Submission ID 118308
| Issue/Objective | To measure the effects of violent attacks against civilians (VAC) on access to healthcare services, it is important to control the influence of potentially confounding variables. While downstream factors associated with access to healthcare are well documented, few quantitative studies have focused on factors associated with the occurrence of VAC in protracted conflicts in sub-Saharan Africa. We aimed to identify these factors to later refine our analyses of the impact on access to healthcare services. |
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| Methodology/Approach | Using Arksey and O'Malley's framework and the PRISMA guidelines, we conducted a scoping review of the literature. Several databases were searched: Medline, Embase, Web of science, CINAHL Complete, Global health, Worldwide political science abstract, International political science abstract, and Peace research abstracts. Studies were included if they: (i) examined quantitatively factors associated with VAC; ii) used data from conflict databases; iii) conducted analyses either at a sub-national level or with a temporal measure less than a year, in at least one African country. |
| Results | From 1097 initially identified studies, 67 were included, of which 25 analysed factors associated to attacks. They were published between 2009 and 2024 and covered 54 African countries. Factors more frequently associated to VAC included: environmental and climate conditions, as precipitations and temperature (N=13), distance to borders or roads (n=9), agricultural activities (n=6), mining resources (n=5) and ethnic and religious composition (n=5). Other factors frequently associated, and considered as controlling variables, were: population size (n=15), distance to capitals (n=9), GDP per capita (n=5) and demographic characteristics (age, gender, education, marital status and income, n=5). There was no overall consistency on the direction and strength of the associations of specific factors; for example, rainfall or distance to borders were associated to an increase in attacks in some studies, and to a decrease in others. |
| Discussion/Conclusion | These findings highlight the multifaceted nature of violent attacks in African countries, with contributing factors spanning social, economic, political, and environmental domains. Factors can also play a different role, both favouring or preventing occurrence of attacks, depending on the specific local situation. This complexity requires a multi-sectoral approach when studying conflict dynamics and their impact on healthcare. |
| Presenters and affiliations | Neda Firouraghi Université de Montreal (ESPUM/CReSP) Cheick Oumar Tiendrebeogo Université de Montreal (ESPUM/CReSP) Federica Fregonese Université de Montreal (ESPUM/CReSP) Thomas Druetz Université de Montreal (ESPUM/CReSP) Thomas Druetz Université de Montreal (ESPUM/CReSP) |
