تلخیص
Objectives: To identify the significant determinants of child mortality in
Pakistan on the basis of Pakistan Demographic and Health Surveys (PDHS
2006-07, PDHS 2012-13).
Methods: Children born from one to five years preceding the survey were
chosen from PDHS (2006-07; 2012-13). Log Rank Test is used to test
equality of survival time between the categories of a factor. Effect of
factors and covariates on child survival is studied through Cox
Proportional Hazard Model.
Results: Wealth index, family size and duration of breastfeeding are
significantly contributing to child mortality for PDHS (2006-07). Hazard
Ratio of child mortality for poorest wealth index as compared to richest is
highest 3.179 (90% Confidence Interval (CI) 1.980% to 5.105%). Hazard
Ratios for family size 1-6 and 7-12 as compared to family size 13+ are
1.664 (90% CI 1.166% to 2.375%) and 1.238 (90% CI 0.885% to 1.732%)
respectively. Duration of breastfeeding has Hazard Ratio 0.948 (90% CI
0.901% to 0.999%).
According to PDHS (2012-13), region, education of mother, preceding
birth interval and duration of breastfeeding are significantly affecting
child mortality. A hazard ratio for child mortality is highest for Balochistan
8.910 (90% CI 3.053% to 25.995%). Hazard Ratio turns lower with an
increase of mother’s educational level (no education to secondary) i.e.
from 3.328 (90% CI 1.174% to 9.424%) to1.268 (90% CI 0.402% to 3.996%).
Hazard ratio is 2.993 (90% CI 2.160% to 4.144%) if preceding birth interval is
< 24 months. Duration of breastfeeding has Hazard Ratio less than one
i.e. 0.227 (90% CI 0.135% to 0.381%).
Conclusion: Poverty, illiteracy, short birth interval are significant risk
factors of child mortality in Pakistan. Duration of breastfeeding is the
common significant protective factor affecting child mortality in both
surveys.
Zoya Ahmed, Asifa Kamal, Asma Kamal. (2016) Determinants of Child Mortality in Pakistan: Cox Proportional Hazard Model Analysis for PDHS (2006-07) and PDHS (2012-13), Pakistan Pediatric Journal, Volume 40, Issue 1.
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