No evidence of association between armed conflict and neonatal mortality or delivery by a skilled birth attendant was found. The long-term impacts of war were demonstrated by associated increases in maternal mortality observed for up to 7 years, in under-5 mortality for 3–5 years, in infant mortality for up to 8 years, in DPT vaccination coverage for up to 3 years, and in measles vaccination coverage for up to 2 years. In adjusted models, conflicts classified as wars were associated with an increase in maternal mortality of 36.9 maternal deaths per 100,000 live births (95% CI 1.9–72.0 0.3 million excess deaths over the study period), an increase in infant mortality of 2.8 per 1,000 live births (95% CI 0.1–5.5 2.0 million excess deaths ), a decrease in DPT vaccination coverage of 4.9% (95% CI 1.5%–8.3%), and a decrease in measles vaccination coverage of 7.3% (95% CI 2.7%–11.8%). Out of 3,718 country–year observations, 522 (14.0%) had minor conflicts and 148 (4.0%) had wars. The number of excess deaths due to conflict was estimated. Further lagged associations up to 10 years post-conflict were tested. Models were adjusted for 10 confounders, country and year fixed effects, and conflict lagged by 1 year. Secondary outcomes were delivery by a skilled birth attendant and diphtheria, pertussis, and tetanus (DPT) and measles vaccination coverage. Primary outcomes were maternal, under-5, infant, and neonatal mortality rates. Data for 181 countries (2000–2019) from the Uppsala Conflict Data Program and World Bank were analysed using panel regression models.

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