Background Violent conflicts are observed in many parts of the world and have profound impacts on the lives of exposed individuals. The limited evidence available from specific country or region contexts suggest that conflict exposure may reduce health service utilization and have adverse affects on health. This study focused on identifying the association between conflict exposure and continuum of care (CoC) services that are crucial for achieving improvements in reproductive, maternal, newborn, and child health and nutrition (RMNCHN). Methods and findings We combined data from 2 sources, the Demographic Health Surveys (DHS) and the Uppsala Conflict Data Program’s (UCDP) Georeferenced Event Dataset, for a sample of 452,192 women across 49 countries observed over the period 1997 to 2018. We utilized 2 consistent measures of conflict—incidence and intensity—and analyzed their association with maternal CoC in 4 key components: (i) at least 1 antenatal care (ANC) visit; (ii) 4 or more ANC visits; (iii) 4 or more ANC visits and institutional delivery; and (iv) 4 or more ANC visits, institutional delivery, and receipt of postnatal care (PNC) either for the mother or the child within 48 hours after birth. To identify the association between conflict exposure and components of CoC, we estimated binary logistic regressions, controlling for a large set of individual and household-level characteristics and year-of-survey and country/province fixed-effects. This empirical setup allows us to draw comparisons among observationally similar women residing in the same locality, thereby mitigating the concerns over unobserved heterogeneity. Around 39.6% (95% CI: 39.5% to 39.7%) of the sample was exposed to some form of violent conflict at the time of their pregnancy during the study period (2003 to 2018). Although access to services decreased for each additional component of CoC in maternal healthcare for all women, the dropout rate was significantly higher among women who have been exposed to conflict, relative to those who have not had such exposure. From logistic regression estimates, we observed that relative to those without exposure to conflict, the odds of utilization of each of the components of CoC was lower among those women who were exposed to at least 1 violent conflict. We estimated odds ratios of 0.86 (95% CI: 0.82 to 0.91, p < 0.001) for at least 1 ANC; 0.95 (95% CI: 0.91 to 0.98, p < 0.005) for 4 or more ANC; and 0.92 (95% CI: 0.89 to 0.96, p < 0.001) for 4 or more ANC and institutional delivery. We showed that both the incidence of exposure to conflict as well as its intensity have profound negative implications for CoC. Study limitations include the following: (1) We could not extend the CoC scale beyond PNC due to inconsistent definitions and the lack of availability of data for all 49 countries across time. (2) The measure of conflict intensity used in this study is based on the number of deaths due to the absence of information on other types of conflict-related harms. Conclusions This study showed that conflict exposure is statistically significantly and negatively associated with utilization of maternal CoC services, in each component of the CoC scale. These findings have highlighted the challenges in achieving the Sustainable Development Goal 3 in conflict settings, and the need for more concerted efforts in ensuring CoC, to mitigate its negative implications on maternal and child health.

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In this paper, we investigate the association between informal non-farm wage employment and household food security in rural Vietnam. The data for our analyses come from a nationally representative panel dataset of 1390 rural households from Vietnam Household Living Standards Survey. We conduct multivariate regression analysis using robust quantitative tools to show that informal employment is associated with a reduction in the consumption of nutritious foods. Our analysis also shows that informal employment reduces consumption of vegetables and fruits, using both the calorie- and expenditure-based shares of food groups.

Background Previous research has consistently found evidence of poor health outcomes among children living in conflict areas. However, the methodological focus of these studies has largely been on case studies, chart or registry reviews, qualitative studies, and single country studies. This reflects the need for a comprehensive multi-country analysis of the associations between conflicts and child health over a longer period. This study analyses the adverse impact of exposure to different types of conflicts  from in utero to five years of age, on several child health measures across a large group of countries. Our analysis pools data from multiple countries and time-points, to provide robust evidence on the relationship between conflict and child health. Methods Geo-referenced data on various forms of conflict are combined with the Demographic Health Survey dataset, to construct a large unique database of 590,488 pre-school age children across 52 developing countries over the period 1997 to 2018. Our analysis exploits the within-country differences in children’s exposure to conflict from in utero to age five, to estimate its association with health outcomes. Our multivariate regression models estimate the links between conflict exposure and child health outcomes, measured using child nutrition outcomes (height-for-age and weight-for-age z-scores) and immunization status. Results and conclusions Empirical estimates show that even after controlling for a large array of socio-economic and demographic characteristics and location fixed effects, conflict exposure is negatively associated with child nutrition and immunization, across all our measures of conflict. These findings are robust across a range of specifications, alternative measures of conflict and sub-samples.