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Maternal and child healthcare-seeking among victims of violence in armed conflict: a quasi-experimental study in Northeast Nigeria

Author

Listed:
  • Schaub, Max
  • Adeyanju, Gbadebo Collins
  • Abulfahi, Aisha Aliyu
  • Bello, Musa Muhammad
  • Kasserra, Lennart
  • Kwaku, Aminatu Ayaba
  • Jalo, Muhammad Ibrahim
  • Mahmud, Ahmad
  • Schrage, Pia
  • Jalo, Rabiu Ibrahim
  • Abreu, Liliana

Abstract

Introduction: Armed conflict severely impacts health, with indirect deaths often exceeding direct casualties two to four times, disproportionately affecting women and children. Although the magnitude of these effects is well-documented, the mechanisms driving them remain insufficiently understood. This study shifts the focus from supply-side factors, such as the destruction of infrastructure, to demand-side processes, particularly healthcare-seeking behaviour and from broader conflict exposure to individual-level violent victimisation. Methods: Data come from a representative survey (n=3006) of caregivers of young children in northeastern Nigeria, a region heavily affected by armed insurgency. Unlike previous studies, our survey included dedicated measures of victimisation, health-seeking outcomes and potential mediating factors within a single instrument, enabling precise measurement and analysis. To compare maternal and child healthcare-seeking behaviour between victimised and non-victimised caregivers, we employed a quasi-experimental observational design using propensity-score matching on demographic and contextual characteristics. Causal mediation analysis was then used to identify the mechanisms linking victimisation to health behaviours. Results: Victimisation was widespread, with 21% of respondents (n=651) having experienced a severe form of violence in the past 3 years. While maternal healthcare-seeking behaviour appeared unaffected, victimisation significantly reduced healthcare-seeking for child health. Children of victimised caregivers were markedly less likely to be fully immunised (OR 0.43, p

Suggested Citation

  • Schaub, Max & Adeyanju, Gbadebo Collins & Abulfahi, Aisha Aliyu & Bello, Musa Muhammad & Kasserra, Lennart & Kwaku, Aminatu Ayaba & Jalo, Muhammad Ibrahim & Mahmud, Ahmad & Schrage, Pia & Jalo, Rabiu , 2025. "Maternal and child healthcare-seeking among victims of violence in armed conflict: a quasi-experimental study in Northeast Nigeria," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 10(12), pages 1-12.
    • Handle: RePEc:zbw:espost:334714
    DOI: 10.1136/bmjgh-2025-019494
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    References listed on IDEAS

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    1. Kirschner, Shanna A. & Finaret, Amelia B., 2021. "Conflict and health: Building on the role of infrastructure," World Development, Elsevier, vol. 146(C).
    2. Chukwuma, Adanna & Ekhator-Mobayode, Uche Eseosa, 2019. "Armed conflict and maternal health care utilization: Evidence from the Boko Haram Insurgency in Nigeria," Social Science & Medicine, Elsevier, vol. 226(C), pages 104-112.
    3. 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.
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