The Interaction Effect of Birth Spacing and Maternal Healthcare Services on Child Mortality in Pakistan

Abstract

There is widespread agreement that improved health should be regarded as a means and an end in the context of the development process. The health of the populace and the equitable provision of healthcare are two indicators of a society’s level of development. A variety of factors influences child mortality. This study investigated the causes of child death and the interaction effect of birth spacing (B.S.) and maternal health care services (MHCS) on child mortality. Using SPSS version 20, we used the Pakistan Demographic and Health Survey (PDHS) 2017–2018 data set to investigate the associated factors of child mortality and the moderating influence of birth spacing using binary logistic regression. The outcome variable is categorical with two categories. The findings indicated that the risk of infant death decreased with adequate B.S. between two pregnancies and access to maternal health care services. Birth spacing was found to moderate the link between access to maternal health care services (MHCS) and child mortality. Our research leads us to conclude that the amount of time between children’s births significantly reduces infant mortality. When the birth spacing is at least 33 months, the relationship between maternal health care services and child mortality becomes more evident and negative.

Short birth interval in the Asia-Pacific region: A systematic review and meta-analysis

“…It is important to note, however, that the reported prevalence rates varied significantly even among the studies that used relatively similar approaches and were conducted in comparable settings [69,70]. This was also observed among the studies that reported following the WHO's recommendation [14,17,[36][37][38][39][40][41][42][43][44], indicating that not only the methodological differences but also other contextual factors might have also contributed to the observed variation.…”

“…Further, 53 studies were specific to short birth interval and reported on either the prevalence or the predictors and 87 studies were not specific to short birth interval but considered birth interval as a covariate (Table S6 in the Online Supplementary Document). Characteristics of the studies that followed the WHO recommendation [14,17,[36][37][38][39][40][41][42][43][44] for the definition and classification of short birth interval are presented in Table 1.…”

“…Among the 140 studies included, 39 studies considered the duration of time elapsed between the birth of the index child (child under study) and the birth of the previous child, commonly referred to as the birth-tobirth interval, to define the short birth interval. Of these 39 studies, 36 studies used the term birth interval to report short birth interval, while the remaining three studies used either inter-pregnancy interval (n = 1) [45], inter-outcome interval (n = 1) [46] or birth spacing (n = 1) [37] to describe the same concept. Additionally, 37 studies considered the duration of time between the birth of the previous child and the subsequent pregnancy, referred to as the birth-to-conception interval, and three studies [47][48][49] measured the time between two pregnancies, known as the pregnancy-to-pregnancy interval.…”

Infant Mortality Trends and Determinants in Kazakhstan

“…Future research could examine the impact of the pandemic on infant mortality rates in Kazakhstan. Additionally, maternal factors such as preterm births, birth spacing, multiple/single gestation, type of delivery, and number of abortions were not included in our study and should be considered when analyzing IMR [ 59 , 60 , 61 , 62 ].…”

Spatial spillover impact of determinants on child mortality in Pakistan: evidence from Spatial Durbin Model

“…Moreover, child mortality is directly associated with poverty indicators, including income inequality and gross national income [ 44 ]. Access to adequate birth spacing between two pregnancies and maternal health care services also significantly reduces the liklihood of infant mortality [ 45 ]. However, the management of access to these health and health-related social indicators in Pakistan is inadequate and varies across geographical boundaries [ 46 ].…”