ArticleConflict and health2021
The impact of armed conflict on utilisation of health services in north-west Syria: an observational study.
Article in Conflict and health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
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Who cites it
51 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Armed violent conflict and healthcare-seeking behavior for maternal and child health in sub-Saharan Africa: A systematic review.PloS one · 2025Pooled it
- Attitude of nurses towards palliative care and its associated factors in Ethiopia, systematic review and meta-analysis.BMC palliative care · 2024Pooled it
- Article
- Hospital system resilience in the face of armed conflicts; a cross sectional study from two regions in Lebanon.BMC health services research · 2026Observational
- Colliding Wars: A Systematic Review on HIV Responses in Conflict-Affected Settings.Public health challenges · 2026Review
- Post-conflict restoration of health facilities in Amhara region, Ethiopia.BMC research notes · 2026Article
- War and wellness: health-system barriers and access-constrained medication adherence for diabetes, hypertension, and dyslipidemia in the West bank, Palestine (2025).BMC primary care · 2026Article
- A cross-sectional study of the burden and risk factors of impetigo and scabies among children during conflict in the middle area of the Gaza strip.Scientific reports · 2026Article
- Impact of prolonged armed conflict on the patterns of emergency department visits.BMC emergency medicine · 2026Article
- Geospatial analysis of the impact of Cameroonian Anglophone Crisis conflict intensity on antenatal care utilisation.Communications medicine · 2026Article
- Acute Trauma and Obsessive Compulsive Disorder: Evidence from October 7th, 2023.Psychotherapy and psychosomatics · 2026Article
- Irrational medicine use and its associated factors in conflict-affected areas in Mali: a cross-sectional study.Global health action · 2025Article
- Profile and management of war casualties in the context of limited resources and conflict in the Eastern Democratic Republic of Congo: a retrospective observational study.BMC public health · 2025Observational
- Health impacts of armed conflict in Ethiopia: a scoping review of evidence from 2018 to 2023.BMC public health · 2025Article
- Voices from Hiding: Assessing the Impact of the 2021 Coup on Nursing in Myanmar.International nursing review · 2025Article
- The Impact of Polycrisis on Healthcare Systems-Analyzing Challenges and the Role of Social Epidemiology.Healthcare (Basel, Switzerland) · 2025Review
- Social and geographical inequalities in prenatal care coverage in Colombia: a multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).BMJ global health · 2025Observational
- Healthcare under fire: quantifying the impact of violence on medical services in facilities supported by International Medical Corps in three prefectures of Central African Republic, 2016-2020.Conflict and health · 2025Article
- Restoring antenatal health services in a war-affected hospital: a quality improvement project.BMJ open quality · 2025Article
- Primary healthcare delivery adaptations in war-induced population displacement.Israel journal of health policy research · 2025Observational
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundArmed conflicts are known to have detrimental impact on availability and accessibility of health services. However, little is known on potential impact on utilisation of these services and health seeking behaviour. This study examines whether exposure to different types of war incidents affected utilisation of key health services-outpatient consultations, antenatal care, deliveries, and C-sections, in conflict affected areas of north west Syria between 1 October 2014 and 30 June 2017.
methodsThe study is an observational study using routinely collected data of 597,675 medical consultations and a database on conflict incidents that has 11,396 events. Longitudinal panel data analysis was used with fixed effect negative binomial regression for the monthly analysis and distributed lag model with a lag period of 30 days for the daily analysis.
resultsThe study found strong evidence for a negative association between bombardments and both consultations and antenatal care visits. The monthly Risk Ratio was 0.95 (95% CI 0.94-0.97) and 0.95 (95% CI 0.93-0.98); and the cumulative daily RR at 30 days was 0.19 (95% CI 0.15-0.25) and 0.42 (95% CI 0.25-0.69) for consultations and antenatal care respectively. Explosions were found to be positively associated with deliveries and C-sections. Each one unit increase in explosions in a given month in a given village was associated with about 20% increase in deliveries and C-sections; RR was 1.22 (95% CI 1.05-1.42) and 1.96 (95% CI 1.03-3.74) respectively.
conclusionThe study found that access to healthcare in affected areas in Syria during the study period has been limited. The study provides evidence that conflict incidents were associated negatively with the utilisation of routine health services, such as outpatient consultations and antenatal care. Whereas conflict incidents were found to be positively associated with emergency type maternity services-deliveries, and C-sections.
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