Inequalities in child health care in Pakistan: measurement and decomposition analysis of maternal educational impact.

OBJECTIVES

The aim of the study was to measure the impact of maternal education on inequalities in child health care and to explore the contribution of different factors to the observed inequality.

STUDY DESIGN

The study is based on secondary data from the Pakistan Demographic and Health Survey 2017-18.

METHODS

Concentration curves and indices were used to identify and quantify the inequality in child health care. Moreover, contributions of different factors to the observed inequality were investigated using decomposition analysis.

RESULTS

The concentration indices for health care provided were 0.078 (P < 0.001) when a child was experiencing diarrhoea and 0.088 (P < 0.001) for fever/cough. The results of this study indicate that healthcare practices are more common among children of educated mothers. The main contributors resulting in the observed inequalities in child health care were improved sanitation (about 6% for diarrhoea and 15% for fever/cough treatment), rural residence (about 4% and 23% for diarrhoea and fever/cough treatment, respectively), wealth status (49% and 28% for diarrhoea and fever/cough treatment, respectively) and maternal education (26% for diarrhoea and 28% for fever/cough treatment).

CONCLUSION

The findings suggested that child health care is more frequently provided among educated mothers; therefore, steps should be taken to improve maternal education. Moreover, policies should seek to increase/improve the roles of women in society, as well as job opportunities to overcome the financial barriers of healthcare provision.