info:eu-repo/semantics/article
Health in conflict and post-conflict settings: reproductive, maternal and child health in Colombia
Registro en:
1752-1505
10.1186/s13031-020-00273-1
Autor
Ramos Jaraba, Sara Milena
Quiceno Toro, Natalia
Ochoa Sierra, María
Ruiz Sánchez, Laura
García Jiménez, Marlly Andrea
Salazar Barrientos, Mary Y.
Bedoya Bedoya, Edison
Vélez Álvarez, Gladis Adriana
Langer, Ana
Gausman, Jewel
Garcés Palacio, Isabel C.
Institución
Resumen
BASTRACT: ABSTRACT: Background: In conflict-afflicted areas, pregnant women and newborns often have higher rates of adverse health
outcomes.
Objective: To describe maternal and child health indicators and interventions between 1998 and 2016 comparing
high and low conflict areas in Colombia.
Methods: Mixed study of convergent triangulation. In the quantitative component, 16 indicators were calculated
using official, secondary data sources. The victimization rate resulting from armed conflict was calculated by
municipality and grouped into quintiles. In the qualitative component, a comparative case study was carried out in
two municipalities of Antioquia: one with high rates of armed conflict and another with low rates. A total of 41
interviews and 8 focus groups were held with local and national government officials, health professionals,
community informants, UN agencies and NGOs.
Results: All of the indicators show improvement, however, four show statistically significant differences between
municipalities with high victimization rates versus low ones. The maternal mortality ratio was higher in the
municipalities with greater victimization in the periods 1998–2004, 2005–2011 and 2012–2016. The percentage of
cesarean births and women who received four or more antenatal visits was lower among women who experienced
the highest levels of victimization for the period 1998–2000, while the fertility rate for women between 15 and 19
years was higher in these municipalities between 2012 and 2016. In the context of the armed conflict in Colombia,
maternal and child health was affected by the limited availability of interventions given the lack of human
resources in health, supplies, geographical access difficulties and insecurity. The national government was the one
that mostly provided the programs, with difficulties in continuity and quality. UN Agencies and NGOs accessed
more easily remote and intense armed conflict areas. Few specific health interventions were identified in the postconflict context.
Conclusions: In Colombia, maternal and child health indicators have improved since the conflict, however a
pattern of inequality is observed in the municipalities most affected by the armed conflict.