Peace and child health in sub-Saharan Africa: the demographic cost paid by young children during and after civil wars

The study describes changing trends in child mortality in selected African countries that suffered civil wars. After an overview of political developments following independence, the study draws a contrast between countries who suffered a civil war and others having remained in peace during the same period. The war case-studies were the following: Angola 1975-2002; Mozambique 1977-1992, Rwanda 1990-1999, Burundi 1988-2005; Uganda 1971-1986; Congo-Brazza 1993-2002; Liberia 1989-2003; Sierra-Leone 1991-2002. The study focuses on the impact of destructions and dysfunctions in health systems on child survival during and after the war period since it takes several years after a conflict for full recovery of the health system. The study discusses the frailty of newly independent states, economic downturns and mismanagement, the difficulties of decolonization, the role of the great powers and competing ideologies during the Cold War period, and the divisions resulting from ethnic rivalries to conquer political power. Overall, the study found an indirect impact (~4.9 million deaths) as high as the estimated direct impact of civil wars.