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Ethnic Violence and Birth Outcomes: Evidence From Exposure to the 1992 Conflict in Kenya

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Demography

Abstract

This study is an examination of the effect of intrauterine exposure to electoral violence on child birth weight, an outcome that has long-term effects on an individual’s education, income, and health in later life. We consider the electoral violence that resulted from the introduction of multiparty democracy in Kenya as an exogenous source of shock, using a difference-in-differences method and a mother fixed-effects model. We find that prenatal exposure to the violence increased the probabilities of low birth weight and a child being of very small size at birth by 19 and 6 percentage points, respectively. Violence exposure in the first trimester of pregnancy decreased birth weight by 271 grams and increased the probabilities of low birth weight and very small size at birth by 18 and 4 percentage points, respectively. The results reaffirm the significance of the nine months in utero as one of the most critical periods in life that shapes future health, economic, and educational trajectories.

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Notes

  1. Prenatal shocks analyzed in relation to birth outcomes are the September 11, 2001, terrorist attack in New York City (Eskenazi et al. 2007); terrorist attacks in Colombia (Camacho 2008) and in Spain (Quintana-Domeque and Ródenas-Serrano 2017); homicides in rural Brazil (Foureaux Koppensteiner and Manacorda 2016); the Guatemalan civil war (Chamarbagwala and Morán 2011); the Mexican drug war (Brown 2018); 1999–2007 massacres in Columbia (Duque 2017); the al-Aqsa intifada in Jerusalem (Mansour and Rees 2012); and Germans exposed to WWII in utero and during early childhood (Akbulut-Yuksel 2017; Akbulut-Yuksel and Yuksel 2017).

  2. According to the African Electoral Violence Database, 60% of elections in SSA from 1990 to 2008 had violent intimidations. These include the 1992 election–related violence in Angola, which metamorphosed into a 10-year civil war with thousands of deaths; about 1,500 deaths in the 1992 Kenya elections; the 2005 election in Ethiopia leading to about 200 deaths; the 2007/2008 Kenyan elections leading to about 1,500 deaths; the 2010 elections in Ivory Coast leading to about 3,000 deaths; and 800 deaths in the 2011 elections in Nigeria (Isola 2018).

  3. The exception is Bell et al. (2012), who investigated the impact of the 2007 post-election violence in Kenya on birth weight. Their study, however, has methodological limitations.

  4. The 1992 violence lasted from October 1991 through the December 1992 elections and beyond throughout 1993. The districts with intense violent incidences were Nakuru, Kericho, Nandi, and Uasin Gishu in the Rift Valley region (Kimenyi and Ndung’u 2005).

  5. The 2007 elections resulted in ethnic violence in Kenya. The differences from the 1993 election violence were in the timing and cause of violence. The 2007 violence occurred after the election results were announced and hence was a protestation against the alleged rigging of the results.

  6. Although KDHS 1993 data contain the information on survey enumeration (primary sampling unit, PSU) and province where each household resides, GPS coordinates were not collected in the survey. We obtained names of districts for each stratum code from local DHS offices, which allows us to identify affected districts and to merge the data with UCDP data. We failed to obtain names of the sublocation for each PSU code.

  7. We use the variable years lived in the current residence for identifying the location at the time of the violence. Because the ethnic violence started in October 1991 and the survey was conducted in July 1993, we consider women who had lived for more than two years in the affected district as having been exposed to the violence, and we consider their children who were born during the violent period to have been affected by the violence. From the data set, 94% of the respondents answered that they had lived in the same residence for more than two years, with 61% having always lived in the same district.

  8. DHS data do not contain information on the gestational stage of birth. We therefore assume a nine-month gestation period for identifying the timing of the in utero exposure.

  9. We acknowledge that is it difficult to determine the exact time of conception using DHS data. One caveat to creating a three-month window of gestational age is that gestational age at birth could be shorter than nine months for premature labor. Therefore, we also conduct analyses by using a more general indicator “early” versus “mid-/late” pregnancy. The results are similar to those based on trimesters.

  10. A question of the size of a child at birth is chosen from these sizes: very large, large, average, small, very small, or does not know.

  11. We do not conduct our analysis using recent data because subsequent incidences of violence were predictable given that Kenyans vote along ethnic lines, making identification of the effect of violence on children’s birth outcomes difficult.

  12. We acknowledge that district-level exposure may not be a precise measure of the physical violence that households face. We cannot create more precise exposure measure with the data available. However, our exposure measures are more precise than those of other studies (e.g., Akresh et al. 2011, 2012b), which used region- and province-level measures.

  13. Exposure to a landmine explosion in the residential municipality during the second trimester of the pregnancy in Colombia decreased birth weight by 8 grams (Camacho 2008), whereas additional fatality from al-Aqsa Intifada during the first trimester of the pregnancy in the district decreased birth weight by 33 grams (Mansour and Rees 2012). Additionally, a study from Mexico showed that homicide in municipalities during the first trimester of the pregnancy decreased birth weight by 42 grams (Brown 2018).

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Acknowledgments

We thank Koichi Ushijima, Eizo Akiyama, Yoshifumi Konishi, Naoko Kaida, Alberto Iniguez Montiel, and Takahiro Tsujimoto; participants in Hitotsubashi Summer Institute, Japanese Economics Association Meeting, and Center for the Study of African Economies (CSAE), Oxford University for their valuable comments; and Thomas Mayers for English editing service.

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Authors and Affiliations

  1. Graduate School of Systems and Information Engineering, University of Tsukuba, Tsukuba, Japan

    Fredah Guantai

  2. National Graduate Institute for Policy Studies (GRIPS), 7-22-1 Roppongi, Minato-ku, Tokyo, 106-8677, Japan

    Yoko Kijima

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Correspondence to Yoko Kijima.

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Guantai, F., Kijima, Y. Ethnic Violence and Birth Outcomes: Evidence From Exposure to the 1992 Conflict in Kenya. Demography 57, 423–444 (2020). https://doi.org/10.1007/s13524-020-00864-w

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