Table 1. Adjusted DID Associations Between Conflict Severity and Key Reproductive, Maternal, Newborn, and Child Health Interventionsa.
| DID Estimator by Conflict Intensity × Timeb | MICS 2003 to MICS 2010 | MICS 2010 to AHS 2018 | ||
|---|---|---|---|---|
| β Coefficient (95% CI) | P Value | β Coefficient (95% CI) | P Value | |
| Contraceptive use | ||||
| Moderate-intensity conflict × time | 1.03 (0.73 to 1.32) | <.001 | –0.85 (–1.14 to –0.57) | <.001 |
| Severe-intensity conflict × time | 1.22 (0.74 to 1.69) | <.001 | –0.50 (–0.92 to –0.08) | .02 |
| Antenatal care | ||||
| Moderate-intensity conflict × time | 0.43 (0.06 to 0.80) | .02 | –0.63 (–0.97 to –0.30) | <.001 |
| Severe-intensity conflict × time | 0.66 (–0.05 to 1.37) | .07 | –0.01 (–0.59 to 0.57) | .97 |
| Skilled birth attendant | ||||
| Moderate-intensity conflict × time | 0.53 (0.20 to 0.86) | .002 | –0.53 (–0.89 to –0.16) | .005 |
| Severe-intensity conflict × time | 0.43 (–0.38 to 1.24) | .29 | 0.10 (–0.55 to 0.75) | .76 |
| BCG vaccine | ||||
| Moderate-intensity conflict × time | 0.05 (–0.45 to 0.55) | .85 | –1.30 (–1.79 to –0.81) | <.001 |
| Severe-intensity conflict × time | –1.33 (–2.17 to –0.49) | .002 | 0.06 (–0.75 to 0.88) | .88 |
| DPT3/penta vaccine | ||||
| Moderate-intensity conflict × time | –0.07 (–0.51 to 0.38) | .77 | –0.88 (–1.33 to –0.43) | <.001 |
| Severe-intensity conflict × time | –2.11 (–3.05 to –1.17) | <.001 | 1.56 (0.71 to 2.41) | <.001 |
| Measles vaccine | ||||
| Moderate-intensity conflict × time | 0.47 (0.01 to 0.94) | .04 | –0.30 (–0.74 to 0.14) | .44 |
| Severe-intensity conflict × time | –1.15 (–2.03 to –0.27) | .01 | 0.33 (–0.51 to 1.17) | <.001 |
| Oral rehydration therapy | ||||
| Moderate-intensity conflict × time | –0.43 (–0.97 to 0.10) | .11 | 0.03 (–0.41 to 0.48) | .89 |
| Severe-intensity conflict × time | 2.78 (2.06 to 3.50) | <.001 | –0.97 (–1.63 to –0.31) | .004 |
| Care seeking for acute respiratory infection | ||||
| Moderate conflict × time | 0.59 (0.16 to 1.02) | .008 | –0.03 (–0.51 to 0.45) | .91 |
| Severe conflict × time | –0.30 (–1.29 to 0.69) | .56 | 0.12 (–0.88 to 1.12) | .81 |
Abbreviations: AHS, Afghanistan Health Survey; DID, difference-in-difference; DPT3, diphtheria, pertussis, and tetanus (3 doses); MICS, Multiple Indicator Cluster Survey; penta, DTP3 plus hepatitis B and poliomyelitis.
a
Models were adjusted for the main effects of conflict and time and covariates including maternal illiteracy, contracting type, and rural residence. Complete results are given in the eFigure 2 and eTable 6 in the Supplement.
b
Minimal-intensity conflict is the reference category.