Trends and population attributable risk estimates for individual and community-level factors of neonatal mortality in Pakistan (1990–2018)

IF 1.9 Q2 ECONOMICS

INTERNATIONAL JOURNAL OF SOCIAL ECONOMICS Pub Date : 2024-03-26 DOI:10.1108/ijse-09-2022-0604

Asifa Kamal, Lubna Naz, Abeera Shakeel

{"title":"Trends and population attributable risk estimates for individual and community-level factors of neonatal mortality in Pakistan (1990–2018)","authors":"Asifa Kamal, Lubna Naz, Abeera Shakeel","doi":"10.1108/ijse-09-2022-0604","DOIUrl":null,"url":null,"abstract":"<h3>Purpose</h3>\n<p>Pakistan ranks third globally in terms of newborn deaths occuring within the first 24 hours of life. With a neonatal mortality rate of 42.0%, it carries the highest burden compared to neighboring countries such as Bangladesh (17%), India (22.7%) and Afghanistan (37%). While there has been a decline in neonatal mortality rates in Pakistan, the pace of this decline is slower than that of other countries in the region. Hence, it is crucial to conduct a comprehensive examination of the risk factors contributing to neonatal mortality in Pakistan over an extended period. This study aims to analyze the trends and determinants of neonatal mortality in Pakistan over three decades, providing valuable insights into this persistent issue.</p>\n<h3>Design/methodology/approach</h3>\n<p>The study focused on neonatal mortality as the response variable, which is defined as the death of a live-born child within 28 days of birth. Neonates who passed away during this period were categorized as “cases,” while those who survived beyond a specific timeframe were referred to as “noncases.” To conduct a pooled analysis of neonatal mortality, birth records of 39,976 children born in the five years preceding the survey were extracted from four waves (1990–2018) of the Pakistan Demographic and Household Survey. The relationship between risk factors and the response variable was examined using the Cox Proportional Hazard Model. Neonatal mortality rates were calculated through the direct method using the “syncmrates” package in Stata 15.</p>\n<h3>Findings</h3>\n<p>During the extended period in Pakistan, several critical protective factors against neonatal mortality were identified, including a large family size, improved toilet facilities, middle-aged and educated mothers, female children, singleton live births, large size at birth and longer birth intervals. These factors were found to reduce the risk of neonatal mortality significantly.</p>\n<h3>Originality/value</h3>\n<p>This study makes the first attempt to analyze the trends and patterns of potential risk factors associated with neonatal mortality in Pakistan. By examining a large dataset spanning several years, the study provides valuable insights into the factors influencing neonatal mortality.</p>\n<h3>Peer review</h3>\n<p>The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0604</p>","PeriodicalId":47714,"journal":{"name":"INTERNATIONAL JOURNAL OF SOCIAL ECONOMICS","volume":"62 1","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"INTERNATIONAL JOURNAL OF SOCIAL ECONOMICS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1108/ijse-09-2022-0604","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Pakistan ranks third globally in terms of newborn deaths occuring within the first 24 hours of life. With a neonatal mortality rate of 42.0%, it carries the highest burden compared to neighboring countries such as Bangladesh (17%), India (22.7%) and Afghanistan (37%). While there has been a decline in neonatal mortality rates in Pakistan, the pace of this decline is slower than that of other countries in the region. Hence, it is crucial to conduct a comprehensive examination of the risk factors contributing to neonatal mortality in Pakistan over an extended period. This study aims to analyze the trends and determinants of neonatal mortality in Pakistan over three decades, providing valuable insights into this persistent issue.

Design/methodology/approach

The study focused on neonatal mortality as the response variable, which is defined as the death of a live-born child within 28 days of birth. Neonates who passed away during this period were categorized as “cases,” while those who survived beyond a specific timeframe were referred to as “noncases.” To conduct a pooled analysis of neonatal mortality, birth records of 39,976 children born in the five years preceding the survey were extracted from four waves (1990–2018) of the Pakistan Demographic and Household Survey. The relationship between risk factors and the response variable was examined using the Cox Proportional Hazard Model. Neonatal mortality rates were calculated through the direct method using the “syncmrates” package in Stata 15.

Findings

During the extended period in Pakistan, several critical protective factors against neonatal mortality were identified, including a large family size, improved toilet facilities, middle-aged and educated mothers, female children, singleton live births, large size at birth and longer birth intervals. These factors were found to reduce the risk of neonatal mortality significantly.

Originality/value

This study makes the first attempt to analyze the trends and patterns of potential risk factors associated with neonatal mortality in Pakistan. By examining a large dataset spanning several years, the study provides valuable insights into the factors influencing neonatal mortality.

Peer review

The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-09-2022-0604

查看原文本刊更多论文

巴基斯坦新生儿死亡率个人和社区因素的趋势和人口可归因风险估计值（1990-2018 年）

目的巴基斯坦的新生儿在出生后 24 小时内死亡人数在全球排名第三。与孟加拉国（17%）、印度（22.7%）和阿富汗（37%）等邻国相比，巴基斯坦的新生儿死亡率高达 42.0%，负担最重。虽然巴基斯坦的新生儿死亡率有所下降，但下降速度低于该地区的其他国家。因此，对造成巴基斯坦新生儿死亡的风险因素进行长期全面的研究至关重要。本研究旨在分析三十年来巴基斯坦新生儿死亡率的趋势和决定因素，从而对这一长期存在的问题提供有价值的见解。研究重点是将新生儿死亡率作为反应变量，其定义为活产婴儿在出生后 28 天内死亡。在此期间死亡的新生儿被归类为 "病例"，而存活超过特定时限的新生儿被称为 "非病例"。为了对新生儿死亡率进行汇总分析，我们从巴基斯坦人口和家庭调查的四次波次（1990-2018 年）中提取了调查前五年内出生的 39976 名儿童的出生记录。风险因素与响应变量之间的关系采用 Cox 比例危险模型进行检验。研究结果在巴基斯坦的延长期内，确定了几个降低新生儿死亡率的关键保护因素，包括大家庭规模、厕所设施改善、中年和受过教育的母亲、女性儿童、单胎活产儿、出生时体型较大和较长的出生间隔。本研究首次尝试分析与巴基斯坦新生儿死亡相关的潜在风险因素的趋势和模式。通过研究跨度达数年的大型数据集，该研究为了解影响新生儿死亡率的因素提供了有价值的见解。同行评议本文的同行评议记录可在以下网址查阅：https://publons.com/publon/10.1108/IJSE-09-2022-0604。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

INTERNATIONAL JOURNAL OF SOCIAL ECONOMICS ECONOMICS-

CiteScore

3.20

自引率

5.30%

发文量

期刊介绍： The International Journal of Social Economics publishes original and peer-reviewed theoretical and empirical research in the field of social economics. Its focus is on the examination and analysis of the interaction between economic activity, individuals and communities. Social economics focuses on the relationship between social action and economies, and examines how social and ethical norms influence the behaviour of economic agents. It is inescapably normative and focuses on needs, rather than wants or preferences, and considers the wellbeing of individuals in communities: it accepts the possibility of a common good rather than conceiving of communities as merely aggregates of individual preferences and the problems of economics as coordinating those preferences. Therefore, contributions are invited which analyse and discuss well-being, welfare, the nature of the good society, governance and social policy, social and economic justice, social and individual economic motivation, and the associated normative and ethical implications of these as they express themselves in, for example, issues concerning the environment, labour and work, education, the role of families and women, inequality and poverty, health and human development.