Predictors of Child’s Health in Pakistan and the Moderating Role of Birth Spacing
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Variables and Measurement
3. Results
4. Discussions
5. Recommendations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
List of Abbreviations
ANC | Antenatal care |
LMICs | Low- middle-income countries |
MHCSU | Mother’s health care services utilization |
PDHS | Pakistan Demographic and Health Survey |
SBA | Skilled birth attendance |
SDGs | Sustainable Development Goals |
SES | Socio-economic status |
TV | Television |
UMNFP | Unmet Need for Family Planning |
USA | United States of America |
References
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Symbol | Variables | Definition of Variables | Measurement |
---|---|---|---|
CH | Child’s Health | Child weight at birth has been used as a proxy of child health. If a child’s weight at birth is less than 2.5 kg, this is considered unhealthy, and if a child’s weight at birth is at least 2.5 kg, this is considered healthy. | 1 = Unhealthy child 2 = Healthy child |
M.Age | Mother’s Age | Mother’s age has been classified into two different groups: mothers aged 15–34, and mothers aged 35–49 years. | 1 = 15–34 2 = 35–49 |
M.Edu | Mother’s Education | Mother’s education is divided into two categories. If the mother has no education and has attended primary school only, this is considered as “less than secondary,” and if the mother has completed secondary school education and has completed higher education, then this is considered as “at least secondary.” | 1 = Less than secondary 2= At least secondary |
M.Emp | Mother’s Employment Status | Mother’s employment status is divided into two categories, i.e., mothers currently not working, and mothers currently working. | 0 = Currently not working (unemployed) 1 = Currently working (employed) |
MHCSU | Mother’s Health Care Services Utilization | This variable was constructed based on whether the mother had at least 4 or more antenatal care visits (ANC), skilled birth attendance (SBA), and received postpartum care within 42 days of delivery. If the mother had received all these services, this is considered more accessible, and if the mother had not received all these services, this is considered less accessible. We used ANC, SBA, and postpartum care as indicators to measure maternal health care utilization, which had been used in several earlier primary studies from neighboring countries [24,25]. | 1 = Less accessible 2 = More accessible |
WSH | Wealth Status of Household | Wealth status was divided into quintiles from poorest to richest. Women belonging to the poorest, poorer, and middle quintiles are considered low wealth status, and if women belonging to the richer and richest quintiles are considered high wealth status. | 1 = Low wealth status 2 = High wealth status |
F.Edu | Father’s Education | Father’s education is divided into two categories. If the father has no education and has attended primary school, this is considered “less than secondary,” and if the father has completed secondary school or higher education, this is considered “at least secondary.” | 1 = Less than secondary 2= At least secondary |
EMM | Exposure to Mass Media | The PDHS 2017-18 provides information on households’ ownership of a radio or television, along with the type of health message delivered to women through these media. In this study, the presence of a television (TV) in the household has been used as a proxy for this variable. | 1 = Presence of TV 0 = Otherwise |
BS | Birth Spacing | The World Health Organization has recommended a minimum birth interval of 33 months between two births, or at least 24 months before attempting the subsequent pregnancy, to reduce the risk of adverse maternal, perinatal, and infant outcomes [26]. | 1 = Women take less than 33 months birth spacing between two children 2 = Women take at least 33 months birth spacing between two children |
MHCSU * BS | Mother’s Health Care Services Utilization * Birth Spacing | The interaction term of mother’s health care services utilization and birth spacing. The interaction term has been used to examine the moderating effect of birth spacing on the relationship between a mother’s health care services utilization and a child’s health. |
Socio-Economic Characteristics | Frequency | Percentage (%) | |
---|---|---|---|
Child’s Health | Unhealthy | 415 | 18.5 |
Healthy | 1831 | 81.5 | |
Mother’s Age | <35 years | 1821 | 81.1 |
>35 years | 425 | 18.9 | |
Mother’s Education | Less than secondary | 643 | 28.6 |
At least secondary | 1603 | 71.4 | |
Mother’s Employment Status | Unemployed | 1938 | 86.3 |
Employed | 308 | 13.7 | |
Mother’s Health Care Services Utilization | Less accessible | 257 | 11.4 |
More accessible | 1989 | 88.6 | |
Wealth Status of Household | Low | 787 | 35.0 |
High | 1459 | 65.0 | |
Father’s Education | Less than secondary | 464 | 20.7 |
At least secondary | 1782 | 79.3 | |
Exposure to Mass Media | No | 397 | 17.7 |
Yes | 1849 | 82.3 | |
Birth Spacing | Less than 33 months | 1633 | 72.7 |
At least 33 months | 613 | 27.3 |
Independent Variables | Β | p-Value | Odds Ratio | 95% C.I. for EXP(β) | ||
---|---|---|---|---|---|---|
Lower | Upper | |||||
Constant | 0.749 | 0.000 | 2.115 | |||
Mother’s Age | <35 years | Reference | ||||
>35 years | 0.195 * | 0.013 | 1.215 | 0.863 | 1.592 | |
Mother’s Education | Less than secondary | Reference | ||||
At least secondary | 0.115 * | 0.039 | 1.122 | 0.835 | 1.298 | |
Mother’s Employment Status | Unemployed | Reference | ||||
Employed | −0.199 * | 0.020 | 0.819 | 0.587 | 1.171 | |
Mother’s Health Care Services Utilization | Less accessible | Reference | ||||
More accessible | 0.206 * | 0.011 | 1.500 | 1.091 | 1.916 | |
Wealth Status of Household | Low | Reference | ||||
High | 0.263 * | 0.045 | 1.301 | 1.116 | 1.672 | |
Father’s Education | Less than secondary | Reference | ||||
At least secondary | 0.197 * | 0.016 | 1.218 | 0.797 | 1.583 | |
Exposure of Mass Media | No | Reference | ||||
Yes | 0.034 * | 0.021 | 1.014 | 0.851 | 1.396 | |
Birth Spacing | Less than 33 months | Reference | ||||
At least 33 months | 0.179 | 0.058 | 1.196 | 0.827 | 1.528 | |
Mother’s Health Care Services Utilization * Birth Spacing | 0.236 * | 0.034 | 1.279 | 0.831 | 1.729 |
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Asif, M.F.; Meherali, S.; Abid, G.; Khan, M.S.; Lassi, Z.S. Predictors of Child’s Health in Pakistan and the Moderating Role of Birth Spacing. Int. J. Environ. Res. Public Health 2022, 19, 1759. https://doi.org/10.3390/ijerph19031759
Asif MF, Meherali S, Abid G, Khan MS, Lassi ZS. Predictors of Child’s Health in Pakistan and the Moderating Role of Birth Spacing. International Journal of Environmental Research and Public Health. 2022; 19(3):1759. https://doi.org/10.3390/ijerph19031759
Chicago/Turabian StyleAsif, Muhammad Farhan, Salima Meherali, Ghulam Abid, Muhammad Safdar Khan, and Zohra S. Lassi. 2022. "Predictors of Child’s Health in Pakistan and the Moderating Role of Birth Spacing" International Journal of Environmental Research and Public Health 19, no. 3: 1759. https://doi.org/10.3390/ijerph19031759