The objective of the current study is to identify the risk factors for malnutrition among the age of under-five children’s in Pakistan. This is secondary data analysis for the data taken from Pakistan Demographic and Health Survey (PDHS 2017–18) and was analyzed by implementing quantile regression analysis. The sample size included 12,708 alive children in the study, for which the data collection period was from November 22, 2017, to April 30, 2018. The prevalence of malnutrition among boys is high (51.2%). Older age mother’s children have more prevalence of malnutrition (20.7%). A child born with small body size (underweight: Q0.25: − 0.625; Q0.50: − 0.623; Q0.75: − 0.426 and wasting: Q0.50: − 0.513); having uneducated mother (underweight: Q0.25: − 0.387; Q0.50: − 0.247; Q0.75: − 0.328), belonged to a poor household (underweight: Q0.50: − 0.251),residing in rural areas (underweight: Q0.25: − 0.443), not following properly breastfeeding practices (underweight: Q0.50: − 0.439; Q0.75: − 0.438) have negative effect on different measures of malnutrition and this effect is significantly raises across different quantiles of stunting , wasting and underweight (at p value < 0.01 and < 0.05). Older age mother (stunting: Q0.50: 0.777; Q0.75: 1.078; underweight Q0.20: 0.568; Q0.50: 0.429; Q0.75: 0.524) and higher birth order number (stunting: Q0.50: 0.415; Q0.75: 0.535), have a positive effect on three measures of under-nutrition and this effect is gradual raises at different quantile of stunting, wasting and underweight. Elder and smoker mothers were proved associated risk factors of both stunting and being underweight in Pakistan. Moreover, Proper breastfeeding practices, better economic status, average or above the average birth weight of the child, and milk consumption are found protective factors against stunting, wasting, and underweight children in Pakistan.
Purpose of the study: This research aims to investigate the impact of mass media exposure and women's autonomy on the use of contraceptives, along with other potential determinants at the individual level and community level among women in Pakistan. Methodology: Data was extracted from Pakistan Demographic & Health Surveys 2017-18. The sample size included 10,461 non-pregnant and married women from a total of 15,068 ever-married women. The analysis was done using two-level mixed-effects logistic regression for the binary outcome variable, i.e., current contraceptive use (yes/no). Main Findings: Significant factors positively associated with contraceptive use at the individual level were women's education, wealth index, parity, age at first cohabitation, child mortality experience, and mass media exposure. Community attributes like region (Sindh, KPK, Balochistan as compared to Punjab), residence (rural as compared to urban) had an inverse relationship with contraceptive use. At the same time, women's education and an ideal number of children were the significant positive associates. Women's empowerment has though insignificant, but it has a positive impact on the use of contraceptives at both individual and community levels. Applications of this study: Family planning programs can be extended by focusing on women residing in rural settings or in high fertility intentions communities, less educated and unprivileged younger women who had reduced the uptake of contraceptives. An increase in women's access to education, media exposure, employment, and women's empowerment can help attain Pakistan's contraceptive prevalence targets. Novelty/Originality of this study: The current study's effect of individual and community-level factors was investigated using National-level data, mainly focusing on the role of mass media and women's autonomy.
BackgroundEvery year, 2 million babies are stillborn in the world. Globally, there has been a decline in the stillbirth rate of 2%. Despite advancements in prenatal care and the implementation of new medical technologies, the incidence of early stillbirths remains unchanged. A slight decrease in the rate of late-term stillbirth has been observed. Pakistan ranked third in South Asia for having the highest stillbirth rate. Compared to its neighbors and other developing nations, Pakistan has shown a lack of progress in reducing maternal and neonatal fatalities. Therefore, the purpose of this study is to use a multivariate decomposition analysis to examine the trends and factors that have contributed to the change in the stillbirth rate over time.MethodsTo conduct this study, we used a secondary data analysis approach and analyzed data from the Pakistan Demographic and Health Survey (PDHS) of 2012–2013 and 2017–2018). For the analysis, a total sample of 15,068 births in 2017–2018 and 13,558 births in the PDHS from 2012 to 2013 were taken into account. Using the MVDCMP function within STATA version 15 statistical software, a logit-based multivariate decomposition model was fitted to determine the variables that influence the change in stillbirth. The current study used two cross-sectional surveys to identify important risk factors for stillbirths.ResultsOver the past 5 years, Pakistan's stillbirth rate has risen from 3.98 to 5.75%. According to the total multivariate decomposition analysis, the change in coefficient (change in the effect of attributes) accounted for 81.17% of the overall change in the proportion of stillbirths. In contrast, the change in endowment was not statistically significant. Changes in maternal education, individual and community-level wealth status, and mode of delivery all significantly impacted the rate of stillbirths over time.ConclusionStillbirths increased in Pakistan from 2012 to 2017. Stillbirths are observed more frequently for women residing in Punjab, Sindh, and rural areas. A major concern that is directly related to the prevalence of stillbirths in Pakistan is the lack of accessible, affordable, and high-quality maternal healthcare facilities. Older, overweight, and uneducated women are more likely to have stillbirths than women who deliver vaginally. High parity and short birth intervals also accelerated the rate of stillbirths. An effective remedy to control stillbirths is the provision of accessible and affordable healthcare services. Awareness campaigns for the health education of pregnant women should focus on raising awareness to support better pregnancy outcomes for poor women living in communities with higher education levels. The risk of stillbirth can be reduced by offering free diagnostics for early detection of birth complications in low-resource settings and referring these cases to knowledgeable gynecologists for safe delivery.
Abstract Objective: To investigate differentials and determinants of neonatal mortality in Pakistan. Methods: Study design was cross sectional. Data from Pakistan Demographic and Health Survey (PDHS 2017-18) was used. Data collection period for PDHS 2017-18 was from 22 November 2017 to 30 April 2018. Neonatal mortality rates (NMRs) were computed to observe the differentials in NMR for various categories of socio-demographic factors. Cox proportional hazard model was fitted to identify significant factors affecting neonatal mortality. Results: Hazard of neonatal mortality had significantly decreased as household size increased (HR 0.41 and HR 0.36). Household with improved toilet facility had significantly lower chances (HR 0.57) of neonatal death as compared to that with unimproved toilet facility. Significantly elevated risk (HR 5.56) of neonate death was observed in case of multiple births. Children had better chances (HR 0.32; HR 0.34) of surviving in neonatal period as duration of birth spacing increased (24-35 months; 36 or more months). Conclusion: Household size, improved toilet facilities, multiple births and preceding birth intervals were found to have significant effect on neonatal mortality. Significant protective factors of neonate deaths were large household size, improved toilet facilities, singleton births and long birth interval. Keywords: PDHS 2017-18, Neonatal Mortality Rate, Cox Proportional Hazard Model
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