Zoya Ahmed, Asifa Kamal, Asma Kamal.
Determinants of Child Mortality in Pakistan: Cox Proportional Hazard Model Analysis for PDHS (2006-07) and PDHS (2012-13).
Pak Paed J Jan ;40(1):47-53.

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.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com