Nawaz Rashed, Khalid Neelum, Ajmal Fatima, Akbary Mohammad Fazel, Gong Shaoqing, Zhou Zhongliang
School of Public Health and Health Nutrition, Luohe Medical College, No.148, Daxue Road, Yuanhui District, Luohe, 462002, Henan Province, China.
School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, People's Republic of China.
J Health Popul Nutr. 2025 Jun 21;44(1):219. doi: 10.1186/s41043-025-00971-7.
Healthcare provider dearth, particularly in Low and Middle-income countries (LMICs), reduces the development towards improved healthcare outcomes and accomplish the Sustainable Development Goals (SDGs-3). This study aims to investigate the association between Professional and Non-professional healthcare provider distribution and neonatal mortality through the mediating role of maternal and child healthcare (MCH) services in Pakistan.
The present research used data from the 2018 Pakistan Demographic and Health Survey (PDHS) total sample that comprises (N = 8022). The dependent variable includes the risk of neonatal mortality 0-30 days. Bivariate and Multivariate analyses were conducted by utilizing the Cox proportional hazards and regression models. The estimation of mortality rates was achieved through generalized structural equation modelling (GSEM) and the 5000 bootstrap technique. All the investigations were carried out in STATA v. 16.1.
Our results revealed that around 2.46% of neonatal deaths occur. The average healthcare provider distribution type was professional, 83.45%, non-professional, 1.45%, and no care, 15.11%. 0.88% of females are less likely to die within the first thirty days of their birth compared to males. The regression outcomes demonstrate that the healthcare providers were positive and significantly linked to neonatal mortality. Additionally, a unit increase in healthcare providers has a 1.20% Higher likelihood of increasing the MCH and overall reducing neonatal mortality (HR = 0.60).
The outcomes illustrate that healthcare provider distribution and MCH play a vital role in minimizing neonatal mortality. To ensure well-distributed healthcare provider distribution, promoting maternal education, empowering women's decision-making in acquiring MCH services utilization, and expanding access to free MCH services are the essentials for better maternal and healthcare outcomes.
医疗服务提供者短缺,尤其是在低收入和中等收入国家(LMICs),阻碍了改善医疗保健成果的发展,也不利于实现可持续发展目标(SDG-3)。本研究旨在通过巴基斯坦母婴保健(MCH)服务的中介作用,调查专业和非专业医疗服务提供者分布与新生儿死亡率之间的关联。
本研究使用了2018年巴基斯坦人口与健康调查(PDHS)总样本的数据(N = 8022)。因变量包括0至30天新生儿死亡风险。采用Cox比例风险模型和回归模型进行双变量和多变量分析。死亡率估计通过广义结构方程模型(GSEM)和5000次自抽样技术实现。所有调查均在STATA v. 16.1中进行。
我们的结果显示,约2.46%的新生儿死亡。医疗服务提供者的平均分布类型为专业人员,占83.45%,非专业人员,占1.45%,无医疗服务,占15.11%。与男性相比,0.88%的女性在出生后的头三十天内死亡的可能性较小。回归结果表明,医疗服务提供者与新生儿死亡率呈正相关且显著相关。此外,医疗服务提供者每增加一个单位,母婴保健增加的可能性就会提高1.20%,总体上降低新生儿死亡率(风险比=0.60)。
结果表明,医疗服务提供者分布和母婴保健在降低新生儿死亡率方面起着至关重要的作用。为确保医疗服务提供者分布合理,促进孕产妇教育,增强妇女在获得母婴保健服务利用方面的决策能力,以及扩大免费母婴保健服务的可及性,是改善孕产妇和医疗保健成果的关键。