Assessing neo-natal mortality trends in Pakistan: an insight using equity lens

Zainab Dawood,Naeem Majeed

doi:10.1186/s13690-021-00767-1

Abstract

BackgroundAlmost 2.5 million neonates died in the first year of life in the year 2017. These account for almost half of the total deaths of children under the age of 5 years. Overall, child mortality has declined over the past two decades. Comparatively, the pace of decline in neonatal mortality has remained much slow. Significant inequalities in health across several dimensions – including wealth, ethnicity, and geography – continue to exist both between and within countries, and these contribute to neonatal mortality. This study aims to quantify the magnitude of inequalities in neonatal mortality trends by wealth quintile and place of residence with province wise segregation.MethodsThe study was done using raw data from the last three Pakistan Demographic & Health Surveys (2017–18, 2012–13 and 2006–07). The concentration curves were drawn in Microsoft Excel 365 using scatter plot as graph type while the frequencies were calculated using SPSS 24.ResultsThe situation of inequity across provinces and in rural vs urban areas has slightly declined, however, gross inequities continue to exist.ConclusionsPresentation of outcomes data, such as neonatal mortality in various wealth quintiles is an effective way to highlight the inequities amongst income groups as it highlights the vulnerable and at-risk groups. In other countries, rural-urban distribution, or ethnic groups may also reflect similar differences and help in identifying high-risk groups.

Highlights

Almost 2.5 million neonates died in the first year of life in the year 2017
The data analysis revealed that out of the total births observed in the sample for 2006–07 Pakistan Demographic & Health Surveys (PDHS), 54% were from Punjab, 25% from Sindh, 16% from Khyber Pakhtunkhwa (KP) and 5% from Balochistan
When we compare the concentration index for neonatal deaths by wealth quintile for Pakistan (Fig. 1), there was an overall decrease from − 0.247 to − 0.1271 from

Summary

Introduction

Almost 2.5 million neonates died in the first year of life in the year 2017. These account for almost half of the total deaths of children under the age of 5 years. The overall under five child mortality has declined over the past decade or so, the decline in the neonatal mortality has not been at the same pace, according to the United Nations’ Interagency Group for Child Mortality Estimation (UNIGME) [2]. This rise in the proportion of neonatal deaths was expected, as predicted in earlier studies which mentioned that the infant mortality rates are expected to decline due to widespread implementation of known and cost-effective interventions like vaccines for preventable diseases, and oral rehydration therapy for diarrhea. These interventions resulted in a decline in mortality beyond the neonatal period, thereby shifting the proportianate burden of mortality more towards neonatal deaths [3]

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Results

Conclusion