@article{fdi:010094215,
  title = {{E}xamining the effect of nearby armed conflict on access to maternal and child health services in {B}urkina {F}aso's primary healthcare facilities},
  author = {{A}mberg, {F}. and {B}lanchet, {K}. and {S}ingh, {N}. {S}. and {R}idde, {V}al{\'e}ry and {B}onnet, {E}mmanuel and {Y}am{\'e}ogo, {P}. and {S}ie, {A}. and {S}eynou, {M}. and {L}ohmann, {J}. and {D}e {A}llegri, {M}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {A}rmed conflict is increasing in sub-{S}aharan {A}frica, impacting access to vital health services. {H}owever, scant evidence exists on the effects of the recently escalated conflict in {B}urkina {F}aso, a country severely affected by rising violence.{M}ethods {W}e conducted a longitudinal study, aligning conflict event data from the {U}ppsala {C}onflict {D}ata {P}rogram with {B}urkina {F}aso's {H}ealth {M}anagement {I}nformation {S}ystem data spanning from 2013 to 2021. {A}pplying negative binomial regression models with health facility fixed effects, we assessed the impact of nearby armed conflict events (within 25 km of primary healthcare centres) on access to six essential maternal and child health services. {W}e investigated effect heterogeneity by varying conflict intensity and duration, and facility characteristics.{R}esults {A}ny nearby armed conflict significantly reduced the incidence of all examined health services, except for non-significant caesarean section declines. {S}pecifically, antenatal care 4 visits decreased by 3.9%, facility-based deliveries by 7.2%, caesarean sections by 9.4%, postnatal care 1 visits by 4.3% and outpatient care visits for children under 5 and aged 5-14 by 7.2% and 12.0%, respectively. {H}igh-intensity conflict events significantly amplified the negative effects across all health services. {W}e observed less pronounced effects on children under 5 compared with those aged 5-14 not encompassed by existing fee removal policies. {P}rolonged conflicts did not adversely affect outpatient care visits for children. {R}ural facilities bore a more pronounced effect than urban facilities.{C}onclusions {O}ur findings show a significant disruption of health services due to contemporaneous conflict in {B}urkina {F}aso. {H}owever, child curative care services seem to exhibit a stabilisation trend in prolonged conflicts, and the mitigating effects of existing fee removal policies were evident. {T}his underscores the need for nuanced policy interventions that consider varying conflict intensities, service types and financing schemes and highlights the importance of detailed, fine-scale analyses during conflict scenarios.},
  keywords = {{H}ealth services research ; {H}ealth systems evaluation ; {P}ublic {H}ealth ; {M}aternal health ; {C}hild health ; {BURKINA} {FASO}},
  booktitle = {},
  journal = {{BMJ} {G}lobal {H}ealth},
  volume = {10},
  numero = {6},
  pages = {e015507 [16 p.]},
  ISSN = {2059-7908},
  year = {2025},
  DOI = {10.1136/bmjgh-2024-015507},
  URL = {https://www.documentation.ird.fr/hor/fdi:010094215},
}