| Impact of Refugees on Local Health Systems:
A Difference-in-Differences Analysis in Cameroon |
| Authors: |
Lambed Tatah, Tefera Darge Delbiso, Jose Manuel Rodriguez-Llanes, Julita Gil Cuesta, and Debarati Guha-Sapir |
| Source: |
PLOS ONE , 11(12): e0168820. doi:10.1371/journal.pone.0168820 |
| Topic(s): |
Antenatal care
Child health
Delivery care
Health equity
Immunization
Women's health
|
| Country: |
Africa
Cameroon
|
| Published: |
DEC 2016 |
| Abstract: |
Hosting refugees may represent a drain on local resources, particularly since external aid is
frequently insufficient. Between 2004 and 2011, over 100,000 refugees settled in the eastern
border of Cameroon. With little known on how refugee influx affects health services of
the hosting community, we investigated the impact of refugees on mother and child health
(MCH) services in the host community in Cameroon. We used Cameroon's 2004 and 2011
Demographic and Health Surveys to evaluate changes in MCH indicators in the refugee
hosting community. Our outcome variables were antenatal care (ANC) coverage, caesarean
delivery rate, place of delivery and child vaccination coverage; whereas the exposure
variable was residence in the refugee hosting community. We used a difference-in-differences
analysis to compare indicators of the refugee hosting community to a control group
selected through propensity score matching from the rest of the country. A total of 10,656
women were included in our 2004 analysis and 7.6% (n = 826) of them resided in the refugee
hosting community. For 2011, 15,426 women were included and 5.8% (n = 902) of them
resided in the hosting community. Between 2004 and 2011, both the proportion of women
delivering outside health facilities and children not completing DPT3 vaccination in the refugee
hosting community decreased by 9.0% (95% Confidence Interval (CI): 3.9±14.1%) and
9.6% (95% CI: 7.9±11.3%) respectively. However, ANC attendance and caesarean delivery
did not show any significant change. Our findings demonstrate that none of the evaluated
MCH service indicators deteriorated (in fact, two of them improved: delivery in health facilities
and completing DPT3 vaccine) with the presence of refugees. This suggests evidence
disproving the common belief that refugees always have a negative impact on their hosting
community. |
| Web: |
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0168820 |
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