WITHDRAWN: Spatial Effects of Internal and External Conflicts on Regional Maternal Mortality

Abstract Background: The high maternal mortality rates in African and Middle Eastern countries motivated the present study to explore the causes of such a phenomenon from a broader perspective. Extensive internal and external conflicts, including war and cross-border, foreign pressures, civil war, terrorism, and civil disorder conflicts, are the dominant feature of these countries. Therefore, this paper aims to elicit the influential factors in maternal mortality in the Middle East and Africa, with a special emphasis on the contribution of internal and external conflicts. Methods: This study investigates data from 46 Asian and African countries from 2011 to 2017 on the regional effects of such conflicts on maternal mortality using spatial models. Results: According to the results, the model control variables, except for trade openness, were found to have significant effects on the maternal mortality rate. Economic growth and natural resource rents through the expansion of health services showed significant effects on mortality reduction. In addition, the expansion of urbanization has led to an increase in maternal mortality rates. Also, most internal and external conflicts lead to a decrease in the production orientation towards health services, increasing maternal mortality rates, while war and cross-border have quite opposite effects. Conclusions: The expansion of health services during the emergence of such conflicts reduces the maternal mortality rate. According to the results, conflicts such as war, foreign pressures, and terrorism in neighboring countries lead to increased mortality rates in the country of origin, suggesting that regional conflicts can have spillover effects on the regional extensions of maternal mortality rates.