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Service utilization patterns for childbirth and neonatal mortality in the occupied Palestinian territory during conflict

Siam, Zeina and Leone, Tiziana ORCID: 0000-0001-9671-5382 (2020) Service utilization patterns for childbirth and neonatal mortality in the occupied Palestinian territory during conflict. European Journal of Public Health. ISSN 1101-1262

[img] Text (Service utilization patterns for childbirth and neonatal mortality in the occupied Palestinian territory during conflict) - Accepted Version
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Abstract

Background. The global incidence of man-made crises has increased in the last decade. Evidence on demand-side deviations in service uptake during conflict is needed to better understand the link between conflict and adverse neonatal outcomes. We assessed the association between conflict intensity in the Occupied Palestinian territory (OPT) at time of birth and 1) utilization patterns for childbirth across different providers; and 2) neonatal mortality. Methods. We combined data on conflict intensity with 4 demographic and health surveys (2004, 2006, 2010 and 2014), that included nationally representative samples of women of childbearing age. Our exposure variable was casualties per 100,000 population in defined sub-regions of the OPT. Our outcome specifications were a binary variable for neonatal deaths and a categorical variable for childbirth location. We used multivariate logistic regressions to assess the associations. Results. High conflict intensity was associated with fewer childbirths in the private sector [RR= 0.97, p= 0.04], and non-governmental organizations [RR= 0.95, P=0.03] compared to public facilities. Conflict intensity was however not predictive of neonatal mortality beyond 2004. Conclusions. Policy implications include better preparedness in the public sector for maternal care provision during conflict and exploring reasons for the slow decline in neonatal mortality in the territory beyond conflict at time of birth.

Item Type: Article
Official URL: https://academic.oup.com/eurpub
Additional Information: © 2020 The Author(s)
Divisions: International Development
Subjects: H Social Sciences > HQ The family. Marriage. Woman
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Date Deposited: 27 Feb 2020 14:51
Last Modified: 10 Jul 2020 11:03
URI: http://eprints.lse.ac.uk/id/eprint/103579

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