The Impact of Armed Conflict on Maternal and Women’s Reproductive Health in Sub-Saharan Africa

Led by Primus Che Chi
Sep 2011 - Feb 2015

​​​​​​​PhD project at the Faculty of Medicine, University of Oslo, Norway.

Supervisor at PRIO: Henrik Urdal​
Supervisor at UiO: Johanne Sundby

Armed conflicts are a public health problem and pose serious challenges to health systems. One of the most affected areas is the state of maternal and reproductive health. Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period, while reproductive health is a state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity, in all matters relating to the reproductive system and to its functions and processes. The project seeks to contribute to the broader literature on maternal and reproductive health in conflict and post-conflict settings by exploring the effects and impacts armed conflicts on maternal and women’s reproductive health, while identifying potential interventions to improve the situation.

​Some of the specific research questions are:

  1. What is the impact of armed conflict on maternal mortality and total fertility rate?
  2. What are the determinants of utilization of maternal health services in post-conflict settings?
  3. What are the consequences of armed conflict on maternal and reproductive health in post-conflict settings?
  4. What are the barriers in the delivery of emergency obstetric and neonatal care in post-conflict Africa?
  5. What are the interventions to improve maternal, newborn and women’s reproductive health in crisis settings?​
​​​​To address these questions a multidisciplinary approach, using quantitative, qualitative and mixed research methods is employed. The impact of armed conflict on maternal mortality and total fertility rates is investigated using a global time-series cross-national study from 1970 -2005. The general consequences of armed conflict on maternal and reproductive health, the determinants of utilization of maternal health services, and the barriers to the delivery of emergency obstetric and neonatal care are determined through qualitative case studies of some post-conflict settings in sub-Saharan Africa. Lastly, a Cochrane systematic review is conducted to identify, synthesize and evaluate existing interventions to improve maternal, newborn and women’s reproductive health in crisis settings.


Publications

Peer-reviewed Journal Article

Chi, Primus Che; Patience Bulage; Henrik Urdal & Johanne Sundby (2015) Barriers in the Delivery of Emergency Obstetric and Neonatal Care in Post-Conflict Africa: Qualitative Case Studies of Burundi and Northern Uganda, PLOS ONE 10(9).
Motaze, Nkengafac V.; Primus Che Chi; Pierre Ongolo-Zogo; Jean Serge Ndongo & Charles Shey Wiysonge (2015) Government regulation of private health insurance, Cochrane Database of Systematic Reviews 2015(4).
Chi, Primus Che; Patience Bulage; Henrik Urdal & Johanne Sundby (2015) A qualitative study exploring the determinants of maternal health service uptake in post-conflict Burundi and Northern Uganda, BMC Pregnancy and Childbirth 15(18).
Chi, Primus Che; Patience Bulage; Henrik Urdal & Johanne Sundby (2015) Perceptions of the effects of armed conflict on maternal and reproductive health services and outcomes in Burundi and Northern Uganda: a qualitative study, BMC International Health and Human Rights 15(7).

Book Chapter

Urdal, Henrik & Primus Che Chi (2015) War and Gender Inequalities in Health, in Gizelis , Theodora-Ismene; & Louise Olsson, eds, Gender, Peace and Security: Implementing UN Security Council Resolution 1325. Abingdon: Routledge (116–137).