ArticleInternational journal of health policy and management2019
Associations Between Acute Conflict and Maternal Care Usage in Egypt: An Uncontrolled Before-and-After Study Using Demographic and Health Survey Data.
Article in International journal of health policy and management, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Understanding health system reconstruction in conflict-affected states: a repeated cross-sectional study of healthcare coverage trends in Rwanda.BMC health services research · 2026Article
- Caregivers´ qualitative insights on trust, resilience and vaccination attitudes shaping child health in conflict-affected Northeast Nigeria.Conflict and health · 2026Article
- Article
- A scoping review of the social determinants of maternal health in the MENA region.The Pan African medical journal · 2024Article
- Article
- Associations of Chinese diagnosis-related group systems with inpatient expenditures for older people with hip fracture.BMC geriatrics · 2022Article
- Regional Effects of Maternal Mortality Determinants in Africa and the Middle East: How About Political Risks of Conflicts?Frontiers in public health · 2022Article
- The Effects of Conflicts and Self-Reported Insecurity on Maternal Healthcare Utilisation and Children Health Outcomes in the Democratic Republic of Congo (DRC).Healthcare (Basel, Switzerland) · 2021Article
- Increase rate of ruptured tubal ectopic pregnancy during the COVID-19 pandemic.European journal of obstetrics, gynecology, and reproductive biology · 2021Article
- Associations of History of Displacement, Food Insecurity, and Stress With Maternal-Fetal Health in a Conflict Zone: A Case Study.Frontiers in public health · 2020Article
- Does the presence of conflict affect maternal and neonatal mortality during Caesarean sections?Public health action · 2019Article
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Abstract
backgroundUnited Nations' (UN) data indicate that conflict-affected low- and middle-income countries (LMICs) contribute considerably to global maternal deaths. Maternal care usage patterns during conflict have not been rigorously quantitatively examined for policy insights. This study analysed associations between acute conflict and maternal services usage and quality in Egypt using reliable secondary data (as conflict-affected settings generally lack reliable primary data).
methodsAn uncontrolled before-and-after study used data from the 2014 Egypt Demographic and Health Survey (EDHS). The 'pre-conflict sample' included births occurring from January 2009 to January 2011. The 'peri-conflict sample' included births from February 2011 to December 2012. The hierarchical nature of demographic and household survey (DHS) data was addressed using multi-level modelling (MLM).
resultsIn total, 2569 pre-conflict and 4641 peri-conflict births were reported. After adjusting for socioeconomic variables, conflict did not significantly affect antenatal service usage. Compared to the pre-conflict period, periconflict births had slightly lower odds of delivery in public institutions (odds ratio [OR]: 0.987; 95% CI: 0.975-0.998; P<.05), institutional postnatal care (OR: 0.995; 95% CI: 0.98-1.00; P=.05), and at least 24 hours post-delivery stay (OR: 0.921; 95% CI: 0.906-0.935; P<.01). Peri-conflict births had relatively higher odds of doctor-assisted deliveries (OR: 1.021; 95% CI: 1.004-1.035; P<.05), institutional deliveries (OR: 1.022; 95% CI: 1.00-1.04; P<.05), private institutional deliveries (OR: 1.035; 95% CI: 1.017-1.05; P<.001), and doctor-assisted postnatal care (OR: 1.015; 95% CI: 1.003-1.027; P<.05). Sensitivity analysis did not change results significantly.
conclusionMaternal care showed limited associations with the acute conflict, generally reflecting pre-conflict usage patterns. Further qualitative and quantitative research could identify the effects of larger conflicts on maternal careseeking and usage, and inform approaches to building health system resilience.
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