Violent Conflict, Insecurity and Access to Healthcare: Insights from the Sahel Region
1
Department of Political Studies, University of Saskatchewan, Saskatoon, Canada
2
Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
The Sahelian crisis has undermined the ability of millions of people to access healthcare. While the health impacts on refugees, internally displaced people and the role of humanitarian organizations in the conflict-health nexus are well documented, there is little research on how conflicts shape non-displaced populations’ access to healthcare. To what extent can non-displaced communities access healthcare in conflict-afflicted areas? How have civil society and governmental actors responded to address healthcare gaps in conflict zones? Which socio-political dynamics shape the ability of different groups to access healthcare in insecure regions?
METHODS:
This paper examines these questions through a comparative analysis of the conflict-health nexus in Burkina Faso, Mali and Niger. The analysis is informed by the literature on the current Sahelian crisis and conflict-health dynamics more broadly. We employ the Levesque et al. (2013) conceptual framework on ‘access’ to structure our analysis. We also draw upon extensive insights from fieldwork conducted in 2024-2025 in the countries’ capital cities (Bamako, Niamey, Ouagadougou) and numerous conflict-wracked regions (Diffa, Macina, Niono, Nord, Sahel, Tillabéry). This includes over 150 semi-directed interviews and focus groups with key stakeholders such as healthcare workers, pregnant women, traditional authorities, government officials, NGOs, and security experts.
RESULTS:
Alongside the direct interventions of jihadist and other state and non-state armed groups, ethnic tensions, land tenure disputes and pastoralist-farmer conflicts contribute to worsening the state of insecurity and compound the challenges around healthcare provision and healthcare seeking. Though limited, novel innovations have emerged to address new conflict-related healthcare challenges. These include the creation of local security agreements, healthcare worker attempts to remain politically neutral, and the use of mobile clinics to reach vulnerable populations.
CONCLUSIONS:
The paper contributes to ongoing debates in global health and conflict studies and generates novel insights on how conflict shapes non-displaced populations’ access to healthcare.
The Sahelian crisis has undermined the ability of millions of people to access healthcare. While the health impacts on refugees, internally displaced people and the role of humanitarian organizations in the conflict-health nexus are well documented, there is little research on how conflicts shape non-displaced populations’ access to healthcare. To what extent can non-displaced communities access healthcare in conflict-afflicted areas? How have civil society and governmental actors responded to address healthcare gaps in conflict zones? Which socio-political dynamics shape the ability of different groups to access healthcare in insecure regions?
METHODS:
This paper examines these questions through a comparative analysis of the conflict-health nexus in Burkina Faso, Mali and Niger. The analysis is informed by the literature on the current Sahelian crisis and conflict-health dynamics more broadly. We employ the Levesque et al. (2013) conceptual framework on ‘access’ to structure our analysis. We also draw upon extensive insights from fieldwork conducted in 2024-2025 in the countries’ capital cities (Bamako, Niamey, Ouagadougou) and numerous conflict-wracked regions (Diffa, Macina, Niono, Nord, Sahel, Tillabéry). This includes over 150 semi-directed interviews and focus groups with key stakeholders such as healthcare workers, pregnant women, traditional authorities, government officials, NGOs, and security experts.
RESULTS:
Alongside the direct interventions of jihadist and other state and non-state armed groups, ethnic tensions, land tenure disputes and pastoralist-farmer conflicts contribute to worsening the state of insecurity and compound the challenges around healthcare provision and healthcare seeking. Though limited, novel innovations have emerged to address new conflict-related healthcare challenges. These include the creation of local security agreements, healthcare worker attempts to remain politically neutral, and the use of mobile clinics to reach vulnerable populations.
CONCLUSIONS:
The paper contributes to ongoing debates in global health and conflict studies and generates novel insights on how conflict shapes non-displaced populations’ access to healthcare.
| eISSN: | 2654-1459 |
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