Geospatial analysis of the impact of Cameroonian Anglophone Crisis conflict intensity on antenatal care utilisation

Résumé fourni par la source

Adequate antenatal care (ANC) is often unrealised in sub-Saharan Africa (SSA). This is exemplified in the Cameroonian Anglophone Crisis, an ongoing armed civil conflict. Conflict intensity varies nationally, causing differential impacts on healthcare access. This study aimed to quantify the impact of the conflict’s intensity on ANC use and identify its geographical variations. We analysed live births from the 2011 and 2018 Cameroonian Demographic and Health Surveys and the 2022 Cameroonian Malaria Indicator Survey. Conflict intensity was measured as the proportion of Anglophone Crisis-related deaths occurring in each division, using Armed Conflict Location & Event Data Project (ACLED) data. Associations between conflict intensity and the proportion of live births attending at least one (ANC1) and at least four (ANC4) ANC visits were assessed using multiple linear regression and geographically weighted regression. Between 2011 and 2022, North West and South West Cameroon experienced ANC4 compliance declines. North West also experienced an ANC1 decline, but South West experienced an ANC1 increase. There is no evidence for an association between ANC1 and conflict intensity (p = 0.403). There is strong evidence for a negative association between conflict intensity and ANC4 (p = 0.007). A 1% increase in conflict intensity is associated with a 1.14% (95% CI: 0.326, 1.963) decrease in ANC4. There is strong evidence for spatial variation of this relationship (p < 0.001). There is strong evidence to suggest that the Anglophone Crisis has adversely impacted ANC use, with varying magnitudes nationwide. Targeted solutions are crucial to mitigate its impacts on sustained ANC use. Ngwang et al. perform an ecological cross-sectional study to assess how the protracted Anglophone Crisis influences antenatal care utilisation across the nation of Cameroon. They find that the intensity of the conflict negatively impacts healthcare utilisation, especially among non-Christian and young mothers. Through its preventative approach, antenatal care (ANC) has the potential to improve outcomes for both mothers and babies. However, many mothers do not have optimal access to ANC due to a plethora of factors, all of which can be aggravated by conflict. This is particularly evident in the context of the Anglophone Crisis, an ongoing civil conflict in Cameroon. This study used mapping techniques to identify areas in Cameroon most negatively affected by the conflict. We found that areas with the highest conflict intensity were more likely to experience declines in sustained ANC use. These findings emphasise the need for interventions specifically tailored to this context to overcome the many obstacles to ANC use that have been created.

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