Correlates of child mortality in Pakistan: a hazards model analysis

Area of Science:

• Public Health
• Demography
• Medical Anthropology

Background:

• Child mortality remains a significant public health concern in urban Pakistan.
• Socioeconomic status is often considered a primary determinant of child mortality.
• Understanding non-economic factors is crucial for targeted interventions.

Purpose of the Study:

• To investigate factors associated with child mortality in Rawalpindi, Pakistan.
• To examine the mechanisms linking child mortality to its covariates, controlling for socioeconomic status.
• To identify significant non-economic correlates of child mortality in a lower-income urban setting.

Main Methods:

• Demographic and anthropological research methods were employed.
• A proportional hazards model was utilized for analysis.
• The study focused on 1301 index children in a lower-income stratum with homogeneous access to facilities.

Main Results:

• Non-economic factors, particularly maternal health-seeking behavior, were significantly related to child mortality.
• The cultural norm of large family size emerged as the most significant correlate of child mortality.
• Other significant correlates included contraceptive use, maternal age, age at marriage, and household hygiene.

Conclusions:

• Cultural norms and maternal behaviors are critical determinants of child mortality, even within a controlled socioeconomic environment.
• Familial clustering of child mortality by birth order was strongly evidenced.
• Interventions should address cultural practices and improve maternal health-seeking behaviors to reduce child mortality.