War and Gender Inequalities in Health: The Impact of Armed Conflict on Fertility and Maternal Mortality

Recent studies have found significant excess mortality in women during and immediately after armed conflicts. This article directly assesses one of the most likely explanations, namely that war negatively affects reproductive health. Armed conflicts may contribute to sustain high fertility levels through increased social insecurity, loss of reproductive health services, and lower female education. Further, war's deteriorating impact on health infrastructure is expected to increase the relative risk that women die from complications associated with pregnancy and childbirth. These claims are tested in a global time-series cross-national study from 1970 through 2005. Three major findings are reported. First, armed conflicts are associated with higher overall fertility in low-income countries only. Second, maternal mortality rates are elevated, albeit moderately, in conflict countries. Third, conflicts in neighboring countries are associated with lower maternal mortality, possibly indicating that health interventions among refugee and host populations are relatively successful. While addressing one of the least successful UN Millennium Development Goals, this study also responds to the UN Security Council Resolution 1325, in which Article 16 specifically calls for the “Secretary-General to carry out a study on the impact of armed conflict on women and girls.”