The Impact of Armed Conflict on Maternal Health in Colombia

This study combines data from the 2010 Demographic and Health Survey and the Conflict Analysis Resource Center (CERAC) to examine the impact of conflict on maternal health service utilization and outcomes in Colombia. The primary results indicate a significant, negative relationship between conflict level and antenatal and postnatal care utilization. Conflict is insignificant in determining the use of professional assistance at delivery. Although rural women are, overall, less likely to access maternal health services, further analysis along rural-urban lines reveals that the negative effect of violence on prenatal and postnatal care is stronger among urban women. Secondary estimation of the occurrence of complications during or after delivery employs a Two-Stage Residuals Inclusion model to address potential endogeneity in service use. Estimated results show that conflict levels are insignificant, but that Indigenous women and women in lower wealth quintiles are significantly more likely to experience complications, even after controlling for service use. The conclusions of this paper suggest that Colombia’s universal healthcare system has been successful in reducing economic barriers to prenatal care and professional delivery, but that significant wealth-related inequalities remain in maternal health outcomes. Additionally, Indigenous and women with lower levels of education are less likely to access services and more likely to experience complications. The primary contribution of this paper is the inclusion of a conflict measure. The significant, negative impact on prenatal and postnatal care utilization, especially for urban women, warrants further study to better inform policy to increase service use and reduce maternal mortality and morbidity.