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The Impact of Armed Conflict on Under Five Mortality: Comparison of Syria and Romania with A Difference-in-Differences Method

Year 2025, Issue: Special Issue: Crisis Entangled – Reimagining the Social in Turbulent Times, 150 - 161, 30.10.2025

Abstract

The purpose of the study was to reveal the effect of armed conflicts on the mortality rates of children under five. This research was conducted using a quasi-experimental difference-in-differences (DID) model on a quantitative longitudinal dataset from Syria and Romania between 2000 and 2023, using Jamovi Version 2.6. According to the findings, being in Syria increased the mortality rate of children under five by 8.9 times compared to Romania. During the period of armed conflict, the mortality rate of children under five in Syria was approximately 10 points higher than in Romania. The results showed that both being in Syria and armed conflicts led to higher mortality rates among children under five. This study clearly revealed the devastating effect of armed conflict on children's fundamental right to life, aiming to provide a concrete basis for improving preparedness and response mechanisms for future humanitarian crises. The research findings not only made significant contributions to the academic literature but also provided directly applicable insights for humanitarian aid and international development policies. The study also brought a new perspective to the field by examining the impact of armed conflict on child mortality under five using data from Syria, one of the most significant conflicts in recent years. The research provided evidence not only of direct violence but also of indirect health and nutrition disruptions. This evidence provides empirical evidence that decision-makers and those who regulate the laws of war can use, enabling more accurate policy development

Ethical Statement

Because the data in this study were obtained from a publicly accessible website and did not involve any intervention on humans or animals, it did not require ethics committee approval. No ethical violations were committed throughout the study.

Supporting Institution

None

Thanks

None

References

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  • Hidayati, M., Salahudin, S., Rizal, S., & Zahidi, M. (2022). The Impact of Armed Conflict on Children Health: Systematic Literature Review. Berumpun: International Journal of Social, Politics, and Humanities, 5, 128–142. https://doi.org/10.33019/berumpun.v5i2.73
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  • Jawad, M., Hone, T., Vamos, E. P., Cetorelli, V., & Millett, C. (2021). Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000-2019. PLoS Medicine, 18(9), e1003810. https://doi.org/10.1371/journal.pmed.-1003810
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Silahlı Çatışmanın Beş Yaş Altı Çocuk Ölümleri Üzerindeki Etkisi: Farkların Farkı Yöntemiyle Suriye ve Romanya'nın Karşılaştırılması

Year 2025, Issue: Special Issue: Crisis Entangled – Reimagining the Social in Turbulent Times, 150 - 161, 30.10.2025

Abstract

Çalışmanın amacı, silahlı çatışmaların beş yaş altı çocuk ölüm oranları üzerindeki etkisini ortaya koymaktır. 2000-2023 yılları arasında Suriye ve Romanya'ya ait nicel uzunlamasına veriler kullanılarak, Jamovi Sürüm 2.6 ile yarı deneysel olan farkların-farkı (DID) modeli ile bir araştırma yürütülmüştür. Bu araştırmanın bulgularına göre, Suriye'de bulunmak, beş yaş altı çocuk ölüm oranını Romanya'ya kıyasla 8,9 kat artırmaktadır. Silahlı çatışma döneminde, Suriye'deki beş yaş altı çocukların ölüm oranı, Romanya'daki çocuklara göre yaklaşık 10 puan daha yüksekti. Elde edilen sonuçlar, hem Suriye'de olmanın hem de silahlı çatışmaların beş yaş altı çocuklar arasında daha yüksek ölüm oranlarına yol açtığını göstermiştir. Bu çalışma, silahlı çatışmanın çocukların temel yaşam hakkı üzerindeki yıkıcı etkisini net bir şekilde ortaya koyarak, gelecekteki insani krizlere hazırlık ve müdahale mekanizmalarının iyileştirilmesi için somut bir temel sağlamayı amaçlamıştır. Araştırma sonuçları, akademik literatüre önemli katkılarda bulunmanın yanı sıra, insani yardım ve uluslararası kalkınma politikaları için doğrudan uygulanabilir bulgular sunuldu. Ayrıca çalışma, silahlı çatışmanın beş yaş altı çocuk ölümleri üzerindeki etkisini son yıllarda en önemli çatışmalara sahne olmuş Suriye verisi ile incelediğinden alana yeni bir bakış açısı getirmiştir. Araştırma doğrudan şiddeti değil, aynı zamanda dolaylı sağlık ve beslenme aksamalarına yönelik kanıt sunmuştur. Bu kanıtlar, karar vericilerin ve savaş hukukunu düzenleyenlerin kullanabileceği ampirik kanıtlar olması sebebiyle daha doğru politikalar geliştirilmesini sağlamıştır.

Ethical Statement

Bu çalışmada veriler kamuya açık bir internet sitesinden elde edildiğinden ve insan veya hayvanlar üzerinde herhangi bir müdahale içermediğinden etik kurul onayı gerektirmemiştir. Çalışma boyunca herhangi bir etik ihlal gerçekleştirilmemiştir.

Supporting Institution

Yok

Thanks

Yok

References

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  • Arage, M. W., Kumsa, H., Asfaw, M. S., Kassaw, A. T., Dagnew, E. M., Tunta, A., Kassahun, W., Addisu, A., Yigzaw, M., Hailu, T., & Tenaw, L. A. (2023). Exploring the health consequences of armed conflict: The perspective of Northeast Ethiopia, 2022: a qualitative study. BMC Public Health, 23, 2078. https://doi.org/10.1186/s12889-023-16983-z
  • Armenakyan, N. (2025). End preventable deaths of newborns and children under 5 years of age [WHO]. https://www.who.int/data/gho/da-ta/themes/topics/sdg-target-3_2-newborn-and-child-mortality
  • Ayele, K. (2025). Impacts of Armed Conflicts on Healthcare and Nutrition Services in Ethiopia: A Narrative Review. Public Health Challenges, 4(3), e70099. https://doi.org/10.1002/puh2.-70099
  • Ayhan, E. (2024). Contemporary Studies on the Rights of Immigrant Adults and Children in Türkiye (1st ed.). Sakarya University, Scientific Publications Coordinatorship. https://doi.org/10.59-537/saupress.2378
  • Bales, M., & Mutschler, M. (n.d.). A new autocratic way of war? Autocracy, precision strike warfare and civilian victimization. Defence Studies, 1–24. https://doi.org/10.1080/14702436.-2025.2522052
  • Bendavid, E., Boerma, T., Akseer, N., Langer, A., Malembaka, E. B., Okiro, E. A., Wise, P. H., Heft-Neal, S., Black, R. E., & Bhutta, Z. A. (2021). The effects of armed conflict on the health of women and children. Lancet (London, England), 397(10273), 522–532. https://doi.org/10.-1016/S0140-6736(21)00131-8
  • Bhusal, M. K., & Khanal, S. P. (2022). A Systematic Review of Factors Associated with Under-Five Child Mortality. BioMed Research International, 2022, 1181409. https://doi.org/10.1155-/2022/1181409
  • Bonati, M. (2025). Child mortality following armed conflict: How long does it take to reduce to pre-conflict level? BMJ Paediatrics Open, 9(1), e003379. https://doi.org/10.1136/bmjpo-2025-003379
  • Boukari, Y., Kadir, A., Waterston, T., Jarrett, P., Harkensee, C., Dexter, E., Cinar, E., Blackett, K., Nacer, H., Stevens, A., & Devakumar, D. (2024). Gaza, armed conflict and child health. BMJ Paediatrics Open, 8. https://doi.org/10.-1136/bmjpo-2023-002407
  • Brook, I. (2024). The Devastating Impact of War on Children’s Health. International Journal of Clinical Pediatrics, 13(2), 39–40. https://www.theijcp.org/index.php/ijcp/article/view/540
  • Ciccacci, F., Ruggieri, E., Scarcella, P., Moramarco, S., Carestia, M., Di Giovanni, D., Silaghi, L. A., Doro Altan, A. M., & Orlando, S. (2025). Between war and pestilence: The impact of armed conflicts on vaccination efforts: a review of literature. Frontiers in Public Health, 13, 1604288. https://doi.org/10.3389/fpubh.-2025.1604288
  • Daou, T., Mansour, F., Abdul Sater, Z., Naal, H., Jaber, L., Gnaedinger, A., Abu Sittah, G., & Saleh, S. (2025). Bridging the data divide: Challenges and opportunities for trauma registries in conflict-affected MENA countries: a qualitative analysis of key informant interviews. Conflict and Health, 19, 60. https://doi.org/10.1186/s13031-025-00701-0
  • David, S. D., & Eriksson, A. (2025). Association between conflict intensity and health outcomes in contemporary conflicts, while accounting for the vulnerability and functioning of healthcare services. Conflict and Health, 19(1), 14. https://doi.org/10.1186/s13031-025-00654-4
  • de Groot, C., Alhaffar, M. B. A., & Eriksson, A. (2025). Societies at risk: The correlation between intensity of armed conflict and child health during the civil war in South Sudan. Archives of Public Health, 83, 45. https://doi.org/10.1186/-s13690-025-01523-5
  • Dieddah, C. (1996). Children and Armed Conflict. World Health, 49th Year(6), 12–13. https://iris.who.int/bitstream/handle/10665/-330536/WH-1996-Nov-Dec-p12-13-eng.pdf
  • Durbin-Watson Test. (2008). Durbin–Watson Test. In The Concise Encyclopedia of Statistics (pp. 173–175). Springer, New York, NY. https://doi.org/10.1007/978-0-387-32833-1_122
  • Ekzayez, A., Alhaj Ahmad, Y., Alhaleb, H., & Checchi, F. (2021). The impact of armed conflict on utilisation of health services in north-west Syria: An observational study. Conflict and Health, 15, 91. https://doi.org/10.1186-/s13031-021-00429-7
  • Gallucci, M. (2019). GAMLj: General analyses for linear models. [Jamovi module] [Computer software]. https://gamlj.github.io/
  • Goto, R., Frodl, T., & Skokauskas, N. (2021). Armed Conflict and Early Childhood Development in 12 Low- and Middle-Income Countries. PEDIATRICS, 148, e2021050332. https://doi.-org/10.1542/peds.2021-050332
  • Harghandiwal, B. (2025). Impact of the humanitarian crisis in Gaza on children’s health: Evidence and recommendations for mitigation. Global Public Health, 20(1), 2495326. https://doi.org/-10.1080/17441692.2025.2495326
  • Hidayati, M., Salahudin, S., Rizal, S., & Zahidi, M. (2022). The Impact of Armed Conflict on Children Health: Systematic Literature Review. Berumpun: International Journal of Social, Politics, and Humanities, 5, 128–142. https://doi.org/10.33019/berumpun.v5i2.73
  • Hoffman, F. G. (2007). Conflict in the 21st Century: The Riseof Hybrid Wars (p. 72). Potomac Institute for Policy Studies. https://www.potomacinstitute.org/images/stories/publications/potomac_hybridwar_0108.pdf
  • Jawad, M., Hone, T., Vamos, E. P., Cetorelli, V., & Millett, C. (2021). Implications of armed conflict for maternal and child health: A regression analysis of data from 181 countries for 2000-2019. PLoS Medicine, 18(9), e1003810. https://doi.org/10.1371/journal.pmed.-1003810
  • Kadir, A., Shenoda, S., Goldhagen, J., & Pitterman, S. (2018). The Effects of Armed Conflict on Children. Pediatrics, 142, e20182586. https://doi.org/10.1542/peds.2018-2586
  • Kruk, M. E., Gage, A. D., Arsenault, C., Jordan, K., Leslie, H. H., Roder-DeWan, S., Adeyi, O., Barker, P., Daelmans, B., Doubova, S. V., English, M., Elorrio, E. G., Guanais, F., Gureje, O., Hirschhorn, L. R., Jiang, L., Kelley, E., Lemango, E. T., Liljestrand, J., … Pate, M. (2018). High-quality health systems in the Sustainable Development Goals era: Time for a revolution. The Lancet. Global Health, 6, e1196–e1252. https://doi.org/10.1016/S2214-109X(18)30386-3
  • Makinde, O. A., Olamijuwon, E., Mgbachi, I., & Sato, R. (2023). Childhood exposure to armed conflict and nutritional health outcomes in Nigeria. Conflict and Health, 17(1), 15. https://doi.org/10.1186/s13031-023-00513-0
  • Marou, V., Vardavas, C. I., Aslanoglou, K., Nikitara, K., Plyta, Z., Leonardi-Bee, J., Atkins, K., Condell, O., Lamb, F., & Suk, J. E. (2024). The impact of conflict on infectious disease: A systematic literature review. Conflict and Health, 18(1), 27. https://doi.org/10.1186/s13031-023-00568-z
  • Meierrieks, D., & Schaub, M. (2024). Terrorism and child mortality. Health Economics, 33(1), 21–40. https://doi.org/10.1002/hec.4757
  • Mhlanga, D., & Ndhlovu, E. (2023). The Implications of the Russia–Ukraine War on Sustainable Development Goals in Africa. Fudan Journal of the Humanities and Social Sciences, 16(4), 435–454. https://doi.org/10.1007/s40647-023-00383-z
  • Miles, J. (2014). Tolerance and Variance Inflation Factor. In Wiley StatsRef: Statistics Reference Online. John Wiley & Sons, Ltd. https://doi.org/-10.1002/9781118445112.stat06593
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There are 47 citations in total.

Details

Primary Language English
Subjects Social Justice
Journal Section Research Articles
Authors

Haşim Çapar 0000-0001-7056-7879

Early Pub Date October 30, 2025
Publication Date October 30, 2025
Submission Date September 15, 2025
Acceptance Date October 30, 2025
Published in Issue Year 2025 Issue: Special Issue: Crisis Entangled – Reimagining the Social in Turbulent Times

Cite

APA Çapar, H. (2025). The Impact of Armed Conflict on Under Five Mortality: Comparison of Syria and Romania with A Difference-in-Differences Method. OPUS Journal of Society Research(Special Issue: Crisis Entangled – Reimagining the Social in Turbulent Times), 150-161. https://doi.org/10.26466/opusjsr.1784544