Imperial College London
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ProfessorChristopherMillett

Faculty of Medicine, School of Public Health

Professor of Public Health
 
 
 
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Contact

 

c.millett Website

 
 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Jawad:2021:10.1371/journal.pmed.1003810,
author = {Jawad, M and Hone, T and Vamos, EP and Cetorelli, V and Millett, C},
doi = {10.1371/journal.pmed.1003810},
journal = {PLoS Medicine},
title = {Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000-2019},
url = {http://dx.doi.org/10.1371/journal.pmed.1003810},
volume = {18},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Armed conflicts have major indirect health impacts in addition to the direct harms from violence. They create enduring political instability, destabilise health systems, and foster negative socioeconomic and environmental conditions-all of which constrain efforts to reduce maternal and child mortality. The detrimental impacts of conflict on global maternal and child health are not robustly quantified. This study assesses the association between conflict and maternal and child health globally. METHODS AND FINDINGS: Data for 181 countries (2000-2019) from the Uppsala Conflict Data Program and World Bank were analysed using panel regression models. Primary outcomes were maternal, under-5, infant, and neonatal mortality rates. Secondary outcomes were delivery by a skilled birth attendant and diphtheria, pertussis, and tetanus (DPT) and measles vaccination coverage. Models were adjusted for 10 confounders, country and year fixed effects, and conflict lagged by 1 year. Further lagged associations up to 10 years post-conflict were tested. The number of excess deaths due to conflict was estimated. Out of 3,718 country-year observations, 522 (14.0%) had minor conflicts and 148 (4.0%) had wars. In adjusted models, conflicts classified as wars were associated with an increase in maternal mortality of 36.9 maternal deaths per 100,000 live births (95% CI 1.9-72.0; 0.3 million excess deaths [95% CI 0.2 million-0.4 million] over the study period), an increase in infant mortality of 2.8 per 1,000 live births (95% CI 0.1-5.5; 2.0 million excess deaths [95% CI 1.6 million-2.5 million]), a decrease in DPT vaccination coverage of 4.9% (95% CI 1.5%-8.3%), and a decrease in measles vaccination coverage of 7.3% (95% CI 2.7%-11.8%). The long-term impacts of war were demonstrated by associated increases in maternal mortality observed for up to 7 years, in under-5 mortality for 3-5 years, in infant mortality for up to 8 years, in DPT vaccination coverage for up to 3 years, and in
AU  - Jawad,M
AU  - Hone,T
AU  - Vamos,EP
AU  - Cetorelli,V
AU  - Millett,C
DO  - 10.1371/journal.pmed.1003810
PY  - 2021///
SN  - 1549-1277
TI  - Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000-2019
T2  - PLoS Medicine
UR  - http://dx.doi.org/10.1371/journal.pmed.1003810
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34582455
UR  - http://hdl.handle.net/10044/1/92220
VL  - 18
ER  -
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