{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T02:04:45Z","timestamp":1789178685201,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T00:00:00Z","timestamp":1574812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>The aim of the study was to define social determinants, causes and trends in child mortality from 1990 to 2013 in Pakistan. Understanding social determinants, causes and temporal trends in child mortality can inform strategies aimed at improving child health in low and middle income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We characterised temporal trends and social determinants of child mortality in Pakistan using national demographic health survey data (1990\u20131991, 2006\u20132007 and 2012\u20132013). We analysed national data to generate regional estimates of health programme effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The annual rates of reduction for child mortality between 1990 and 2013 were estimated as follows: neonatal (\u22120.33% <jats:italic>per annum<\/jats:italic>), post\u2010neonatal (3.13% <jats:italic>per annum<\/jats:italic>), infant (0.9% <jats:italic>per annum<\/jats:italic>), child (2.47% <jats:italic>per annum<\/jats:italic>) and under 5 (1.19% <jats:italic>per annum<\/jats:italic>). Bivariate analyses of 2013 data showed that living in Punjab or Balochistan province, belonging to lowest wealth quintile, lack of maternal education, previous birth interval\u2009&lt;\u20092\u2009years, first birth order and below average birth size were associated (p\u2009&lt;\u20090.05) with greater risk of child mortality in Pakistan. Common factors associated with child mortality were fever, diarrhoea and pneumonia, while among stillbirths, intrapartum asphyxia, unexplained antepartum and antepartum maternal disorders were most frequent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Child survival strategies should integrate leading biosocial indicators and causes of death. Further research is needed to define the role(s) of social factors in child health and survival. These data should inform the implementation of cost\u2010effective interventions for child survival and advance targeting of interventions to populations at increased risk of child mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14670","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T12:59:27Z","timestamp":1574859567000},"page":"457-472","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Social determinants and causes of child mortality in Pakistan: Analysis of national demographic health surveys from 1990 to 2013"],"prefix":"10.1111","volume":"56","author":[{"given":"Kiran","family":"Afshan","sequence":"first","affiliation":[{"name":"Department of Animal Sciences, Faculty of Biological Sciences Quaid\u2010i\u2010Azam University  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghulam","family":"Narjis","sequence":"additional","affiliation":[{"name":"Department of Statistics, Faculty of Natural Sciences Quaid\u2010i\u2010Azam University  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan Z","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Animal Sciences, Faculty of Biological Sciences Quaid\u2010i\u2010Azam University  Islamabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2255-8833","authenticated-orcid":false,"given":"Michael","family":"Cappello","sequence":"additional","affiliation":[{"name":"Yale Partnerships for Global Health, Department of Pediatrics Yale School of Medicine  New Haven Connecticut United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,27]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Levels and Trends in Child Mortality: Report 2013","author":"The UN Inter\u2010Agency Group for Child Mortality Estimation","year":"2013"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71048-5"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001303"},{"key":"e_1_2_6_5_1","volume-title":"The Millennium Development Goals Report","author":"Ki\u2010Moon B","year":"2013"},{"key":"e_1_2_6_6_1","volume-title":"The World Health Report 2005: Make every Mother and Child Count","author":"Van Lerberghe W","year":"2005"},{"key":"e_1_2_6_7_1","unstructured":"National Institute of Population Studies (NIPS) [Pakistan] and ICF International.Pakistan Demographic and Health Survey 2012\u201313. 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