SOCIOECONOMIC DETERMINANTS OF INFANT AND UNDER-FIVE MORTALITY RATES IN PAKISTAN: A PROVINCIAL/AREA COMPARISON USING MULTIPLE INDICATOR CLUSTER SURVEY (MICS6) DATA

Abstract

Some indicators that reflect the population's health are used for measuring infant mortality rate (IMR) and under-five mortality rate (UFMR), which incorporate the impact of maternal health, newborn care, nutrition, socioeconomic factors, and performance of health care systems. However, although there have been some improvements in child survival in Pakistan yet there are large regional and socioeconomic disparities. This study focuses on interprovincial and socioeconomic inequalities in infant and under-five mortality rates for the provinces/areas of Punjab, Sindh, Khyber Pakhtunkhwa (KP), Balochistan, Azad Jammu and Kashmir (AJ&K) and Gilgit-Baltistan (GB), with data from the most recent Multiple Indicator Cluster Surveys (MICS) available. Mortality differentials by geographical residence, level of maternal education and wealth status of the household were analyzed using a comparative descriptive methodology. The results show significant regional differences in early childhood mortality outcomes. The highest burden of mortality against1000 live births is seen in Punjab (IMR 60 & UFMR 69), followed by AJ&K (IMR 51 & UFMR 59), Balochistan (IMR 48 & UFMR 53), GB (IMR 43 & UFMR 50), Sindh (IMR 39 & UFMR 46) and KP (IMR 35 & UFMR 39). Analysis shows high socioeconomic disparities: children from poorer households and children of mothers with low education levels are at higher risk of dying. Rural residents typically also have higher death rates, because they have less access to health care, face geographic challenges, and experience inequities in provision of maternal and child health services. The study finds that regional disadvantage, socioeconomic inequality, maternal education, and healthcare availability interact in complex ways to affect early childhood mortality in Pakistan. It suggests region-specific child survival interventions that target maternal education, equity in health outcomes related to poverty, health services for neonates and mothers, and expanding access to health services for rural and underserved populations.