Associations of acute conflict with equity in maternal healthcare: an uncontrolled before-and-after analysis of Egypt demographic and health survey data

International Journal for Equity in Health
Saji Saraswathy GopalanNatasha Howard

Abstract

Equity of usage of maternal services during conflict is considered key to reducing maternal health risks globally. However, evidence showing how conflict affects maternal care use among different population groups is minimal. This study examined how the Egyptian acute conflict of 2011-2012 affected maternal care use among different socioeconomic, demographic, and geographic groups. An 'uncontrolled before-and-after' study design was used to perform multi-level modelling regression analysis on 2014 Egypt Demographic and Health Survey data. The pre-conflict sample included 2569 births occurring from January 2009 to January 2011 and the peri-conflict sample included 4641 births from February 2011 to December 2012. Interaction analysis indicated that the effect of conflict on some aspects of maternal care differed by mother's age, residential status, employment, education level and household wealth. In the stratum-specific analysis, increased odds of skilled delivery during conflict was relatively greater among women who were rural (odds ratio [OR] 1.02; 95%CI 1.02-1.03), educated to primary level (OR 1.04; 95%CI 1.01-1.07), employed (OR 1.04; 95%CI 1.01-1.07), less poor (OR 1.03; 95%CI 1.02-1.05) or middle-income (OR 1.02; 95%CI 1...Continue Reading

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