placestats

Armed conflict present vs. Skilled birth attendance

Holds up after adjusting for income

Across 175 countries, Armed conflict present and Skilled birth attendance rise and fall together at r = -0.46 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to -0.27 (q = 0.024, allowing for the many pairs tested). Much of the first figure is that both measures rise with national income, but a weak negative link remains.

Comparing countries across the middle half of armed conflict present, 0 to 1 points, skilled birth attendance is worse by 15.7% of births at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 7.46% of births.

Link before adjusting (r)-0.455p = 2.5e-10 · 175 countries
After adjusting for national income-0.272p = 0.000 · likely range [-0.40, -0.13]
p, allowing for regions0.001standard error 0.048 · 7 regions
Check for luck (q)0.024across 12,497 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Armed conflict present · 1 if any conflict, else 0link with income -0.39 · moderate
Skilled birth attendance · % of birthslink with income +0.69 · high

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

Armed conflict present · 1 if any conflict, else 0 →Skilled birth attendance · % of births →0131.9%100%Afghanistan: 1 1 if any conflict, else 0, 61.8% of birthsAngola: 1 1 if any conflict, else 0, 49.6% of birthsAlbania: 0 1 if any conflict, else 0, 99.8% of birthsAndorra: 0 1 if any conflict, else 0, 100% of birthsUnited Arab Emirates: 0 1 if any conflict, else 0, 99.2% of birthsArgentina: 1 1 if any conflict, else 0, 98.8% of birthsArmenia: 0 1 if any conflict, else 0, 99.8% of birthsAntigua and Barbuda: 0 1 if any conflict, else 0, 99% of birthsAustralia: 0 1 if any conflict, else 0, 96% of birthsAustria: 0 1 if any conflict, else 0, 98.1% of birthsAzerbaijan: 0 1 if any conflict, else 0, 99.9% of birthsBurundi: 1 1 if any conflict, else 0, 76.5% of birthsBenin: 1 1 if any conflict, else 0, 78.1% of birthsBurkina Faso: 1 1 if any conflict, else 0, 79.8% of birthsBangladesh: 0 1 if any conflict, else 0, 59% of birthsBulgaria: 0 1 if any conflict, else 0, 94.5% of birthsBahrain: 0 1 if any conflict, else 0, 99.6% of birthsBahamas, The: 0 1 if any conflict, else 0, 99% of birthsBosnia and Herzegovina: 0 1 if any conflict, else 0, 99.9% of birthsBelarus: 0 1 if any conflict, else 0, 99.9% of birthsBelize: 0 1 if any conflict, else 0, 94.6% of birthsBolivia: 1 1 if any conflict, else 0, 81.1% of birthsBrazil: 1 1 if any conflict, else 0, 98.4% of birthsBarbados: 0 1 if any conflict, else 0, 98.4% of birthsBrunei Darussalam: 0 1 if any conflict, else 0, 99.6% of birthsBhutan: 0 1 if any conflict, else 0, 98.9% of birthsBotswana: 0 1 if any conflict, else 0, 99.8% of birthsCentral African Republic: 1 1 if any conflict, else 0, 40.3% of birthsCanada: 0 1 if any conflict, else 0, 98% of birthsChile: 0 1 if any conflict, else 0, 99.8% of birthsChina: 0 1 if any conflict, else 0, 99.9% of birthsCote d'Ivoire: 0 1 if any conflict, else 0, 84% of birthsCameroon: 1 1 if any conflict, else 0, 69% of birthsCongo, Dem. Rep.: 1 1 if any conflict, else 0, 85.2% of birthsCongo, Rep.: 1 1 if any conflict, else 0, 91.2% of birthsColombia: 1 1 if any conflict, else 0, 98.8% of birthsComoros: 0 1 if any conflict, else 0, 82.2% of birthsCabo Verde: 0 1 if any conflict, else 0, 97.3% of birthsCosta Rica: 1 1 if any conflict, else 0, 99% of birthsCyprus: 0 1 if any conflict, else 0, 99.3% of birthsCzechia: 0 1 if any conflict, else 0, 99.8% of birthsGermany: 0 1 if any conflict, else 0, 96.2% of birthsDjibouti: 0 1 if any conflict, else 0, 87.4% of birthsDominica: 0 1 if any conflict, else 0, 100% of birthsDenmark: 0 1 if any conflict, else 0, 95.3% of birthsDominican Republic: 0 1 if any conflict, else 0, 99.2% of birthsAlgeria: 0 1 if any conflict, else 0, 98.8% of birthsEcuador: 1 1 if any conflict, else 0, 99.4% of birthsEgypt, Arab Rep.: 0 1 if any conflict, else 0, 97.1% of birthsSpain: 0 1 if any conflict, else 0, 99.9% of birthsEstonia: 0 1 if any conflict, else 0, 99.6% of birthsEthiopia: 1 1 if any conflict, else 0, 49.8% of birthsFinland: 0 1 if any conflict, else 0, 99.5% of birthsFiji: 0 1 if any conflict, else 0, 99.8% of birthsFrance: 0 1 if any conflict, else 0, 98.2% of birthsGabon: 0 1 if any conflict, else 0, 89.3% of birthsGeorgia: 0 1 if any conflict, else 0, 99.8% of birthsGhana: 1 1 if any conflict, else 0, 78.9% of birthsGuinea: 0 1 if any conflict, else 0, 55.3% of birthsGambia, The: 0 1 if any conflict, else 0, 83.8% of birthsGuinea-Bissau: 0 1 if any conflict, else 0, 53.8% of birthsEquatorial Guinea: 0 1 if any conflict, else 0, 68.3% of birthsGreece: 0 1 if any conflict, else 0, 99.9% of birthsGrenada: 0 1 if any conflict, else 0, 100% of birthsGuatemala: 1 1 if any conflict, else 0, 69.6% of birthsGuyana: 0 1 if any conflict, else 0, 97.6% of birthsHonduras: 0 1 if any conflict, else 0, 94.1% of birthsCroatia: 0 1 if any conflict, else 0, 99.9% of birthsHaiti: 1 1 if any conflict, else 0, 41.6% of birthsHungary: 0 1 if any conflict, else 0, 99.7% of birthsIndonesia: 1 1 if any conflict, else 0, 94.7% of birthsIndia: 1 1 if any conflict, else 0, 89.4% of birthsIreland: 0 1 if any conflict, else 0, 99.7% of birthsIran, Islamic Rep.: 1 1 if any conflict, else 0, 99% of birthsIraq: 1 1 if any conflict, else 0, 95.6% of birthsIceland: 0 1 if any conflict, else 0, 97.4% of birthsItaly: 0 1 if any conflict, else 0, 99.8% of birthsJamaica: 0 1 if any conflict, else 0, 99.7% of birthsJordan: 0 1 if any conflict, else 0, 99.7% of birthsJapan: 0 1 if any conflict, else 0, 99.8% of birthsKazakhstan: 0 1 if any conflict, else 0, 99.9% of birthsKenya: 1 1 if any conflict, else 0, 70.2% of birthsKyrgyz Republic: 0 1 if any conflict, else 0, 100% of birthsCambodia: 1 1 if any conflict, else 0, 98.7% of birthsKiribati: 0 1 if any conflict, else 0, 91.9% of birthsSt. Kitts and Nevis: 0 1 if any conflict, else 0, 100% of birthsKorea, Rep.: 0 1 if any conflict, else 0, 100% of birthsKuwait: 0 1 if any conflict, else 0, 99.9% of birthsLao PDR: 0 1 if any conflict, else 0, 64.4% of birthsLiberia: 0 1 if any conflict, else 0, 84.4% of birthsLibya: 0 1 if any conflict, else 0, 99.9% of birthsSt. Lucia: 0 1 if any conflict, else 0, 100% of birthsSri Lanka: 0 1 if any conflict, else 0, 99.5% of birthsLesotho: 0 1 if any conflict, else 0, 86.6% of birthsLithuania: 0 1 if any conflict, else 0, 100% of birthsLatvia: 0 1 if any conflict, else 0, 99.9% of birthsMorocco: 0 1 if any conflict, else 0, 86.6% of birthsMoldova: 0 1 if any conflict, else 0, 99.6% of birthsMadagascar: 0 1 if any conflict, else 0, 45.8% of birthsMaldives: 0 1 if any conflict, else 0, 99.5% of birthsMexico: 1 1 if any conflict, else 0, 96.6% of birthsMarshall Islands: 0 1 if any conflict, else 0, 92.4% of birthsNorth Macedonia: 0 1 if any conflict, else 0, 100% of birthsMali: 1 1 if any conflict, else 0, 67.3% of birthsMalta: 0 1 if any conflict, else 0, 99.8% of birthsMyanmar: 1 1 if any conflict, else 0, 60.2% of birthsMontenegro: 0 1 if any conflict, else 0, 98.8% of birthsMongolia: 0 1 if any conflict, else 0, 99.3% of birthsMozambique: 1 1 if any conflict, else 0, 73% of birthsMauritania: 0 1 if any conflict, else 0, 70.4% of birthsMauritius: 0 1 if any conflict, else 0, 99.7% of birthsMalawi: 0 1 if any conflict, else 0, 96.4% of birthsMalaysia: 0 1 if any conflict, else 0, 99.6% of birthsNamibia: 0 1 if any conflict, else 0, 88.2% of birthsNiger: 1 1 if any conflict, else 0, 43.7% of birthsNigeria: 1 1 if any conflict, else 0, 50.7% of birthsNicaragua: 0 1 if any conflict, else 0, 94.1% of birthsNorway: 0 1 if any conflict, else 0, 99.2% of birthsNepal: 0 1 if any conflict, else 0, 77.2% of birthsNew Zealand: 0 1 if any conflict, else 0, 96.5% of birthsOman: 0 1 if any conflict, else 0, 99.9% of birthsPakistan: 1 1 if any conflict, else 0, 68% of birthsPanama: 0 1 if any conflict, else 0, 95% of birthsPeru: 0 1 if any conflict, else 0, 94.9% of birthsPhilippines: 1 1 if any conflict, else 0, 84.4% of birthsPalau: 0 1 if any conflict, else 0, 97.2% of birthsPapua New Guinea: 1 1 if any conflict, else 0, 56.4% of birthsPoland: 0 1 if any conflict, else 0, 99.6% of birthsPortugal: 0 1 if any conflict, else 0, 98.6% of birthsParaguay: 0 1 if any conflict, else 0, 92.2% of birthsWest Bank and Gaza: 1 1 if any conflict, else 0, 99.7% of birthsQatar: 1 1 if any conflict, else 0, 100% of birthsRomania: 0 1 if any conflict, else 0, 93% of birthsRussian Federation: 1 1 if any conflict, else 0, 99.6% of birthsRwanda: 1 1 if any conflict, else 0, 94.2% of birthsSaudi Arabia: 1 1 if any conflict, else 0, 94.8% of birthsSudan: 1 1 if any conflict, else 0, 77.7% of birthsSenegal: 0 1 if any conflict, else 0, 74.5% of birthsSingapore: 0 1 if any conflict, else 0, 99.6% of birthsSolomon Islands: 0 1 if any conflict, else 0, 86.2% of birthsSierra Leone: 0 1 if any conflict, else 0, 86.9% of birthsEl Salvador: 0 1 if any conflict, else 0, 99.9% of birthsSomalia, Fed. Rep.: 1 1 if any conflict, else 0, 31.9% of birthsSerbia: 0 1 if any conflict, else 0, 99.9% of birthsSao Tome and Principe: 0 1 if any conflict, else 0, 96.8% of birthsSuriname: 0 1 if any conflict, else 0, 98.4% of birthsSlovak Republic: 0 1 if any conflict, else 0, 98% of birthsSlovenia: 0 1 if any conflict, else 0, 99.8% of birthsEswatini: 0 1 if any conflict, else 0, 88.3% of birthsSeychelles: 0 1 if any conflict, else 0, 99.5% of birthsChad: 1 1 if any conflict, else 0, 47.2% of birthsTogo: 1 1 if any conflict, else 0, 69.4% of birthsThailand: 1 1 if any conflict, else 0, 99.1% of birthsTajikistan: 0 1 if any conflict, else 0, 94.8% of birthsTurkmenistan: 0 1 if any conflict, else 0, 100% of birthsTimor-Leste: 0 1 if any conflict, else 0, 56.7% of birthsTonga: 0 1 if any conflict, else 0, 98.3% of birthsTrinidad and Tobago: 0 1 if any conflict, else 0, 100% of birthsTunisia: 0 1 if any conflict, else 0, 99.5% of birthsTurkiye: 1 1 if any conflict, else 0, 97% of birthsTuvalu: 0 1 if any conflict, else 0, 99.5% of birthsTanzania: 1 1 if any conflict, else 0, 63.5% of birthsUganda: 1 1 if any conflict, else 0, 74.2% of birthsUkraine: 1 1 if any conflict, else 0, 99.9% of birthsUruguay: 0 1 if any conflict, else 0, 100% of birthsUnited States: 0 1 if any conflict, else 0, 99.1% of birthsUzbekistan: 0 1 if any conflict, else 0, 99% of birthsSt. Vincent and the Grenadines: 0 1 if any conflict, else 0, 98.6% of birthsViet Nam: 0 1 if any conflict, else 0, 96.1% of birthsVanuatu: 0 1 if any conflict, else 0, 89.4% of birthsSamoa: 0 1 if any conflict, else 0, 88.9% of birthsKosovo: 0 1 if any conflict, else 0, 99% of birthsSouth Africa: 1 1 if any conflict, else 0, 96.7% of birthsZambia: 0 1 if any conflict, else 0, 80.4% of birthsZimbabwe: 0 1 if any conflict, else 0, 86% of birthsANDCAFDMAGINGNBGRDHTIMDGPSEQATSOMUKR

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted-0.4552.5e-10175
By rank (Spearman), not adjusted-0.4322.5e-9175
Standard (Pearson), adjusted for national income-0.2720.000175
By rank (Spearman), adjusted for national income-0.2420.001175

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 175 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.183 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from -0.296 (without MDG) to -0.253 (without AGO). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: MDG (-0.024).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific27-0.25
Europe & Central Asia44-0.01
Latin America & Caribbean31-0.35
Middle East, North Africa, Afghanistan & Pakistan19-0.32
Sub-Saharan Africa46-0.30

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third59-0.37
Middle third58-0.12
Richest third58-0.12

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians102-0.31
Muslims48-0.29

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France23+0.25
Never a European colony21-0.55
Spain19-0.14
United Kingdom61-0.59

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = -0.269 after dropping 18 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 33years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

Within countries over time, there is no link that is clearly more than chance (r = -0.054, comparing each country only with itself over the years, and each year only with the same year elsewhere). Whatever the cross-country picture shows, countries whose armed conflict present moved did not tend to see their skilled birth attendance move with it.

Across countries (adjusted)-0.272for comparison
Within countries-0.069each country vs itself
…and vs the same year elsewhere-0.054q = 0.292 · 167 countries
Year-on-year changes+0.034q = 0.454

2,819 country-years (one country in one year), 167 countries, 1990–2022, about 17 years each on average. Share of the variation that happens within countries over time: 42% for Armed conflict present, 13% for Skilled birth attendance. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.

Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.

With one measure years behind the other

0.20−0.2-100+10years Skilled birth attendance trails Armed conflict present →lag -10: r = 0.045 (n = 2,345)lag -9: r = 0.032 (n = 2,456)lag -8: r = 0.023 (n = 2,549)lag -7: r = 0.046 (n = 2,648)lag -6: r = -0.002 (n = 2,737)lag -5: r = 0.018 (n = 2,790)lag -4: r = -0.028 (n = 2,816)lag -3: r = -0.027 (n = 2,819)lag -2: r = -0.030 (n = 2,819)lag -1: r = -0.047 (n = 2,819)lag +0: r = -0.054 (n = 2,819)lag +1: r = -0.049 (n = 2,759)lag +2: r = -0.070 (n = 2,710)lag +3: r = -0.093 (n = 2,657)lag +4: r = -0.087 (n = 2,596)lag +5: r = -0.080 (n = 2,541)lag +6: r = -0.107 (n = 2,463)lag +7: r = -0.130 (n = 2,398)lag +8: r = -0.107 (n = 2,303)lag +9: r = -0.087 (n = 2,217)lag +10: r = -0.060 (n = 2,129)

Same year (lag 0): -0.054. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.

The largest value on this curve (-0.13 at lag +7) is higher than the same-year one by 0.08. That gap is not a finding. It is the largest of 21 closely related estimates, and picking the biggest of many tests always makes it look bigger. That is exactly why nothing on this site is ranked or chosen by lag.

The data


1 if any conflict, else 0
% of births		Years
South Africa ZAF196.7%2025, 2016
Ukraine UKR199.9%2025, 2014
Uganda UGA174.2%2025, 2016
Tanzania TZA163.5%2025, 2016
Turkiye TUR197%2025, 2019
Thailand THA199.1%2025, 2019
Togo TGO169.4%2025, 2017
Chad TCD147.2%2025, 2019
Somalia, Fed. Rep. SOM131.9%2025, 2019
Sudan SDN177.7%2025, 2014
Saudi Arabia SAU194.8%2025, 2019
Rwanda RWA194.2%2025, 2020
Russian Federation RUS199.6%2025, 2020
Qatar QAT1100%2025, 2019
West Bank and Gaza PSE199.7%2025, 2020

Uppsala Conflict Data Program, Georeferenced Event Dataset; rate per population from Our World in Data
World Bank, World Development Indicators

Sources

Armed conflict present

Whether an armed conflict is taking place in the country

Uppsala Conflict Data Program, Uppsala University · via Our World in Data · CC BY 4.0 · updated annual

One if any armed conflict took place on the country's territory that year, and zero if not. That makes it the site's first true yes-or-no measure. A link with a yes-or-no measure is a fair one: it compares the countries at war with the countries not at war. It answers a different question from the death rate: whether a country has a war at all, not how many people die. The two are treated as measuring the same thing, so their pair reads as two views of one thing, not as a finding. It is kept out of the crime score. A yes-or-no flag averaged into a combined score beside a rate would count the same conflicts twice.

Skilled birth attendance

Births attended by skilled health staff (% of total)

UNICEF and WHO · CC BY 4.0 · updated quarterly

Based on surveys, so a country reports it every few years rather than yearly.

How this was computed

Data used: most recent value in 2010-2025; values come from 2011–2025. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Armed conflict present and Skilled birth attendance

This page shows that two measures go together. It does not show that Armed conflict present changes Skilled birth attendance, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with Armed conflict present or Skilled birth attendance