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Civil Conflict and Child Health in Africa: An Instrumental Variables Approach

This study examined the linkages between civil conflict and child health in Africa during the period 1992‐2013. Civil insecurity is endemic in some parts of Africa, and non‐existent in other parts. In affected areas, civil conflict shapes the food system through disruption of trade routes, looting, displacement of farmers, and land tenure insecurity. Using a collection of the Demographic and Health Survey (DHS) for 28 countries, merged spatially and temporally with the Armed Conflict Location and Event Dataset (ACLED), I estimated the impact of civil insecurity on mortality risk, heights and weights for over 700,000 children born between 1992 and 2013. For statistical identification in face of measurement error and endogeneity concerns for the civil conflict data, I used geographic variables as instruments for civil conflict risk, and mother fixed‐effects to compare sibling pairs. The results indicate that child mortality risk is increased with exposure to violent conflict during the year before birth and during the year of birth. Being exposed to conflict during the year of birth is especially detrimental for children living in rural areas. Conflict exposure has adverse effects on future child height and weight attainment, and these effects differ depending on the child's geographic location. Findings are robust to the inclusion of child and household controls, country and mother fixed‐effects, and region‐specific time trends. This study builds on previous work which estimates the human health impact of civil insecurity, utilizing a newly constructed database which merges child health information with conflict incident reports at a fine spatial resolution across a long time frame and vast geographic area. This study was supported by a U.S. Borlaug Fellowship in Global Food Security.