Sindh Province Research Articles

Changes in the prevalence of hepatitis B and C viral infections in Sindh province, Pakistan: Findings from two sero-surveys in 2007 and 2019.

Pakistan harbours a large burden of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. We utilised repeat sero-surveys to assess progress achieved towards hepatitis elimination in Pakistan. Multilevel logistic regression evaluated the change in HBV infection (HBV surface antigen (HBsAg)-positive) prevalence and HCV exposure (HCV antibody (HCV-Ab)-positive) prevalence between two sero-surveys from 2007 and 2019 for Sindh province and associated risk factors. Adjusted odds ratios (aORs) were estimated and population-attributable fractions (PAF) for modifiable risk factors for HCV exposure. The 2007 and 2019 surveys included 8855 and 6672 individuals. HBsAg prevalence decreased from 2.6% (95% confidence intervals (95% CI): 2.2-2.9) in 2007 to 1.1% (95% CI: 0.8-1.3) in 2019, while HCV-Ab prevalence increased from 5.1% (95% CI: 4.6%-5.5%) to 6.2% (95% CI: 5.6%-6.8%). The age and gender-adjusted HBsAg prevalence decreased by 80% (aOR = 0.2, 95% CI: 0.1-0.4) among children and 60% (aOR = 0.4, 95% CI: 0.3-0.6) among adults over 2007-2019, while HCV-Ab prevalence decreased by 60% (aOR = 0.4, 95%CI:0.2-0.7) in children and increased by 40% (aOR = 1.4, 95% CI: 1.2-1.7) in adults. HCV-Ab prevalence was lower in adults with secondary (aOR = 0.6, 95% CI: 0.5-0.8) and higher (aOR = 0.5, 95%CI:0.3-0.8) education compared to illiterates and higher among adults reporting blood transfusion (aOR = 1.7, 95% CI: 1.2-2.4), family history of hepatitis (aOR = 2.5, 95% CI: 1.9-3.3), past year medical injection (aOR = 2.1, 95% CI: 1.6-2.7), being tattooed (aOR = 1.4, 95% CI: 1.0-1.9) and shaved by traditional barber (aOR = 1.2, 95% CI: 1.0-1.5). Modifiable risk factors accounted for 45% of HCV exposure, with medical injection(s) accounting for 38% (95%CI,25.7-48.4%). Overall HCV has increased over 2007-2019 in Sindh province, while HBV prevalence has decreased. Medical injections should be an important focus of prevention activities.

CORDEX Ensemble-based drought projections for Sindh Province of Pakistan under climate change

CORDEX Ensemble-based drought projections for Sindh Province of Pakistan under climate change

Impacts of Gender Disparity and Socio-Educational Structure on Legal Awareness of Women Inmates: A Case Study of Prisons in Sindh, Pakistan

The study is an endeavor to undertake an in-depth analysis of the prevailing injustices faced by women inmates incarcerated in one of the merged prisons(merger of 2 districts)of Sindh Province Pakistan. It aims to explore how social norms, education system, and gender discrimination, collectively influence the women inmates' legal awareness and struggles for availing their legal rights and equitable treatment. By employing a mixed-method research design, including in-depth interviews with women inmates, questionnaires, and an interview guide with open-ended questions, the study uncovered the multifaceted barriers they encounter. The study also advocates fostering a more inclusive and gender-responsive criminal justice system and concludes that the intersectional nature of these challenges impacts legal awareness of women inmates and also has some significant implications for stakeholders and reformists in the context of entertaining the female inmates without gender discrimination as ensuring Article-4 of the 1973 constitution of the Islamic Republic of Pakistan.

Evaluation of subsurface geothermal groundwater aquifers at Southern Kirthar Range Sindh province Pakistan through the application of vertical electrical sounding

Pakistan has significant geothermal potential but due to poor energy management and low utilization of rich geothermal energy, the country is ranked among the energy deficient nations in the world. In this study, integrated geophysical techniques were used to assess the geothermal energy potential of various hot springs in the Sindh province. The study revealed that Naing Shareef and Gaji Shah hot springs have remarkable potential for geothermal energy having pool water temperature of 43 °C and 45 °C, respectively. Geophysical resistivity survey was carried out at both Naing Shareef and Gaji Shah hot spring to determine depth, thickness and quality of thermal water. At Naing Shareef hot spring, only a single thermal aquifer zone has been pinpointed within the shale composition of the Oligocene Nari Formation, and it is on average 55.07 m depth and 29.8 m thick. At an average depth of 100.66 m and an aquifer thickness of 77.03 m, the Gaji Shah hot springs exclusively possess a thermal aquifer region established within the sandstone composition of the Oligocene Nari Formation.

Exploring the child marriage practices and their impact on women's lives in Pakistan: A qualitative analysis.

The study aimed to qualitatively explore the relationship between intimate partner violence and early marriage, focusing on the psychological and physical health issues faced by married women in rural Pakistan. Specifically, it investigated how resilience moderates the effects of early marriage, physical health problems, intimate partner abuse, and psychological issues. Using an intrinsic qualitative approach, the research involved interviews with 20 household heads, 62 husbands, and 40 wives in Sindh province. The findings indicated significant differences related to early marriage, intimate partner abuse, physical health issues, stress, anxiety, and depression. The results align with other South Asian studies, highlighting early marriage as a major risk factor for physical health issues and intimate partner violence. Additionally, the study underscores the widespread nature of violence as a social problem affecting married couples' health in Pakistan.

Assessment of Groundwater Quality and Hydrochemistry using Water Quality Index in District Mirpur Khas, Sindh, Pakistan

Groundwater is a major source of drinking water in the rural areas of Sindh province, including District Mirpur Khas of Pakistan. This study was undertaken to evaluate the suitability of groundwater in Mirpur Khas for drinking purposes. In October and November 2018, the groundwater samples were collected from 50 bore wells and analyzed 17 physico-chemical parameters. The pH ranged from 7.8 to 8.8, indicating the slightly alkaline nature of the water. The mean abundance of major cations is Na+ > Ca2+ > Mg2+ > K+ and for major anions, it is SO42– > Cl– > HCO3– > NO3– > F–. The hydrochemical facies of groundwater samples show that 29 have a mixed composition, Na+-K+-Cl– characterized by 17 and the remaining 4 fall into the Ca2+-Mg2+-HCO3– category. The water quality index (WQI) was calculated based on WHO standards for drinking water using 16 physico-chemical parameters. The computed WQI values range from 20.4 to 503.1. Out of the 50 samples, 9 are classified as ‘excellent,’ 21 as ‘good,’ 13 as ‘poor,’ 4 as ‘very poor,’ and 3 as ‘unsuitable for drinking.’ The average WQI value is 118.7 for 50 samples, which falls under the ‘good’ category. Turbidity and EC exhibited the highest mean effective weight values, indicating their significant influence on the WQI values.

The Impacts of Corporal Punishment on Students in Schools: An investigation through Sindh Province

The purpose of the study was to determine the effects of corporal punishment on students, with a particular focus on students in grades 9 and 10 at the chosen boys' schools in the Hyderabad area. The study also aimed to determine the nature, sorts, and effects of corporal punishment on students. Finding the social and other effects of physical punishment on the pupils in the aforementioned classrooms was the main goal of the study. This study is the first of its kind in Hyderabad district. There were 500 parents, instructors, and students in the sample overall. It was shown that physical punishment remained a barrier to the development of positive teacher-student relationships, character development, a decrease in the rate of dropouts, a discouragement of the learning environment, a negative opinion of teachers, and a decrease in students' enthusiasm in their studies. Furthermore, pupils' hostile attitudes and anxiousness were primarily brought on by corporal punishment, which also reduced their academic performance and caused psychological damage. The analysis suggests that physical punishment be outlawed and that the current legal framework be strictly enforced. Through training programs, teachers must be made aware of the detrimental effects of corporal punishment. The study goes on to say that in order for children to engage in healthy extracurricular activities and create a learning environment for themselves, there needs to be a supportive school environment.

Climate change impact on water scarcity in the Hub River Basin, Pakistan

The Hub River Basin (HRB), a critical transboundary water source for Sindh and Baluchistan provinces in Pakistan, may face worsening water scarcity due to climate change and population growth. This study aims to assess the current state of water scarcity in the HRB and assesses its vulnerability to these pressures in future. To evaluate the baseline water scarcity in the HRB, a calibrated and validated Soil and Water Assessment Tool (SWAT) was established. Five General Circulation Models (GCMs) were employed to project the future climate under Representative Concentration Pathways (RCP 4.5 and 8.5) for the HRB. Sector-specific indicators were also used to assess the temporal and altitudinal sensitivity of the basin to climate change. These climate projections were incorporated in the SWAT model to simulate flows for three different periods: Early Future (EF; 2010–2039), Mid Future (MF; 2040–2069), and Far Future (FF; 2070–2099). The SWAT model results indicate significant increase in mean flows simulated by SWAT, ranging from 15.27 to 52.78 m3/s under RCP 4.5 and RCP 8.5 compared to baseline flows at HRB. Additionally, the study examines the temporal variation in basin stress and scarcity levels using Falkenmark and Water scarcity indicators. The findings indicate a general decrease in the basin's stress and scarcity levels, potentially benefiting water users of the HRB, especially under RCP8.5. This study offers crucial insights for shaping policies and strategies to adapt to climate change and population growth, ultimately aiming to minimize their impacts on HRB's water resources. By informing water managers and promoting sustainable water management practices, this research can help prevent future conflicts over water allocation and infrastructure development linked with the HRB.

Impact of Hybrid Varieties on the Productivity of Rice Cultivation: The Case of Sindh, Pakistan

Agriculture is a very important sector and crucial for poverty reduction and employment generation. The use of hybrid seeds leading to increased yield of crops and farmers’ income has been widely discussed in the literature. Through this study, an effort has been made to identify factors that impact obtaining high crop yield of rice by using the hybrid varieties. This study focuses on the use of hybrid varieties in the rice crop and presents a comparison in yield with the traditional open-pollinated varieties. The plot level information collected from eight major rice-producing districts of Sindh province of Pakistan was used to conduct this study and a propensity score matching technique was used to estimate the results of the study by using plot level variation between hybrid varieties and open-pollinated varieties. The results of the study showed significant improvement in rice yield with the adoption of hybrid rice varieties in the study area. This study highlights that the farmers have achieved a higher average yield of rice by using hybrid seeds as compared to open-pollinated varieties. Besides the crop yield, the overall income and profit of farmers have also increased by using hybrid seeds in the Sindh province. The study illustrates different interesting patterns relating to different characteristics of the household cultivating rice crops, different plot-level characteristics, and their comparison with hybrid and traditional varieties.

A nexus among high performance work systems, employee engagement, perspective-taking, trust in leader and organisational innovation: an insight from developing country

PurposeThe purpose of this research is to examine the relationship between high- performance work systems (HPWS) and organisational innovation in hospital settings, examining the role of employee engagement as a mediator in this relationship. Additionally, the study aims to investigate the moderating role of perspective-taking between HPWS and employee engagement as well as the moderating effect of trust in leader on the connection between employee engagement and organisational innovation.Design/methodology/approachA quantitative-deductive causal method, along with a cross-sectional approach, was utilized. Structural equation modelling was applied to analyse data from a sample of 530 doctors employed in hospitals, practicing human resources management in the public and private sectors of Sindh province, Pakistan.FindingsThe findings show positive effects of HPWS on employee engagement and organisational innovation. Additionally, employee’s engagement partially mediates the relationship between HPWS and organisational innovation, while the moderating role of perspective-taking significantly influences the link between HPWS and employee engagement.Originality/valueWhile HPWS are recognized for enhancing organisational innovation, this study confirms their positive effects on individual and organisational outcomes, particularly within the healthcare sector in Pakistan. This study suggests that when HPWS are effectively perceived and implemented, these integrated practices can be beneficial for both employees and organizations, even in challenging situations.

Consumption of Milk Beverages Reduces Iron, Vitamin A, Vitamin C, Calcium, and B Vitamins Inadequacies in Pakistani School-Aged Children from Sindh and Punjab: A Diet Modeling Study

BackgroundOnly 47% of households in Pakistan’s Sindh and Punjab provinces are food secure. More than 80% of 5–9 y old children are below recommended intakes of calcium, iron, zinc, and vitamin A and vitamin D. Although 89% consume dairy products daily, only 3% comply with Pakistan’s recommended dairy consumption of 2–3 servings/d. ObjectivesThe objectives of this study were to evaluate the theoretical impact of substituting or adding fortified milk and/or buffalo milk in the diets of Pakistani school-aged children to address nutrient inadequacy. MethodsDairy consumption and nutrient intakes were calculated using dietary data collected from 5842 children via a 24-h diet recall in the School-age Children Health and Nutrition Survey conducted in Sindh and Punjab provinces of Pakistan between 2019 and 2020. Given daily intakes documented in the School-age Children Health and Nutrition Survey, 2 modeling scenarios were applied to test the impact on nutrient intakes of 1) substituting current milk (buffalo, cow, and goat) consumption (volume by volume) with a fortified milk beverage and 2) adding a fortified milk beverage or buffalo milk to current consumption to meet dairy consumption recommendations. ResultsThe hypothetical substitution of current milk consumption with fortified milk lowered nutrient inadequacies for vitamin C (by 86%), vitamin A (by 45%), thiamin (by 26%), riboflavin (by 14%), vitamin B6 (by 13%), calcium (by 8%), and iron (by 7%), compared to baseline (relative percent reduction). Among children consuming <2 dairy servings/d, theoretically adding buffalo milk had a positive contribution to calcium, phosphorous, zinc, vitamin A, vitamin C, riboflavin, niacin, and folate; theoretically adding fortified milk additionally reduced inadequacies of iron, thiamin, vitamin B6, and greatly reduced vitamin C inadequacy. ConclusionsBuffalo milk and fortified milk each have their own value in closing nutrient gaps. Increasing their consumption can be integrated into a multi-pronged public health strategy (including fortified foods, ensuring food security, and diet diversity) to tackle nutrient inadequacies in children.

The annual prevalence of syphilis among blood donors of regional blood centers of Sindh: A study conducted by the Sindh blood transfusion authority to evaluate the infectious rate of syphilis among blood donors.

Objective: To detect any possible illnesses, such as syphilis, and stop them from spreading through transfusion, screening blood donors is crucial. Study Design: Cross-sectional Retrospective Research study. Setting: Four RBCs and the sixteen associated hospital-based blood banks (HBBBs) that are spread over Sindh's various areas. Period: January 2022 to December 2022. Methods: Employing non-probability convenience sampling was carried out. We collected data from Sindh province's Regional Blood Centers (RBCs) and Hospital Based Blood Banks (HBBBs), dispersed throughout the province. Sindh Blood Transfusion Authority (SBTA)'s ethical committee approved the study. To screen selected blood donors for Syphilis, the Chemiluminescence Immunoassay Analyzer (CLIA) was used. Data from the study were summarized using simple percentages after they were statistically examined. Results: With 171,725 male donors and 1,460 female donors, men comprised the bulk of the 173,185 blood donors. Syphilis turned up in 2.5% of the male donors, resulting in an additional 4,311 cases. On the other hand, just 18 (1.2%) of the female donors had a positive syphilis test. The gender distribution of cases with positive Syphilis indicates a notable difference in its frequency between people of both sexes. The age group of 25 to 40 years old accounted for the largest proportion of syphilis cases among blood donors. Conclusion: One of Sindh's biggest public health concerns is the high incidence of syphilis among blood donors. Additionally, the results show that the incidence of syphilis varies by gender. Furthermore, there are considerable age range differences in the distribution of syphilis cases. These results highlight the need for increased screening and preventive programmes, especially in areas with higher incidence rates. Given the high frequency of syphilis among Sindhi red blood cell donors, this could point to a greater number of cases in the overall community.

HIV outbreak in Pakistan - a wakeup call?

Human immune-deficiency virus (HIV) is a global threat with an estimated 38.6 million people being previously infected while 25 million of them have succumbed to the disease. In Pakistan, since 2004, there has been a 50-fold increase from 2700 to 130,000 in the number of people infected with HIV, while Sub- Saharan Africa alone bears the heaviest burden of HIV having 25 million infected individuals. Considering these devastating numbers, it was alarming to find that in June 2019, 751 new cases of HIV were diagnosed in Larkana, in the province of Sindh, Pakistan. Therefore, to make sure that the efforts of international institutions like The Joint United Nations Programme on HIV/AIDS (UNAIDS) which are trying to effectively reduce the spread of HIV are such regions is streamlined it is extremely important to highlight some of the underlying causes which are endemic to such regions such as re-using of blades by barbers and the practice of re-using needles by un-licensed medical practitioners offering miraculous cures. It is also equally important to suggest and re-iterate possible ways in which this situation, which is rapidly worsening, can be improved.

Quantifying the impacts of varying groundwater table depths on cotton evapotranspiration, yield, water use efficiency, and root zone salinity using lysimeters

Determining the evapotranspiration (ET) of cotton as a water-intensive crop is crucial for effective irrigation planning and water management, especially in regions like Sindh province, Pakistan, where shallow groundwater table depths (WTDs) are prevalent. Despite the importance of cotton, a major cash crop in Sindh, previous studies on ET were conducted decades ago and may no longer be reliable due to ongoing climate change and the introduction of new crop varieties. Thus, we quantified cotton ET across two cropping seasons and at various WTDs (0.45, 0.60, 0.75, 1.50, 2.25, and 2.75 m). The experimental study was based on the data procured from 12 mini lysimeters and 12 large lysimeters for two years (2018 and 2019) and at two soil series. The findings revealed that cotton ET ranged from 1332 to 1437, 1114–1202, 988–1075, 781–821, 690–733, and 637–683 mm at WTDs of 0.45, 0.60, 0.75, 1.50, 2.25, and 2.75 m, respectively. WTDs from 0.45 to 0.75 m fulfilled 94–96 % of cotton ET through groundwater (GW) contribution in Sultanpur soil (silt loam) and 93–97 % in Miani soil (silty clay loam). At 1.50–2.75 m WTDs, irrigation water requirements (excluding rainfall and leaching) were 63–88 % in Sultanpur soil and 67–89 % in Miani soil. The highest yield was observed at a 1.50 m WTD, while the highest water use efficiency was identified at a 2.25 m WTD. However, soil salinity increased by 60–80 %, resulting in a 40–60 % lower cotton yield at 0.45–0.75 m WTD. Therefore, periodic flushing of salts is necessary to utilize shallow WTDs effectively. Considering GW contribution to ET when allocating water for irrigation channels and devising irrigation schedules is crucial. This approach can lead to water savings, prevent land from becoming waterlogged and saline, manage the groundwater table, and reduce the need for drainage channels and labor force for their preparation.

Exploring ICT-based learning adoption in higher education: An extended perspective of the technology acceptance model

This article analyses the self-perception of digital technology learning competence among engineering and science students. The use of information and communication technologies (ICT) is now considered highly essential in higher education. Today's higher education institutions (HEIs) seldom employ traditional methods of instruction; instead, sophisticated ICT is starting to emerge as a feasible paradigm for fundamental change. To this end, Pakistan's Higher Education Commission (HEC) has heavily invested in technology in the education sector and initiated several programs. The ramifications of ICT utilization on the environment, student academic performance, and capabilities remain ambiguous. In delving into how students embrace and utilize ICT systems for learning in HEIs, researchers felt the need to grasp the factors that influence students' acceptance and utilization of ICT skills through the lens of the Extended Technology Acceptance Model (TAM). This study develops an exclusive conceptual model by incorporating TAM with a set of latent variables identified in the available literature: interest, ICT self-efficacy, economic cost, and performance expectancy. The adapted TAM model developed in this study considers the influence of these variables on students’ ICT acceptance and its impact on academic performance in emerging countries. As part of this study, reports on the development of instruments and validation in the research field were managed using a cross-sectional survey method and SPSS-22 and Smart PLS-4 software. In addition, association rule mining applied in demographic data. A sample of 69 students was randomly selected from three universities representing engineering, medical, and general HEIs in the Sindh province. Though the sample size was small, it showcases that the reliability of the scales is within an acceptable range and can be used to test the main study hypotheses. A conceptual framework model is introduced to offer a comprehensive framework derived from the amalgamation of various acceptance and usage models of technology. The results demonstrate that the survey items are appropriate and suitable for further research.

Climate change impacts: exploring the rising climate-security nexus in Pakistan

This research aims to bring to the fore the climate security nexus in Pakistan. According to this study, the anthropogenic climate change in Pakistan has been a probable cause of internal migrations that have played an important role in exacerbating the existing conflicts in Khyber Pakhtunkhwa (KP), Sindh, and Balochistan provinces. The climate security nexus in Pakistan is established through a deductive approach using the lens of environmental security and political ecology. The study plays a crucial role in shaping Pakistani policy-making circles, providing insights into climate change mitigation, conflict-sensitive adaptation, and societal resilience. The study adopts an exploratory approach using primary and secondary data sources with semi-structured interviews and multidisciplinary assessment to analyse the issue comprehensively and provide accurate findings. The study concludes that the anthropogenic climate change-induced internal migration exacerbating armed conflict in the Pakistani regions of KP and Balochistan has the potential to cause significant economic losses in the future. It argues that the migration triggered by resource scarcity due to climate change can lead to armed conflict and provide fertile grounds for militant groups to gain strength.

Income and Expenditure Relationship in Local Municipalities: A Case Study of Sindh Province

Income and Expenditure Relationship in Local Municipalities: A Case Study of Sindh Province

Effect of Raised Flat Bed and Ridge Planting on Wheat Crop Growth and Yield under Varying Soil Moisture Depletions

Crop yields remain significantly low in underdeveloped countries, such as Pakistan, primarily due to the prevalent use of traditional farming methods by most farmers. Resource-saving strategies, like ridge and raised flat bed systems, could boost water use efficiency and production per acre. However, further research is needed to investigate the effectiveness of these methods, along with different levels of soil moisture depletion (SMD), on wheat development in the climatic conditions of Sindh Province. Thus, field trials were undertaken at Sindh Agriculture University’s Tandojam for two years (2022 and 2023) during the wheat growing seasons. The experiment included six treatments, viz., T1 (raised flat bed method under 40% depletion), T2 (ridge method under 40% depletion), T3 (raised flat bed method under 50% depletion), T4 (ridge method under 50% depletion), T5 (raised flat bed method under 60% depletion), and T6 (ridge method under 60% depletion). The bed planter was employed to make raised flat beds, and the ridges were prepared using a ridge planter. Wheat variety (TJ-83) was sown. Under all treatments, the plant population, plant height, and seed index were statistically significant (p &lt; 0.05), although spike length, grain spikes−1, and grain weight spikes−1 were non-significant at different SMD levels. To compute water saving through the ridge and raised flat methods, the recommended delta value for wheat crops under the traditional method was used as a benchmark. Both irrigation technologies conserve water compared to traditional irrigation methods. The T5 treatment conserved the most water, followed by T6. Under a 60% depletion level, the ridge approach produced the highest yield of 2175 kg ha−1, compared to 601 kg ha−1 with the raised flat bed method. The best crop water productivity (CWP) of 1.34 kg m−3 was achieved under T6, whereas raised flat beds attained the lowest CWP of 0.27 kg m−3 under T1. In terms of wheat grain production and CWP, the ridge furrow method outperformed the raised flat bed furrow method. Based on the results, it is recommended that farmers should use the ridge furrow method and allow a 60% depletion of soil moisture to obtain a high yield of wheat crops.

Impact of COVID-19 on dietary diversity and food security in Pakistan: A comprehensive analysis

This study investigates the impact of COVID-19 on dietary diversity and food security in Pakistan's Punjab and Sindh provinces, assessing how the pandemic has influenced individuals' access to varied and nutritious foods. Utilizing data from 1067 respondents collected through online surveys, the research highlights significant changes in food consumption patterns, with infected individuals showing higher Dietary Diversity Scores (DDS) than those not infected. The findings indicate a shift towards more readily available and affordable food items such as cereals, fruits, and dairy products, reflecting adjustments in dietary habits during the pandemic. Socio-economic factors, including age, gender, urban residency, and wealth, were identified as key determinants of dietary diversity. Specifically, women and urban residents showed improved dietary habits during the pandemic. In addition, the study identifies nutritional awareness as a critical factor in promoting healthier food choices, suggesting that well-informed individuals have more diverse diets, which could aid in disease prevention, contributing to potential disease prevention. The research underscores the pandemic's profound effects on dietary patterns and food security. It calls for policy interventions focused on improving food access, enhancing public awareness on nutrition, and integrating food security measures into pandemic response strategies to support vulnerable populations and ensure long-term resilience against health crises.

Risk factors of child malnutrition under 5 years: Evidence from Pakistan using the Composite Index of Anthropometric Failure

ObjectivesChild malnutrition is a very serious health issue globally, particularly in emerging countries. Among South Asian countries, Pakistan has been observed to have a high prevalence of child malnutrition. In spite of the implementation of many health strategies and preventive measures for vulnerable populations, this issue is still unresolved and needs further investigation. The purpose of this study was to investigate the role of various social-, maternal-, and child-level factors considered to be responsible for nutritional health disparities among children. MethodsAn assessment method of malnutrition, i.e., Composite Index of Anthropometric Failure (CIAF), was used to detect the prevalence of malnutrition among children under 5 years of age in Pakistan in order to present a comprehensive view that was lacking conventional indices of malnutrition. A binary logistic regression model was fitted to assess the link between malnutrition and socioeconomic, maternal, and child attributes based on CIAF data compiled from weight-for-height, weight-for-age, and height-for-age Z-scores using data from the Pakistan Demographic Health Survey (2017–2018). ResultsA total of 4224 children under 5 years of age were included in the analysis. Approximately half of the children (45.34%) comprised anthropometric failures for the overall prevalence of undernutrition based on CIAF. The results of this study revealed that the leading determinant associated with CIAF was the child's age in months, small birth size, lack of breastfeeding, lack of maternal education, poor economic status of the household, and poor-quality water sources. The factors associated with stunting comprised the child's age in months, small child birth size, underweight maternal body mass index, and uneducated mothers. Only one factor—low household economic profile—was significantly associated with waste. Sindh, Baluchistan, and Khyber Pakhtunkhwa provinces had a higher risk of having wasted children. On the other hand, children aged 25-36 months had higher, small child birth size, underweight maternal BMI, un-educated mother, un-educated father, low economic profile of household experiencing of being underweight. ConclusionsThe findings of this study reinforce the significance of maternal health, parental education, and household economic profile in the prevention of malnutrition within young children of adequate birth size, as well as better overall health care up to adolescence in Pakistan. Well-nourished individuals are a valuable human resource and a requirement for a nation's progress and prosperity. In emerging nations such evidence-based policies are crucial for fostering children's optimal physical and mental development to ensure a healthier future generation. Therefore, the execution of national health policies aimed at the improvement of maternal and societal factors could result in improved nutrition levels among children below 5 years of age in Pakistan.