Characterizing Social Determinants of Maternal and Child Health: A Qualitative Community Health Needs Assessment in Underserved Areas.

Abstract

This study aimed to identify social determinants of maternal and child health (SDoH) in Pakistan. Using a qualitative study design, data were collected from community members in seven underserved areas of Lahore City, Pakistan. A total of 22 qualitative in-depth interviews and 10 focus group discussions (FGDs) were conducted. The participants included basic health unit healthcare staff, women of reproductive ages, male family members, mothers-in-law, and religious leaders. We found that maternal and child health is adversely affected by the following socioeconomic and environmental barriers: (i) poor housing quality and sanitation; (ii) inadequate food supply and safety; (iii) unsatisfactory public sector school services; (iv) a lack of safety and security; (v) scarce poverty alleviation efforts and loan schemes; (vi) unsatisfactory transport and internet services; and (vii) inadequate health services. The targets for maternal and child health in Pakistan cannot be met without close coordination between the primary health sector, local governance, and macro state structures, which collectively must monitor and improve housing adequacy, food security, public sector services (primary healthcare services, public schooling, public transport, and public internet access), overall safety, and poverty emergence.