浪花直播

While most people killed in wars are male, several studies have found that 鈥渕ortality among women in some high-intensity conflicts was as severe as male mortality,鈥� said Henrik Urdal, the Director of the Peace Research Institute Oslo (PRIO), at a recent 浪花直播 Center event on the links between maternal and child health, aid, and armed conflict. 鈥淢aternal health is a very natural place to start鈥� when researching excess mortality and indirect deaths among women impacted by war, said Urdal.

Conflict Increases Risk of Maternal, Child Mortality 

鈥淭he damages really extend far beyond the direct combatants in conflict,鈥� said Dr. Eran Bendavid, an Associate Professor of Medicine at Stanford University. Most conflict research focuses on direct combatant and civilian deaths caused by organized violence, so there are less data on its indirect health effects on women and children.

Violent conflicts 鈥渋ncrease the risk of the child not making it to his or her first birthday,鈥� said Bendavid. In a published in The Lancet, Bendavid and his coauthors found that a child born within 50 km of armed conflict had a 7.7 percent higher risk of dying before the age of one year than another born in the same region during periods without conflict.  

鈥淲e need to get a better understanding of why organized violence reduces the use of maternal health services,鈥� said Gudrun 脴stby, a Senior Researcher at PRIO. shows that proximity to recent organized violence decreases the chance that a child is born at a medical facility by approximately one percent. Although the effect seems small, one percent translates to 47,000 additional children being born outside health facilities every year due to armed conflict.

Ensuring Quality Care in Conflict and Crisis

鈥淲hat does it actually mean to give birth at a health facility?鈥� said 脴stby. Having access to a health facility does not guarantee that a woman will receive high quality maternal health services or have positive health outcomes. Health infrastructure and personnel are frequently and health facilities struggle to stay functional during complex emergencies.

In Bangladesh, for example, facilities that serve Rohingya refugees face major challenges in maintaining the basic quality of reproductive and maternal health care in a humanitarian crisis in what was an already fragile state. In 2010, UNFPA launched its in Bangladesh to meet the needs of both residents and the influx of refugees. The program aims to grow a workforce of well-trained and well-supported midwives to reduce maternal and newborn mortality in these crisis settings.

The crisis in Bangladesh highlights the importance of local healthcare systems and building the capacity of local providers. 鈥淭hese midwives that we are deploying are fresh midwives,鈥� said Geeta Lal, UNFPA鈥檚 Global Midwifery Programme Coordinator. 鈥淭hey need mentoring, they need support, they need clinical skills.鈥�

In conflict areas, providing aid becomes challenging and dangerous for both the recipients and the providers. 鈥淭he people who are working there, the midwives who are working there, they鈥檙e risking their lives every single day,鈥� said Lal.

Local maternal and child health data are essential to guiding the efforts of frontline workers. Yet monitoring access and quality of services is quite difficult during conflict. Many conflict-affected facilities do not track maternal and newborn mortality 鈥渆ven at the facility level, much less having any idea of what is going on at the population level,鈥� said Dr. Kathleen Hill of USAID鈥檚 flagship .

Without adequate health reporting, information from some of the world鈥檚 severest conflicts is overlooked. In addition, data on 鈥渋nterventions that increase access and have an effect on health outcomes for women鈥攎aternal health鈥攁re really, unsurprisingly, not available,鈥� said Dr. Hill.

Aid as a Double-Edged Sword   

鈥淎id follows success rather than creating it,鈥� said Siri Aas Rustad, a Senior Researcher at PRIO. Although proximity to aid projects is proven to , especially among marginalized groups, aid may not always reach those that need it most as it is often allocated to areas with or areas where previous aid and infrastructure are already in place.

鈥淎id can be politically manipulated in the way that it is distributed,鈥� said Rustad. PRIO researchers found that areas with politically excluded groups from the World Bank than other areas. Consequently, development aid may exacerbate existing inter-group disparities instead of reducing them. To minimize harm, 鈥渢here needs to be a more critical assessment of where aid is distributed,鈥� said Rustad.

Policymakers and future studies should focus on the underlying factors that drive inequitable access to healthcare for mothers and children, as well as investigate how armed conflict interacts with other causes of death among these populations.

鈥淯nderstanding the causes鈥攁nd the causes of those causes鈥攊s critical to understanding how we can help those families stay together and stay alive in the midst of the chaos and disruption of crisis and conflict,鈥� said Meaghan Parker of the 浪花直播 Center.

Written by Elizabeth Wang and edited by Meaghan Parker.