Determinants of child survival, health care seeking and nutritional status in a rural district of Pakistan

Abstract

Abstract This thesis examines associations between (i) under-five deaths and poor maternal health; (ii) child health care and gender and (iii) childb s nutritional status and gender. It also assesses impact of new WHO growth standard on nutritional assessment. In Thatta district of Pakistan, poor maternal health was associated with 87% significantly greater mortality risk (95% C.I. = 1.18, 2.95). In a two-level model, gender was not a significant predictor of illness reporting, visit to health facilities, choice of provider, hospitalization and health expenditure. Girls had 18% and 14% lesser risk of stunting [P.R. (95% C.I.) = 1.18 (1.03, 1.36)] and under-weight [P.R. (95% C.I.) = 1.14 (1.03, 1.26)], respectively than boys. Prevalence of stunting and wasting increased by 18% and 46% respectively with WHO standard compared to NCHS reference. Recommendations include integrating maternal health in child survival, introduction of the WHO standard for nutritional assessment and gender sensitive approach in nutritional programmes.