title: Maternal chronic ill health negatively affects child survival in a poor rural population of Pakistan.
abstract: Pakistan ranks fourth globally in terms of absolute numbers of under-5 deaths. Although several determinants of child deaths have been identified, the possibility of an association between mother's health and under-5 deaths has not been assessed in Pakistan. We compared data on 106 deceased children 0-59 months old with those on 3718 live children, using a cross-sectional survey of 2276 households among 99 randomly selected villages in Thatta, a rural district of Pakistan. We examined the association between self-reported maternal health status and under-5 deaths, using the SUDAAN statistical package to account for cluster sampling technique. Three models for logistic regression analysis were Model-1: demographic factors, Model-2: household socio-economic factors and Model-3: demographic and household socio-economic factors. Mothers of deceased children were 60% more likely to report chronic illnesses than mothers of live children after controlling for child's age, mother's age and type of house (final Model-3 analysis) (adjusted odds ratio [aOR; 95% confidence interval]: 1.6 [1.01, 2.5]). The association of self-reported maternal ill health with under-5 deaths in Thatta suggests the role of maternal health in child survival. Child survival strategies should include screening and treating mothers for common chronic illnesses. This is particularly important in a setting where only a quarter of chronically ill mothers seek care outside the home.
authors.affiliation: Department of Community Health Sciences, The Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan. rozina.nuruddin@aku.edu
authors.forename: R
authors.initials: R
authors.lastname: Nuruddin
authors.forename: L Meng
authors.initials: LM
authors.lastname: Kin
authors.forename: W C
authors.initials: WC
authors.lastname: Hadden
authors.forename: I
authors.initials: I
authors.lastname: Azam
mesh_terms: D016022:Case-Control Studies; D002391:Catchment Area, Health; D046688:Child Mortality; D002675:Child, Preschool; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D010154:Pakistan / Q000453:epidemiology; D012423:Rural Health; D012959:Socioeconomic Factors; D015996:Survival Rate