Determinants of newborn care utilization in Pakistan: Findings from the Demographic and Health Surveys.

Information on determinants of postnatal care is essential for maternal health services, and this information is scarce in Pakistan. This study aimed to determine the factors of newborn postnatal care utilization from the Pakistan Demographic and Health Surveys (PDHS) conducted from 2006-2018. We analyzed data from three rounds of cross-sectional, nationally representative PDHS 2006-07, 2012-13, and 2017-18. Multivariable logistic regression models were applied to explore factors associated with utilization of newborn postnatal care within two months. This study included 5724 women from the 2006-07 PDHS, 7461 from the 2012-13 survey, and 8287 from the 2017-18 survey. The proportion of women receiving newborn postnatal care within the first two months of delivery increased from 13% in 2006-07 to 43% in 2012-13 but dropped to 27% in 2017-18. Respondent's occupation and prenatal care utilization of maternal health services were common factors that significantly influenced newborn postnatal care utilization within two months. The utilization of postnatal care was greater among women having educated husbands and where the first child was a male in PDHS 2007 round. Higher wealth index and educated respondent had higher postnatal care utilization odds in DHS 2012 and DHS 2018. However, the odds of using postnatal care decreased with the number of household members and total number of children ever born in DHS 2012 and 2018 rounds. There was a general increase in the proportion of women who utilized postnatal care for their newborns during 2006-2013 but a decrease in 2018. The decreased utilization in 2018 warrants further investigation. Improving women's economic status, education, employment, and antenatal care attendance and reducing parity may increase newborn postnatal care utilization.