Authors : Maryam Yusuf Bayero; Bashir Abdulmumin

Volume/Issue : Volume 10 - 2025, Issue 12 - December

Google Scholar : https://tinyurl.com/nk9p6vet

Scribd : https://tinyurl.com/mrpxwkrh

DOI : https://doi.org/10.38124/ijisrt/25dec357

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background: Pastoralist communities in conflict-affected regions face significant barriers to healthcare access due to persistent insecurity, infrastructure destruction, and displacement. This study examined the impact of conflict on healthcare accessibility, outcomes, and delivery systems among pastoralist communities in Bokos Local Government Area (LGA), Plateau State, Nigeria.  Objective: To assess the multifaceted impact of conflict on healthcare access in pastoralist communities, focusing on healthcare accessibility, health outcomes (maternal and child health, vaccination coverage, chronic disease management), healthcare delivery system disruptions, and community coping mechanisms.  Methods: A mixed-methods concurrent triangulation design was employed. The study included 94 participants: 50 pastoralist community members through Google Forms questionnaires, 24 through Focus Group Discussions (FGDs), and 20 healthcare workers through Key Informant Interviews (KIIs). Participants were selected through purposive sampling with snowball technique for communities and purposive sampling for healthcare workers. Data were analyzed using Microsoft Excel for quantitative data with descriptive statistics, and thematic analysis for qualitative data.  Results: All participants (100%) had experienced conflict, with religious conflicts (79.7%) and farmer-herder conflicts (70.3%) being most prevalent. Fear of traveling due to insecurity was the primary barrier to healthcare access (90.5%). Healthcare facility utilization shifted from government hospitals (70.3% before conflict vs. 50.0% during/after conflict) to increased reliance on traditional healers (29.7% vs. 70.3%) and self-medication (20.3% vs. 79.7%). Maternal health outcomes were severely affected, with only 28.8% of women completing recommended antenatal care visits and 42.3% experiencing delivery complications. Child vaccination coverage was critically low, with only 20.3% fully vaccinated and 62.7% partially vaccinated. Chronic disease management was severely disrupted, affecting 59.5% of households. Healthcare system disruptions included 90.0% healthcare worker displacement, facility closures, and severe medical supply shortages (rated 8.2/10). Communities adopted various coping strategies including increased traditional medicine use (79.7%), self-medication (70.3%), and mobile phone consultations (40.5%). Healthcare workers implemented adaptive strategies including mobile clinics, community partnerships, and "hit-and-run" vaccination campaigns.  Conclusion: Conflict has severely compromised healthcare access for pastoralist communities in Bokos LGA, resulting in poor health outcomes and increased reliance on informal healthcare sources. While communities and healthcare workers have developed adaptive strategies, these are insufficient to meet healthcare needs. The study validates the Frustration- Aggression Theory's application to understanding how systemic exclusion contributes to cycles of conflict that further undermine healthcare access. Urgent interventions are needed including conflict-sensitive health policies, mobile health services expansion, technology-enabled solutions, and addressing root causes of conflict.

Keywords : Conflict, Healthcare Access, Pastoralist Communities, Maternal Health, Vaccination Coverage, Chronic Disease Management, Nigeria, Bokos LGA.

References :

1. Adebayo, A. (2023). Telemedicine in rural Nigeria: Opportunities and challenges. Journal of Health Technology, 15(3), 45-62.
2. Adepoju, A. (2021). Conflict and healthcare access in Northern Nigeria. African Health Sciences, 21(2), 134-145.
3. Adepoju, A., Ibrahim, M., & Yusuf, S. (2022). Healthcare disruption in conflict zones: Evidence from Nigeria. Global Health Action, 15(1), 2089456.
4. Ahmed, S., Mohammed, A., & Hassan, B. (2021). Healthcare access among marginalized populations in Nigeria. Public Health Reports, 136(4), 456-467.
5. Asah, N., & Moses, K. (2025). Armed conflict and healthcare delivery in Nigeria: A scoping review. Conflict and Health, 19(1), 12-28.
6. Asomba, C., &Ofodu, J. (2024). Frustration-aggression theory and pastoralist-farmer conflicts in Nigeria. Journal of Peace Studies, 31(2), 78-95.
7. Awojobi, O. N. (2019). The impact of conflict on health outcomes in Sub-Saharan Africa: A systematic review. African Journal of Health Sciences, 32(3), 123-145.
8. Awogbade, M. O. (1983). Fulani pastoralism: Jos case study. Ahmadu Bello University Press.
9. Chukwu, P., & Bello, A. (2022). Vaccination coverage in conflict-affected areas of Nigeria. Vaccine, 40(15), 2345-2352.
10. Chukwuma, E., & Eze, P. (2023). Traditional conflict resolution and pastoralist communities. African Studies Review, 66(1), 45-67.
11. Daniels, M., & Eriksson, L. (2025). Conflict intensity and health outcomes: A global analysis. The Lancet Global Health, 13(2), e234-e245.
12. Das, J., Woskie, L., Rajbhandari, R., Abbasi, K., & Jha, A. (2024). Interventions for improving healthcare delivery by informal providers in low- and middle-income countries. Cochrane Database of Systematic Reviews, 3, CD013786.
13. Etim, J., &Ukpere, W. (2023). Deconstructing the frustration-aggression theory: Civil society and conflict in Nigeria. African Journal of Political Science, 28(4), 112-128.
14. Eze, C., & Musa, D. (2023). Maternal health in conflict settings: Nigeria's experience. Maternal and Child Health Journal, 27(8), 1456-1467.
15. Gutema, B., Kaba, M., Birhanu, Z., Diribi, T., &Elemo, A. (2023). Impact of armed conflicts on public health infrastructure and services in Oromia, Ethiopia. Conflict and Health, 17(1), 23-38.
16. Ibrahim, A., & Okafor, C. (2024). Community health networks in conflict zones. Community Health Journal, 19(2), 89-104.
17. Ibrahim, M., & Yusuf, A. (2023). Pastoralism and health outcomes in Nigeria. Pastoralism: Research, Policy and Practice, 13(1), 15-29.
18. Jawad, M., Hone, T., Vamos, E. P., Cetorelli, V., Raine, R., Kossali, N., ... & 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.
19. JSTOR. (2023). Pastoralism and conflict in West Africa: Historical perspectives. Retrieved from https://www.jstor.org/stable/pastoralism-conflict
20. Kassah, B. L., Tindana, P., &Akweongo, P. (2022). Barriers to healthcare access among pastoralist populations: A mixed-methods study. International Journal for Equity in Health, 21(1), 45-62.
21. Kruglanski, A. W., Jasko, K., Webber, D., Chernikova, M., & Molinario, E. (2023). The making of violent extremists: A psychological perspective. Nature Reviews Psychology, 2(4), 243-257.
22. Nwankwo, B., & Salihu, A. (2023). Chronic disease management in conflict-affected populations. Global Health Research and Policy, 8(1), 12-25.
23. Okello, A. (2014). Pastoralist health systems in East Africa. Cambridge University Press.
24. Ojeleke, O., Pavlova, M., &Bonuedi, D. (2022). Effects of armed conflict on healthcare utilization in Northern Nigeria. Social Science & Medicine, 298, 114873.
25. Okonkwo, U., & Ibrahim, S. (2022). Healthcare access challenges in rural Nigeria. Rural Health Review, 18(3), 67-82.
26. Okonkwo, U., Mohammed, A., & Sani, B. (2023). Faith-based healthcare delivery in conflict zones. Journal of Religion and Health, 62(4), 1234-1251.
27. Okoli, A., &Atelhe, G. (2022). Beyond frustration-aggression: Understanding conflict dynamics in Nigeria. African Security Review, 31(3), 234-251.
28. World Health Organization. (2016). Global vaccine action plan 2011-2020: Review and lessons learned. WHO Press.
29. World Health Organization. (2025). Health in humanitarian emergencies: Annual report 2024. WHO Press.
30. Wulfan, S., Dordah, O., &Sumankuuro, J. (2022). Nomadic pastoralists' experiences in accessing reproductive and maternal healthcare services: A scoping review. Reproductive Health, 19(1), 78-95.
31. Yusuf, M., Abdullahi, S., & Mohammed, K. (2021). Maternal mortality in conflict-affected areas of Nigeria. Nigerian Medical Journal, 62(4), 234-245.