Differentials and determinants of neonatal mortality in Pakistan: A cross sectional analysis; Pakistan Demographic and Health Survey (2017-18).

Abstract

To investigate differentials and determinants of neonatal mortality in Pakistan. The cross-sectional data-based study was conducted at Lahore College for Women University, Lahore, Pakistan from February to July 2019, and comprised data obtained from the Pakistan Demographic and Health Survey 2017-18 which related to the period from November 22, 2017, to April 30, 2018. Neonatal mortality rates were computed to observe the differentials in relation to various categories of socio-demographic factors. Cox proportional hazard model was used to identify significant factors affecting neonatal mortality. Hazard of neonatal mortality significantly decreased as household size increased (hazard ratio: 0.41 and 0.36). Household with improved toilet facility had significantly lower chances (hazard ratio: 0.57) of neonatal death compared to that with unimproved toilet facility. Significantly elevated risk (hazard ratio: 5.56) of neonate death was observed in case of multiple births. Children had better chances (hazard ratio: 0.32 and 0.34) of surviving in neonatal period as duration of birth spacing increased (24-35 months; 36 or more months). Household size, improved toilet facilities, multiple births and preceding birth intervals had significant effect on neonatal mortality.