & Guerra, M. E. & Rodríguez, P & Vargas, J. F., 2020. "The Peace Baby Boom: Evidence from Colombia’s peace agreement with the FARC," Documentos de Trabajo 18430, Universidad del Rosario.
    17. Nepal, Apsara Karki & Halla, Martin & Stillman, Steven, 2018. "Violent Conflict and the Child Quantity-Quality Tradeoff," IZA Discussion Papers 11690, Institute of Labor Economics (IZA).
    18. Luc Onambele & Wilfrido Ortega-Leon & Sara Guillen-Aguinaga & Maria João Forjaz & Amanuel Yoseph & Laura Guillen-Aguinaga & Rosa Alas-Brun & Alberto Arnedo-Pena & Ines Aguinaga-Ontoso & Francisco Guil, 2022. "Maternal Mortality in Africa: Regional Trends (2000–2017)," IJERPH, MDPI, vol. 19(20), pages 1-20, October.
    19. Gudrun Østby & Henrik Urdal & Andreas Forø Tollefsen & Andreas Kotsadam & Ragnhild Belbo & Christin Ormhaug, 2018. "Organized Violence and Institutional Child Delivery: Micro-Level Evidence From Sub-Saharan Africa, 1989–2014," Demography, Springer;Population Association of America (PAA), vol. 55(4), pages 1295-1316, August.
    20. Orsola Torrisi, 2020. "Armed Conflict and the Timing of Childbearing in Azerbaijan," Population and Development Review, The Population Council, Inc., vol. 46(3), pages 501-556, September.
    21. Parlow, Anton, 2016. "Birth and Fertility during War: Afghanistan from 2007 to 2010," MPRA Paper 76366, University Library of Munich, Germany.
    22. Muhammad Badiuzzaman & Syed Mansoob Murshed, 2016. "Impact of post-conflict development interventions on maternal healthcare utilization," WIDER Working Paper Series wp-2016-82, World Institute for Development Economic Research (UNU-WIDER).
    23. Ngepah, Nicholas & Saba, Charles Shaaba & Tinga, Cleide L.M., 2024. "Gender Inequality and Economic Growth in Developing Countries," Economia Internazionale / International Economics, Camera di Commercio Industria Artigianato Agricoltura di Genova, vol. 77(3), pages 371-416.
    24. Andrés Felipe Castro Torres & B. Piedad Urdinola, 2019. "Armed Conflict and Fertility in Colombia, 2000–2010," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 38(2), pages 173-213, April.

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