Child Morbidity and Camp Decongestion in Post-War Uganda

Abstract

Conflict related displacement affects millions of families throughout the world. Very little is known about the determinants of health outcomes in the period immediately after a cease-fire is agreed, in which currently displaced people living in camps consider returning to their place of origin. In this paper, we study the effects of war and displacement on the health of children, using morbidity data collected as part of a large household survey from post-war northern Uganda in 2007. We combine this dataset with geo-coded conflict event data at the individual level to overcome the challenges of selection bias and endogeneity arising from households choosing their location in part based on their health status. This methodological concern is confirmed in our analysis. We then estimate the determinants of child morbidity (proxied by various health indicators) in an instrumental variables multivariate model, where conflict intensity at place of birth of the head of household is used as an instrument. We find that while children in IDP camps and in returnee locations exhibit the same mean morbidity rates, IDP camp residency almost doubles morbidity while poor access to safe drinking water in return locations counteracts the positive health effects of camp decongestion. Our results point to the importance of overcrowding and poor cooking technologies in IDP camps for worsening morbidity in children and the need to provide better sanitation and drinking water access in return locations to further improve the health status of conflict-affected children. Better data and analysis in early post-war periods can help to balance public health interventions, thereby strengthening the peace process.