ArticleBMJ global health2026
Geographical accessibility to hospital care amid armed conflict in Myanmar: a population-weighted analysis of compounding health inequality, 2021-2024.
Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionArmed conflict disrupts health systems, but whether it compounds pre-existing geographical barriers to hospital care has not been quantified. We aimed to estimate population-weighted travel time to public hospital care across Myanmar's 330 townships; test whether conflict following the February 2021 coup concentrated in populations with the worst baseline access, and whether attacks on health facilities followed the same pattern; and measure the cumulative person-year burden of simultaneous poor access and intense conflict.
methodsWe conducted a longitudinal ecological analysis of 330 townships over 16 quarters from 2021 to 2024. Travel time from each populated square kilometre to the nearest of 68 general hospitals, representing the surgical-care tier, was estimated using the pre-coup facility registry, OpenStreetMap road data and WorldPop 2020 population estimates. Townships were classified by population-weighted median travel time. Quarterly conflict intensity was calculated from 35 647 Armed Conflict Location and Event Data Project battle and explosion or remote-violence events; 655 Safeguarding Health in Conflict Coalition-reported facility attacks were analysed separately. The concentration index assessed whether conflict events, fatalities and facility attacks were disproportionately concentrated among populations with worse baseline access. Double-burden exposure (poor or very poor access combined with high or extreme conflict) was accumulated in person-years. Because access was held at pre-coup baseline, estimates should be read as optimistic bounds.
resultsBefore the coup, 5.8 million people (12%) lived over 2 hours from a general hospital. Double-burden exposure grew from 0.4 million (Q1 2021) to 3.1 million (Q1 2024). Conflict was significantly concentrated in worse-access populations: concentration index 0.126 (95% CI 0.053 to 0.199) for events, 0.169 (95% CI 0.078 to 0.263) for fatalities. Facility attacks showed no significant concentration (0.049, 95% CI -0.041 to 0.145), as remote townships lack targetable facilities. An estimated 8.4 million person-years of double-burden exposure accumulated over 2021-2024, rising roughly eightfold quarterly, from about 100 000 (Q1 2021) to 780 000 (Q1 2024).
conclusionConflict in Myanmar has compounded pre-existing geographical inequality in hospital access, with populations furthest from surgical care bearing a disproportionate burden. The concentration curve framework used is transferable to other conflict-affected settings.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.