Fear, accessibility, and legitimacy: An examination of the effects of political violence on health security in Pakistan

Abstract

How does political violence affect public health risks? While past research provides useful insights, it remains unclear how the effect of violence on health risks varies by perpetrator identity, target, and the intensity of attacks. We argue that indiscriminate attacks by militants will discourage civilians from accessing healthcare services. In contrast, clashes between militants and governments are likely to induce state actors to augment healthcare provision, while reinforced state control may facilitate civilians’ access. We test our arguments by employing multilevel modeling using subnational data on political violence events within Pakistan between 2005 and 2011, and immunization rates for under-5 infectious diseases.