Access to health services, food, and water during an active conflict: Evidence from Ethiopia

Civil conflict began in Ethiopia in November 2020 and has reportedly caused major disrup tions in access to health services, food, and related critical services, in addition to the direct impacts of the conflict on health and well-being. However, the population-level impacts of the conflict have not...

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Autores principales: Abay, Kibrom A., Abay, Mehari Hiluf, Berhane, Guush, Chamberlin, Jordan, Croke, Kevin, Tafere, Kibrom
Formato: Journal Article
Lenguaje:Inglés
Publicado: 2022
Materias:
Acceso en línea:https://hdl.handle.net/10568/141179
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author Abay, Kibrom A.
Abay, Mehari Hiluf
Berhane, Guush
Chamberlin, Jordan
Croke, Kevin
Tafere, Kibrom
author_browse Abay, Kibrom A.
Abay, Mehari Hiluf
Berhane, Guush
Chamberlin, Jordan
Croke, Kevin
Tafere, Kibrom
author_facet Abay, Kibrom A.
Abay, Mehari Hiluf
Berhane, Guush
Chamberlin, Jordan
Croke, Kevin
Tafere, Kibrom
author_sort Abay, Kibrom A.
collection Repository of Agricultural Research Outputs (CGSpace)
description Civil conflict began in Ethiopia in November 2020 and has reportedly caused major disrup tions in access to health services, food, and related critical services, in addition to the direct impacts of the conflict on health and well-being. However, the population-level impacts of the conflict have not yet been systematically quantified. We analyze high frequency phone surveys conducted by the World Bank, which included measures of access to basic ser vices, to estimate the impact of the first phase of the war (November 2020 to May 2021) on households in Tigray. After controlling for sample selection, a difference-in-differences approach is used to estimate causal effects of the conflict on population access to health services, food, and water and sanitation. Inverse probability weighting is used to adjust for sample attrition. The conflict has increased the share of respondents who report that they were unable to access needed health services by 35 percentage points (95% CI: 14–55 pp) and medicine by 8 pp (95% CI:2–15 pp). It has also increased the share of households unable to purchase staple foods by 26 pp (95% CI:7–45 pp). The share of households unable to access water did not increase, although the percentage able to purchase soap declined by 17 pp (95% CI: 1–32 pp). We document significant heterogeneity across popula tion groups, with disproportionate effects on the poor, on rural populations, on households with undernourished children, and those living in communities without health facilities. These significant disruptions in access to basic services likely underestimate the true bur den of conflict in the affected population, given that the conflict has continued beyond the survey period, and that worse-affected households may have higher rates of non-response. Documented spatial and household-level heterogeneity in the impact of the conflict may help guide rapid post-conflict responses.
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spelling CGSpace1411792025-10-26T13:02:19Z Access to health services, food, and water during an active conflict: Evidence from Ethiopia Abay, Kibrom A. Abay, Mehari Hiluf Berhane, Guush Chamberlin, Jordan Croke, Kevin Tafere, Kibrom low income groups undernutrition surveys households water food tigray children health services hygiene civil conflict conflicts rural areas Civil conflict began in Ethiopia in November 2020 and has reportedly caused major disrup tions in access to health services, food, and related critical services, in addition to the direct impacts of the conflict on health and well-being. However, the population-level impacts of the conflict have not yet been systematically quantified. We analyze high frequency phone surveys conducted by the World Bank, which included measures of access to basic ser vices, to estimate the impact of the first phase of the war (November 2020 to May 2021) on households in Tigray. After controlling for sample selection, a difference-in-differences approach is used to estimate causal effects of the conflict on population access to health services, food, and water and sanitation. Inverse probability weighting is used to adjust for sample attrition. The conflict has increased the share of respondents who report that they were unable to access needed health services by 35 percentage points (95% CI: 14–55 pp) and medicine by 8 pp (95% CI:2–15 pp). It has also increased the share of households unable to purchase staple foods by 26 pp (95% CI:7–45 pp). The share of households unable to access water did not increase, although the percentage able to purchase soap declined by 17 pp (95% CI: 1–32 pp). We document significant heterogeneity across popula tion groups, with disproportionate effects on the poor, on rural populations, on households with undernourished children, and those living in communities without health facilities. These significant disruptions in access to basic services likely underestimate the true bur den of conflict in the affected population, given that the conflict has continued beyond the survey period, and that worse-affected households may have higher rates of non-response. Documented spatial and household-level heterogeneity in the impact of the conflict may help guide rapid post-conflict responses. 2022-11-29 2024-04-12T13:37:25Z 2024-04-12T13:37:25Z Journal Article https://hdl.handle.net/10568/141179 en https://doi.org/10.2499/p15738coll2.135056 Open Access Abay, Kibrom A.; Abay, Mehari Hiluf; Berhane, Guush; Chamberlin, Jordan; Croke, Kevin; and Tafere, Kibrom. 2022. Access to health services, food, and water during an active conflict: Evidence from Ethiopia. PLoS Global Public Health 2(11): e0001015. https://doi.org/10.1371/journal.pgph.0001015
spellingShingle low income groups
undernutrition
surveys
households
water
food
tigray
children
health services
hygiene
civil conflict
conflicts
rural areas
Abay, Kibrom A.
Abay, Mehari Hiluf
Berhane, Guush
Chamberlin, Jordan
Croke, Kevin
Tafere, Kibrom
Access to health services, food, and water during an active conflict: Evidence from Ethiopia
title Access to health services, food, and water during an active conflict: Evidence from Ethiopia
title_full Access to health services, food, and water during an active conflict: Evidence from Ethiopia
title_fullStr Access to health services, food, and water during an active conflict: Evidence from Ethiopia
title_full_unstemmed Access to health services, food, and water during an active conflict: Evidence from Ethiopia
title_short Access to health services, food, and water during an active conflict: Evidence from Ethiopia
title_sort access to health services food and water during an active conflict evidence from ethiopia
topic low income groups
undernutrition
surveys
households
water
food
tigray
children
health services
hygiene
civil conflict
conflicts
rural areas
url https://hdl.handle.net/10568/141179
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