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

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

EconStor Open Access Articles and Book Chapters, 2025, vol. 10, issue 12, 12 pages

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

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:zbw:espost:334714

DOI: 10.1136/bmjgh-2025-019494

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