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Associates of Neonatal, Infant and Child Mortality in the Islamic Republic of Pakistan: A Multilevel Analysis Using the 2012-2013 Demographic and Health Surveys.
- Source :
- Maternal & Child Health Journal; Feb2017, Vol. 21 Issue 2, p367-375, 9p, 2 Charts
- Publication Year :
- 2017
-
Abstract
- Objectives Pakistan is one of five nations contributing to half of the world's child mortality and holds under-five mortality rates which are nearly double global targets. Reasons for this shortfall include civil conflicts, political uncertainty, low education, poverty, rural-urban disparities, and limited health care access. The aim of this study was to explore associations between individual characteristics, community factors, and child mortality in Pakistan. Methods Data were derived from the 2012 to 2013 Pakistan Demographic and Health Survey, and included 7399 live births and 380 child deaths. Multivariate, multilevel logistic regression was used to model risk of neonatal, infant and under-five child deaths. Results Seventy-one percent of child deaths occurred during the neonatal period. Significant factors ( p < 0.05) associated with lower odds of child mortality included adhering to recommended minimum of 24 months interpregnancy interval and higher household wealth. These were significant for neonatal (OR 0.448; 0.871), infancy (OR 0.465; 0.881), and under-five deaths (OR 0.465; 0.879). Employed mothers had higher odds of neonatal (OR 1.479), infant (OR 1.506), and child mortality (OR 1.459). Likewise, women living in consanguineous marriages had higher odds of infant (OR 1.454) and under-five deaths (OR 1.381). Children in Balochistan, Punjab, and Sindh, regions disproportionately poor, rural with low levels of education, were at highest risk of dying. Conclusions for Practice Findings may assist in designing targeted interventions, developing appropriate public health messaging, and implementing policies designed to lower child mortality. Focusing on lowering rates of maternal poverty, increasing opportunities for education, and improving access to health care could assist in reducing child mortality in Pakistan. [ABSTRACT FROM AUTHOR]
- Subjects :
- BIRTH intervals
BIRTH order
CHILD mortality
CONCEPTUAL structures
EMPLOYMENT
INFANT mortality
MARITAL status
MATHEMATICAL models
MOTHERS
MULTIVARIATE analysis
POVERTY
PRENATAL care
PROBABILITY theory
QUESTIONNAIRES
STATISTICAL sampling
SURVEYS
MATHEMATICAL variables
LOGISTIC regression analysis
SAMPLE size (Statistics)
THEORY
EDUCATIONAL attainment
DATA analysis software
ODDS ratio
Subjects
Details
- Language :
- English
- ISSN :
- 10927875
- Volume :
- 21
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Maternal & Child Health Journal
- Publication Type :
- Academic Journal
- Accession number :
- 121083438
- Full Text :
- https://doi.org/10.1007/s10995-016-2121-y