Claudio A. Mora-García , Mounu Prem , Paul Rodríguez-Lesmes , Juan F. Vargas
{"title":"冲突后卫生人力的重新分配:来自哥伦比亚的证据","authors":"Claudio A. Mora-García , Mounu Prem , Paul Rodríguez-Lesmes , Juan F. Vargas","doi":"10.1016/j.labeco.2025.102710","DOIUrl":null,"url":null,"abstract":"<div><div>While a large literature has studied the effects of violent conflict on health outcomes, little is known about how violence reduction can affect a key driver of post-conflict recovery, namely the quantity and type of healthcare workers. By leveraging a permanent ceasefire that ended over five decades of armed conflict between the Colombian government and the FARC insurgency, we study the extent to which conflict termination affected the share of different types of health workers in areas more exposed to FARC violence relative to other places. Based on administrative records on the location of all formal healthcare workers in Colombia and using a <em>difference-in-differences</em> strategy, we find that a municipality that experienced one standard deviation higher FARC violence intensity relative to the rest of the country witnessed 13.4% post-ceasefire differential decrease in the share of employed healthcare workers per 1,000 people. We find a stronger decrease among vocational nurses and a weaker decrease among physicians. We show that this effect is likely explained by lifting mobility restrictions in previously violent areas, and document that, because the net reduction in healthcare workers increased the within-municipality share of (higher-educated) physicians, it did not translate into a deterioration of mortality rates or healthcare service provision.</div></div>","PeriodicalId":48153,"journal":{"name":"Labour Economics","volume":"94 ","pages":"Article 102710"},"PeriodicalIF":2.2000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Health workforce reallocation in the aftermath of conflict: Evidence from Colombia\",\"authors\":\"Claudio A. Mora-García , Mounu Prem , Paul Rodríguez-Lesmes , Juan F. Vargas\",\"doi\":\"10.1016/j.labeco.2025.102710\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>While a large literature has studied the effects of violent conflict on health outcomes, little is known about how violence reduction can affect a key driver of post-conflict recovery, namely the quantity and type of healthcare workers. By leveraging a permanent ceasefire that ended over five decades of armed conflict between the Colombian government and the FARC insurgency, we study the extent to which conflict termination affected the share of different types of health workers in areas more exposed to FARC violence relative to other places. Based on administrative records on the location of all formal healthcare workers in Colombia and using a <em>difference-in-differences</em> strategy, we find that a municipality that experienced one standard deviation higher FARC violence intensity relative to the rest of the country witnessed 13.4% post-ceasefire differential decrease in the share of employed healthcare workers per 1,000 people. We find a stronger decrease among vocational nurses and a weaker decrease among physicians. We show that this effect is likely explained by lifting mobility restrictions in previously violent areas, and document that, because the net reduction in healthcare workers increased the within-municipality share of (higher-educated) physicians, it did not translate into a deterioration of mortality rates or healthcare service provision.</div></div>\",\"PeriodicalId\":48153,\"journal\":{\"name\":\"Labour Economics\",\"volume\":\"94 \",\"pages\":\"Article 102710\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-03-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Labour Economics\",\"FirstCategoryId\":\"96\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0927537125000375\",\"RegionNum\":2,\"RegionCategory\":\"经济学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Labour Economics","FirstCategoryId":"96","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0927537125000375","RegionNum":2,"RegionCategory":"经济学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
Health workforce reallocation in the aftermath of conflict: Evidence from Colombia
While a large literature has studied the effects of violent conflict on health outcomes, little is known about how violence reduction can affect a key driver of post-conflict recovery, namely the quantity and type of healthcare workers. By leveraging a permanent ceasefire that ended over five decades of armed conflict between the Colombian government and the FARC insurgency, we study the extent to which conflict termination affected the share of different types of health workers in areas more exposed to FARC violence relative to other places. Based on administrative records on the location of all formal healthcare workers in Colombia and using a difference-in-differences strategy, we find that a municipality that experienced one standard deviation higher FARC violence intensity relative to the rest of the country witnessed 13.4% post-ceasefire differential decrease in the share of employed healthcare workers per 1,000 people. We find a stronger decrease among vocational nurses and a weaker decrease among physicians. We show that this effect is likely explained by lifting mobility restrictions in previously violent areas, and document that, because the net reduction in healthcare workers increased the within-municipality share of (higher-educated) physicians, it did not translate into a deterioration of mortality rates or healthcare service provision.
期刊介绍:
Labour Economics is devoted to publishing research in the field of labour economics both on the microeconomic and on the macroeconomic level, in a balanced mix of theory, empirical testing and policy applications. It gives due recognition to analysis and explanation of institutional arrangements of national labour markets and the impact of these institutions on labour market outcomes.