Determinants of neonatal and post-neonatal mortality in Pakistan

Abstract

Using data from the Demographic and Health Survey conducted in Pakistan in 1991, this paper examines how the socioeconomic factors affect child survival through environmental, demographic, nutritional, and health care factors. The findings do not fully support the hypothesis that socioeconomic factors affect child survival through the proximate determinants, as proposed by Mosley and Chen's (1984) framework; rather they also have their independent and direct effect in improving child survival in Pakistan. However, the proximate determinants have stronger influence on neonatal and post-neonatal mortality than do the socioeconomic factors. Among the socioeconomic factors, the father's education has a stronger effect on post-neonatal mortality as compared to the mother's education. However, the mother's education does have an effect on improving child survival in rural areas. The preceding birth interval and the survival status of the older siblings are the most important demographic determinants of neonatal and post-neonatal mortality. The survival of children improves significantly when the mothers with shorter birth intervals and women living in rural areas attend prenatal care services. The analysis documented a disturbing picture of mortality among children in underprivileged segments of the population. On the basis of the results, paper suggests that the rise in parental education, improvements in the quality of water supply, and motivation of mothers to utilise the health services for prenatal and post-natal care including immunisation are the most important steps to be taken to improve the neonatal and post-neonatal mortality in Pakistan.