Description
Since 2012, the Sahelian region of West Africa has been embroiled in a protracted crisis. Aside from the political and economic toll caused by this state of insecurity, this volatile situation has undermined the ability of local communities to access health services. This paper examines the complex ways in which insecurity and local political dynamics intersect with the area of healthcare. More specifically, we explore how conflict dynamics shape local populations’ ability to access healthcare services in areas disproportionately affected by conflict. The analysis reveals how local level identity politics, struggles over authority, and threats to agrarian livelihoods contribute to shaping health outcomes in diverging ways in this conflict-wracked region. While the findings shed light on how recent political developments undermine the ability of local populations to access healthcare, they also fundamentally reveal the novel innovations that various actors have employed to provide ongoing healthcare in these insecure environments. The analysis is informed by the existing literature on the Sahelian crisis and the conflict-health nexus more broadly. However, we also draw upon extensive qualitative research conducted during fieldwork in Burkina Faso, Mali and Niger in 2024-2025. This includes crucial insights garnered from over 150 interviews and focus groups with key stakeholders such as healthcare workers, traditional authorities, government officials, NGOs, and security experts. The paper provides an important contribution to the literature on conflict and health as there is a limited body of scholarship on the politics around access to healthcare in ongoing zones of conflict.
