Under-Five Child Mortality and Morbidity Associated with Consanguineous Child Marriage in Pakistan: Retrospective Analysis using Pakistan Demographic and Health Surveys, 1990–91, 2006–07, 2012–13

Abstract

Objective To assess the combined effect of consanguineous and child marriages (CCM) on children health, which has not previously been explored, either globally or locally. Methods We analyzed secondary data from a series of cross-sectional, nationally representative Pakistan Demographic and Health Surveys 1990-91, 2006-07, and 2012-13. A total of 5406 mothers with 10,164 children were included in the analysis. Child health was assessed by variables such as history of diarrhea, acute respiratory infection (ARI), ARI with fever, Under-5 child mortality (U5CM) and small-size birth (SSB). Associations among variables were assessed by calculating unadjusted Odd Ratios (OR) and adjusted OR (AOR). Results A majority (n = 6,247, 61%) of the births were to mothers having CCM as compare to non-CCM (3917, 39%). There was a significant association between CCM and U5CM during 1990-91 (AOR 1.24, 95% CI 1.03-1.49) and 2006-07 (AOR 1.25, 95% CI 1.05-1.51), and infant mortality in 1990-91 (AOR 1.39, 95% CI 1.05-1.85) and 2006-07 (AOR 1.61, 95% CI 1.17-2.21). A significant association was also found between CCM and SSB infants in the period 2006-07 (AOR 1.19, 95% CI 1.01-1.42) and 2012-13 (AOR 1.22, 95% CI 1.02-1.46). We noted no effect of CCM on diarrhea, ARI, and ARI with fever. Conclusion CCM increases the likelihood of U5CM, infant mortality and SSB infants. Further quantitative and qualitative research should be conducted to assess the effects of environmental, congenital and genetic factors on the health of children born to mothers in CCM.

Changes in inequality of childhood morbidity in Bangladesh 1993-2014: A decomposition analysis

“…Pathogens are frequently transmitted through consuming food contaminated by unsafe and unaware preparation [38,54,55]. Furthermore, their physical and mental health conditions most likely place their children at a higher risk of morbidity [52,56–57]. Behavioural change through health promotion interventions could be an effective strategy to reduce the prevalence of childhood morbidity within poorer households and the children of mothers with low levels of schooling [42,51,55,58,59].…”

An Assessment of the Knowledge, Attitudes, and Practices of Patients and Families with Diagnoses of Hereditary Neuromuscular Disorders

“…Given the estimated global prevalence of all MD ranging between 19.8 and 25.1 per 100,000 person-years, and estimated worldwide SMA prevalence of 1-2 per 100,000 [1,9] there is an under-recognized burden of these diseases in Pakistan. With a high rate of consanguineous marriages in the west Asian population, including Pakistan, the prevalence of hereditary genetic disorders is also high [10,11]. However, no official data are available yet at the population level in Pakistan.…”

“…The most profound lack of awareness was regarding the symptom of difficulty in feeding, which was only correctly identified by a quarter of the subjects, even though dysphagia and feeding problems are a commonly seen feature among a wide spectrum of MDs and SMA. Indeed, dysphagia proposes an increased risk of aspiration and associated infections, which add to the burden of respiratory care in patients with late stage manifestations of various NMDs, reducing lifespan [5,11]. With 80% of the respondents believing that MDs/ SMA are curable, the need to better underscore the severity and prognosis in physician encounters is elucidated.…”

Maternal empowerment and healthcare access determines stillbirths and early neonatal mortality in Pakistan: analysis of demographic and health survey 2012-13

“…23 -24 Another surrogate of women's empowerment was being related to her husband which increased the risk of stillbirth by 1.45-fold. Apart from the biological aspect of consanguineous marriages and their relation with adverse child health outcomes 25 , this highlights that women in rural communities lack autonomy and authority for making decisions to choose life partners and are often married against their will at very young ages mostly to their paternal or maternal cousins. 26 Similarly women's contraceptive empowerment is closely linked with their planning, and decision making about access to and use of modern contraceptives giving long-term protection from pregnancy.…”