RESUMEN
ABSTRACT Objectives To establish and quantify the effect of the internal armed conflict in Colombia on infant health, particularly birth weight. Methods This document explores time differences in relation to the impact of the internal armed conflict in Colombia, measured by municipal homicide rates, on infant health, quantified as infant mortality and birth weight. Based on individual data from the 1995 and 2000 Colombian National Demographic and Health Surveys, along with annual municipal data on violence and economic performance, results obtained from two biological siblings are compared using a maternal fixed logistic regression, as one was born in a violent era and the other during a peaceful moment. Results Political violence negatively affected infant health outcomes during the peak of violence experienced by Colombia in the 1990s, with worse outcomes for male infants than for females. Controlling fixed maternal effects shows a three times greater probability of being born with low birth in infants born during increased violence, compared to their siblings born in more peaceful times. Conclusions These results make visible all the effects of intense and long-lasting armed conflicts, as is the case of Colombia, since not only direct actors involved in conflict are affected, but also infants who show worse health outcomes. These results allows targeting policies for reducing the effects on populations in conflict or during the reconstruction period; in this case, the provision of maternal care during the gestational period and special care for newborns in areas under high violence levels should be a priority.(AU)
RESUMEN Objetivos Establecer y cuantificar el efecto del conflicto armado interno en Colombia en la salud infantil, particularmente en el peso al nacer. Métodos Este documento explora las diferencias en el tiempo de la intensidad del conflicto armado interno en Colombia, medido por las tasas de homicidios municipales, sobre la salud infantil, cuantificado como mortalidad infantil y peso al nacer. Mediante el uso de datos individuales de las encuestas nacionales de demografía y salud de Colombia de 1995 y 2000, combinados con datos anuales de nivel municipal sobre violencia y desempeño económico, se confrontan los resultados entre dos hermanos biológicos, uno nacido en una era violenta y otro en un momento pacífico utilizando una regresión logística de control materno. Resultados La violencia política afecta negativamente la salud infantil, lo que se pudo cuantificar durante el pico de violencia que experimentó Colombia en los años 90, con peores resultados para los bebés varones que en sus contrapartes. El control de los efectos fijos maternos muestra una probabilidad significativa tres veces mayor de nacer con bajo peso al nacer para los bebés nacidos durante el aumento de la violencia, en comparación con sus hermanos nacidos en épocas más pacíficas. Conclusiones Estos resultados hacen visibles la totalidad de los efectos de conflictos armados intensos y duraderos, como es el caso colombiano, en donde no sólo los actores directos involucrados en el mismo se ven afectados, sino que también los recién nacidos muestran peores resultados de salud. Los resultados de este estudio permiten focalizar políticas en la reducción de los efectos en poblaciones en conflicto o durante el período de reconstrucción, en este caso se sugiere la provisión de cuidado materno durante el período gestacional y cuidado especial para recién nacidos en áreas de altos niveles de violencia como una prioridad.(AU)
Asunto(s)
Humanos , Recién Nacido , Peso al Nacer , Mortalidad Infantil/tendencias , Salud Infantil/estadística & datos numéricos , Guerra y Conflictos Armados/psicología , Modelos Logísticos , Demografía/métodosRESUMEN
OBJECTIVES: To establish and quantify the effect of the internal armed conflict in Colombia on infant health, particularly birth weight. METHODS: This document explores time differences in relation to the impact of the internal armed conflict in Colombia, measured by municipal homicide rates, on infant health, quantified as infant mortality and birth weight. Based on individual data from the 1995 and 2000 Colombian National Demographic and Health Surveys, along with annual municipal data on violence and economic performance, results obtained from two biological siblings are compared using a maternal fixed logistic regression, as one was born in a violent era and the other during a peaceful moment. RESULTS: Political violence negatively affected infant health outcomes during the peak of violence experienced by Colombia in the 1990s, with worse outcomes for male infants than for females. Controlling fixed maternal effects shows a three times greater probability of being born with low birth in infants born during increased violence, compared to their siblings born in more peaceful times. CONCLUSIONS: These results make visible all the effects of intense and long-lasting armed conflicts, as is the case of Colombia, since not only direct actors involved in conflict are affected, but also infants who show worse health outcomes. These results allows targeting policies for reducing the effects on populations in conflict or during the reconstruction period; in this case, the provision of maternal care during the gestational period and special care for newborns in areas under high violence levels should be a priority.