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. 2025 Jun 19;10(6):e015507. doi: 10.1136/bmjgh-2024-015507

Table 2. Effect of conflict intensity and duration.

ANC4 visits Facility-based deliveries Caesarean sections PNC1 visits Curative care visits (0–4 years) Curative care visits (5–14 years)
Equation 1
 Any death 0.961** (0.932–0.991) 0.928*** (0.905–0.952) 0.906 (0.760–1.079) 0.957** (0.917–0.999) 0.928*** (0.906–0.951) 0.880*** (0.856–0.904)
Equation 2
 Below median 1.003 (0.968–1.039) 0.959*** (0.937–0.981) 0.959 (0.848–1.086) 1.000 (0.953–1.049) 0.954*** (0.930–0.978) 0.886*** (0.861–0.913)
 Above median 0.916*** (0.881–0.953) 0.895*** (0.864–0.928) 0.841 (0.637–1.110) 0.909*** (0.861–0.960) 0.900*** (0.872–0.929) 0.872*** (0.841–0.905)
Equation 3
 1–2 deaths 1.005 (0.963–1.049) 0.976* (0.951–1.001) 0.917 (0.797–1.056) 0.991 (0.939–1.045) 0.967** (0.941–0.994) 0.903*** (0.874–0.933)
 3–4 deaths 0.999 (0.955–1.046) 0.926*** (0.893–0.961) 1.029 (0.865–1.224) 1.017 (0.948–1.092) 0.928*** (0.892–0.965) 0.855*** (0.815–0.898)
 5–14 deaths 0.915*** (0.873–0.958) 0.915*** (0.878–0.953) 0.820 (0.560–1.200) 0.933** (0.872–0.999) 0.903*** (0.868–0.939) 0.907*** (0.866–0.950)
 14+ deaths 0.918*** (0.873–0.966) 0.869*** (0.833–0.907) 0.861 (0.651–1.138) 0.879*** (0.827–0.934) 0.897*** (0.865–0.930) 0.828*** (0.791–0.867)
Equation 4
 Month 1 only 0.972** (0.948–0.995) 0.951*** (0.933–0.969) 0.951 (0.823–1.098) 0.978 (0.942–1.016) 0.941*** (0.921–0.961) 0.895*** (0.873–0.917)
 2 consecutive months 0.963 (0.887–1.045) 0.869*** (0.825–0.914) 0.734** (0.572–0.941) 0.900** (0.822–0.986) 0.895*** (0.851–0.941) 0.836*** (0.787–0.888)
 3 consecutive months 0.893* (0.791–1.008) 0.842*** (0.764–0.927) 0.647*** (0.587–0.713) 0.841*** (0.739–0.957) 0.821*** (0.761–0.887) 0.799*** (0.725–0.881)
 4 consecutive months 0.768* (0.578–1.021) 0.726*** (0.600–0.879) 0.902 (0.660–1.233) 0.807*** (0.706–0.923) 0.738*** (0.610–0.893)
 5+ consecutive months 0.645* (0.393–1.058) 0.689** (0.486–0.976) 0.583*** (0.421–0.808) 0.961 (0.669–1.381) 0.773* (0.578–1.036)
 Observations 208 074 208 685 4556 186 863 215 499 215 328

Data are IRRs (95% CI) or n. All specifications include time-varying health facility level controls, health facility fixed effects, calendar months as well as a baseline trend and a quadratic term of the baseline trend. Conflict is represented as a binary exposure (equation 1) and is broken down into categorical indicators representing conflict intensity (equations 2 and 3), and conflict duration (equation 4). The estimates under equations 1−3 (figure 2) represent the IRR within health facilities during months of conflict (within 25 km of the health facility) as compared with months without conflict. If the IRR is less than 1, the incident rate is lower during conflict compared with non-conflict. The remaining estimates under equation 4 (figure 3) represent the IRR within health facilities during conflict (within 25 km of the health facility) lasting 1 month only or for consecutive months leading up to the month of health service access as compared with month without conflict. Standard errors (SEs) are clustered at the health facility level.

*p<0.1; **p<0.05; ***p<0.01.

ANC, antenatal care; IRR, incidence rate ratio; PNC, postnatal care.