{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T04:39:00Z","timestamp":1782880740121,"version":"3.54.5"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hum Biol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Differential sex child mortality is an important indicator of gender\u2010based discrimination. Decentralization refers to the distribution of power from the federal to the provincial governments in Pakistan. Present research highlights the sex differential sex trends in infant, neonatal, and child mortality before and after decentralization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>The research utilizes the four waves of the Demographic and Health Survey from 1990 to 2018, applying Cox proportional regression in STATA. The sample size includes 164\u2009005 total live births and 24\u2009089 deaths across all years, with 8204 neonatal, 5107 infants, and 11\u2009778 child deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study provides crucial insights into the gendered patterns of neonatal, infant, and child mortality in Pakistan before and after key policy reforms. This study reveals persistent gender disparities in neonatal, infant, and child mortality in Pakistan before and after policy reforms. While girls initially had a biological survival advantage, this diminished at higher birth orders, where they faced increased mortality risks. Despite some improvements post\u2010reform, gender\u2010based discrimination and son preference continue to disadvantage female children, particularly in larger families.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings highlight the need for targeted policies to address healthcare inequities and discriminatory practices. Strengthening gender\u2010sensitive interventions is crucial to improving female child survival and achieving long\u2010term progress in reducing mortality disparities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajhb.70012","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T07:25:15Z","timestamp":1739863515000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Differential Sex Trends in Infant, Neonatal, and Child Mortality Before and After Decentralization in Pakistan"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7378-266X","authenticated-orcid":false,"given":"Mukhtiar Hussain","family":"Ibupoto","sequence":"first","affiliation":[{"name":"School of Education Fujian Normal University  Fuzhou Fujian People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athar Ali","family":"Shah","sequence":"additional","affiliation":[{"name":"School of Education Fujian Normal University  Fuzhou Fujian People's Republic of China"},{"name":"School of Public Policy and Administration Xian Jiao Tong\u00a0University  Shanxi Xian People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anqi","family":"Sang","sequence":"additional","affiliation":[{"name":"School of Education Fujian Normal University  Fuzhou Fujian People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"issue":"3","key":"e_1_2_11_2_1","first-page":"331","article-title":"Decentralization's Effects on Health","volume":"62","author":"Ahmed M.","year":"2023","journal-title":"Pakistan Development Review"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13524-016-0455-0"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1353\/jda.2008.0026"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/children9101559"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13524-015-0377-2"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.25336\/P67P5Z"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70213-X"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13524\u2010020\u201000863\u2010x"},{"key":"e_1_2_11_10_1","volume-title":"Learning for All. 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