Background
Aims and objectives
Methods
Data source
Study population
Outcome variables
-
At least four ANC visits (ANC4+) conducted by respondents during pregnancy for healthcare check-ups;
-
Deliveries assisted by a qualified skilled health professional, e.g. doctor, nurse, midwife or LHV; and
-
PNC check-ups of mothers and newborns within 41 days or six weeks after childbirth.
Independent variables
Statistical analysis
Results
Socio-demographic characteristics of respondents
Characteristics | PDHS (2006/07) | PDHS (2012/13) | ||
---|---|---|---|---|
n=5,724 |
n=7,461 | |||
n
| % |
n
| % | |
Regions/Provinces | ||||
Punjab | 2,305 | 40.3 | 2,008 | 27.0 |
Sindh | 1,626 | 28.4 | 1,591 | 21.3 |
Baluchistan | 1,113 | 19.4 | 1,149 | 15.4 |
Khyber Pakhtunkhwa | 680 | 11.9 | 1,532 | 20.5 |
Gilgit Baltistan | - | - | 709 | 9.5 |
Islamabad | - | - | 472 | 6.3 |
Geographical classification | ||||
Urban | 1,998 | 34.9 | 3,278 | 43.9 |
Rural | 3,726 | 65.1 | 4,183 | 56.1 |
Respondents age | ||||
15-24 years | 1,377 | 24.1 | 1,710 | 22.9 |
25-34 years | 2,925 | 51.1 | 3,967 | 53.2 |
35 years and above | 1,422 | 24.8 | 1,784 | 23.9 |
Respondents educational status | ||||
Uneducated | 3,811 | 66.6 | 4,121 | 55.2 |
Primary | 789 | 13.8 | 1,065 | 14.3 |
Secondary | 763 | 13.3 | 1,373 | 18.4 |
Higher | 361 | 6.3 | 902 | 12.1 |
Husbands educational status | ||||
Uneducated | 2,088 | 36.6 | 2,293 | 30.8 |
Primary | 921 | 16.1 | 1,014 | 13.6 |
Secondary | 1,788 | 31.4 | 2,441 | 32.8 |
Higher | 906 | 15.9 | 1,689 | 22.7 |
Respondents employment status | ||||
Unemployed | 4,092 | 71.5 | 5,936 | 79.6 |
Employed | 1,628 | 28.5 | 1,524 | 20.4 |
Husbands employment status | ||||
Unemployed | 191 | 3.3 | 197 | 2.6 |
Employed | 5,531 | 96.6 | 7,262 | 97.4 |
Respondents age at first birth | ||||
Less than 20 years | 2,549 | 44.5 | 2,952 | 39.6 |
20-29 years | 2,985 | 52.1 | 4,243 | 56.9 |
30 years and above | 190 | 3.3 | 266 | 3.6 |
Parity/Number of children | ||||
1-2 children | 2,024 | 35.4 | 2,828 | 37.9 |
3-4 children | 1,627 | 28.4 | 2,249 | 30.1 |
5 children or more | 2,073 | 36.2 | 2,384 | 32.0 |
Wealth quintile | ||||
Richest | 1,289 | 22.5 | 1,503 | 20.1 |
Richer | 1,235 | 21.6 | 1,423 | 19.1 |
Middle | 1,118 | 19.5 | 1,429 | 19.2 |
Poorer | 1,064 | 18.6 | 1,483 | 19.9 |
Poorest | 1,018 | 17.8 | 1,623 | 21.8 |
Exposure to mass mediaa
| ||||
Yes | - | - | 5,204 | 70.0 |
No | - | - | 2,226 | 30.0 |
Respondents autonomy in healthcare decision-making | ||||
Yes | - | - | 3,221 | 43.7 |
No | - | - | 4,146 | 56.3 |
Distance to health facility for medical care | ||||
Big Problem | - | - | 3,237 | 43.5 |
Not a big problem | - | - | 4,209 | 56.5 |
Transport arrangement for medical care | ||||
Big Problem | - | - | 3,555 | 47.7 |
Not a big problem | - | - | 3,891 | 52.3 |
Changing trends on measures of continuum of care
Characteristics | PDHS (2006/07) | PDHS (2012/13) | PDHS (2006/07) | PDHS (2012/13) | Gap over time | ||
---|---|---|---|---|---|---|---|
n=5,724 |
n=7,461 | mean | |||||
n
| % |
n
| % | % | |||
Continuum of Care for MNCH | |||||||
Pregnancy level: Antenatal care - at least four visits (ANC4+) | |||||||
At least 4 visits or more | 1,559 | 27.7 | 2,859 | 38.4 | 28 | 38 | 10 |
Less than 4 visits | 4,077 | 72.3 | 4,584 | 61.6 | |||
Delivery level: Skilled birth attendance at delivery (SBA) | |||||||
Yes | 2,408 | 42.1 | 4,224 | 56.8 | 42 | 57 | 15 |
No | 3,292 | 57.5 | 3,216 | 43.2 | |||
Postpartum level: Postnatal care (PNC) for mothers and newborn | |||||||
Yes | 2,755 | 48.5 | 4,708 | 63.2 | 48 | 63 | 15 |
No | 2,927 | 51.5 | 2,738 | 36.8 | |||
Continuum of Care (CoC) | |||||||
Continued Care at pregnancy | |||||||
Yes, received ANC4+ | 1,559 | 27.7 | 2,859 | 38.4 | 28 | 38 | 10 |
Not received | 4,077 | 72.3 | 4,584 | 61.6 | |||
Continued Care at delivery | |||||||
Yes, received ANC4+ and SBA | 1,139 | 20 | 2,397 | 32.3 | 20 | 32 | 12 |
Not received | 4,565 | 80 | 5,033 | 67.7 | |||
Complete Continuum of Carea
| |||||||
Continued Care at all three levels (ANC4+, SBA and PNC) | 852 | 14.9 | 2,045 | 27.4 | 15 | 27 | 12 |
Discontinued Care | 4,852 | 85.1 | 5,416 | 72.6 |
Associations of achievement of continued care at pregnancy, delivery and postpartum (complete CoC) with various factors
Characteristics | PDHS (2006/07) | PDHS (2012/13) | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n=5,724 |
n=7,461 | |||||||||||||||||
Care at pregnancy | Care at delivery | Complete Continued Care | Care at pregnancy | Care at delivery | Complete Continued Care | |||||||||||||
Cont. Care | Discont. Care |
p-valuea
| Cont. Care | Discont. Care |
p-valuea
| Cont. Care | Discont. Care |
p-valuea
| Cont. Care | Discont. Care |
p-valuea
| Cont. Care | Discont. Care |
p-valuea
| Cont. Care | Discont. Care |
p-valuea
| |
% | % | % | % | % | % | |||||||||||||
Geographical classification | ||||||||||||||||||
Urban | 56.2 | 26.7 | <0.01 | 63.2 | 27.9 | <0.01 | 64.9 | 29.7 | <0.01 | 61.3 | 33.1 | <0.01 | 64.8 | 34.1 | <0.01 | 65.2 | 35.9 | <0.01 |
Rural | 43.8 | 73.3 | 36.8 | 72.1 | 35.1 | 70.3 | 38.7 | 66.9 | 35.2 | 65.9 | 34.8 | 64.1 | ||||||
Respondents age | ||||||||||||||||||
15-24 years | 23.3 | 24.5 | <0.01 | 23.4 | 24.3 | <0.01 | 22.8 | 24.4 | <0.01 | 23.5 | 22.6 | <0.01 | 23.6 | 22.6 | <0.01 | 23.7 | 22.6 | <0.01 |
25-34 years | 57.2 | 49 | 58.7 | 49.2 | 60.8 | 49.4 | 56.3 | 51.2 | 56.6 | 51.6 | 56.1 | 52.0 | ||||||
35 years and above | 19.4 | 26.5 | 17.8 | 26.5 | 16.4 | 26.3 | 20.2 | 26.2 | 19.8 | 25.8 | 20.1 | 25.3 | ||||||
Respondents age at first birth | ||||||||||||||||||
Less than 20 years | 37.7 | 47.3 | <0.01 | 32.4 | 47.6 | <0.01 | 29.8 | 47.2 | <0.01 | 29.6 | 45.8 | <0.01 | 27.5 | 45.3 | <0.01 | 25.3 | 44.9 | <0.01 |
20-29 years | 58.6 | 49.6 | 63.2 | 49.3 | 66.0 | 49.7 | 64.7 | 51.9 | 66.0 | 52.5 | 67.7 | 52.8 | ||||||
30 years and above | 3.7 | 3.2 | 4.4 | 3.1 | 4.2 | 3.2 | 5.7 | 2.3 | 6.4 | 2.2 | 6.9 | 2.3 | ||||||
Respondents educational status | ||||||||||||||||||
Uneducated | 41.2 | 76.3 | <0.01 | 33.4 | 74.9 | <0.01 | 31.6 | 72.8 | <0.01 | 29.3 | 71.4 | <0.01 | 24.3 | 69.9 | <0.01 | 22.2 | 67.7 | <0.01 |
Primary | 16.7 | 12.6 | 16.7 | 13.0 | 16.3 | 13.3 | 15.7 | 13.4 | 15.0 | 13.9 | 15.2 | 13.9 | ||||||
Secondary | 24.8 | 8.9 | 27.7 | 9.7 | 27.9 | 10.8 | 29.7 | 11.4 | 31.6 | 12.2 | 31.2 | 13.6 | ||||||
Higher | 17.3 | 2.2 | 22.3 | 2.3 | 24.2 | 3.2 | 25.4 | 3.8 | 29.2 | 4.0 | 31.4 | 4.8 | ||||||
Husbands educational status | ||||||||||||||||||
Uneducated | 20.5 | 42.8 | <0.01 | 16.1 | 41.8 | <0.01 | 15.4 | 40.4 | <0.01 | 15.7 | 40.3 | <0.01 | 12.6 | 39.4 | <0.01 | 11.5 | 38.1 | <0.01 |
Primary | 12.4 | 17.5 | 11.0 | 17.4 | 10.2 | 17.1 | 10.7 | 15.5 | 9.6 | 15.5 | 9.4 | 15.2 | ||||||
Secondary | 38 | 29 | 39.1 | 29.4 | 38.2 | 30.1 | 38.0 | 29.6 | 38.1 | 30.4 | 38.2 | 30.8 | ||||||
Higher | 29.1 | 10.7 | 33.7 | 11.4 | 36.1 | 12.3 | 35.6 | 14.6 | 39.6 | 14.8 | 40.9 | 15.9 | ||||||
Respondents employment status | ||||||||||||||||||
Unemployed | 77.0 | 69.3 | <0.01 | 80.0 | 69.3 | <0.01 | 78.9 | 70.2 | <0.01 | 83.3 | 77.2 | <0.01 | 85.1 | 76.9 | <0.01 | 84.4 | 77.7 | <0.01 |
Employed | 23.0 | 30.7 | 20.0 | 30.7 | 21.1 | 29.8 | 16.7 | 22.8 | 14.9 | 23.1 | 15.6 | 22.3 | ||||||
Husbands employment status | ||||||||||||||||||
Unemployed | 3.0 | 3.5 | 0.34 | 2.9 | 3.5 | 0.34 | 2.2 | 3.5 | 0.05 | 1.9 | 3.1 | <0.01 | 1.8 | 3.0 | <0.01 | 1.5 | 3.1 | <0.01 |
Employed | 97.0 | 96.5 | 97.1 | 96.5 | 97.8 | 96.5 | 98.1 | 96.9 | 98.2 | 97.0 | 98.5 | 96.9 | ||||||
Parity/Number of children | ||||||||||||||||||
1-2 children | 42.4 | 32.8 | <0.01 | 47.2 | 32.5 | <0.01 | 48.2 | 33.2 | <0.01 | 49.6 | 30.7 | <0.01 | 52.5 | 30.9 | <0.01 | 53.8 | 31.9 | <0.01 |
3-4 children | 30.6 | 27.7 | 30.6 | 27.9 | 31.6 | 27.8 | 30.3 | 30.0 | 30.2 | 30.2 | 30.1 | 30.2 | ||||||
5 children or more | 27.0 | 39.5 | 22.2 | 39.7 | 20.2 | 39.0 | 20.1 | 39.3 | 17.3 | 38.9 | 16.1 | 37.9 | ||||||
Respondents autonomy to healthcare decision-making | ||||||||||||||||||
Yes | - | - | - | - | - | - | - | - | - | 52.3 | 38.3 | <0.01 | 54.1 | 38.9 | <0.01 | 54.0 | 39.8 | <0.01 |
No | - | - | - | - | - | - | - | - | - | 47.7 | 61.7 | 45.9 | 61.1 | 46.0 | 60.2 | |||
Exposure to mass media | ||||||||||||||||||
Yes | - | - | - | - | - | - | - | - | - | 87.4 | 59.1 | <0.01 | 89.9 | 60.5 | <0.01 | 91.2 | 62.0 | <0.01 |
No | - | - | - | - | - | - | - | - | - | 12.6 | 40.9 | 10.1 | 39.5 | 8.8 | 38.0 | |||
Wealth quintile | ||||||||||||||||||
Richest | 40.8 | 9.0 | <0.01 | 48.6 | 10.1 | <0.01 | 51.4 | 11.9 | <0.01 | 40.1 | 7.7 | <0.01 | 44.8 | 8.5 | <0.01 | 48.2 | 9.5 | <0.01 |
Richer | 24.8 | 16.1 | 24.8 | 17.0 | 23.7 | 17.6 | 24.5 | 15.6 | 25.0 | 16.2 | 24.6 | 17.0 | ||||||
Middle | 14.6 | 21.4 | 12.7 | 21.2 | 12.4 | 20.8 | 15.8 | 21.2 | 14.5 | 21.5 | 13.6 | 21.3 | ||||||
Poorer | 11.5 | 25.6 | 8.8 | 24.8 | 7.5 | 24.1 | 12.0 | 24.9 | 10.7 | 24.1 | 8.9 | 24.0 | ||||||
Poorest | 8.2 | 27.9 | 5.0 | 26.9 | 4.9 | 25.6 | 7.6 | 30.6 | 5.0 | 29.7 | 4.6 | 28.2 | ||||||
Distance from health facility for medical care | ||||||||||||||||||
Big problem | - | - | - | - | - | - | 28.7 | 52.7 | <0.01 | 25.2 | 52.0 | <0.01 | 23.9 | 50.9 | <0.01 | |||
Not a big problem | - | - | - | - | - | - | 71.3 | 47.3 | 74.8 | 48.0 | 76.1 | 49.1 | ||||||
Transport arrangement for medical care | ||||||||||||||||||
Big problem | - | - | - | - | - | - | 31.8 | 57.7 | <0.01 | 28.3 | 56.9 | <0.01 | 27.1 | 55.5 | <0.01 | |||
Not a big problem | - | - | - | - | - | - | 68.2 | 42.3 | 71.7 | 43.1 | 72.9 | 44.5 |
Characteristics | Model I (ANC4+) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
PDHS (2006/07) | PDHS (2012/13) | |||||||||||
Bivariate | Multivariate | Bivariate | Multivariate | |||||||||
OR | CI (95%) |
p-value | AOR | CI (95%) |
p-value | OR | CI (95%) |
p-value | AOR | CI (95%) |
p-value | |
Regions/Provinces | ||||||||||||
Baluchistan | 1 | 1 | 1 | 1 | ||||||||
Punjab | 4.39 | 3.32-5.79 | <0.01 | 3.01 | 2.21-4.10 | <0.01 | 3.94 | 3.27-4.74 | <0.01 | 2.42 | 1.94-3.03 | <0.01 |
Sindh | 4.95 | 3.73-6.57 | <0.01 | 4.96 | 3.63-6.77 | <0.01 | 5.17 | 4.27-6.25 | <0.01 | 4.30 | 3.45-5.36 | <0.01 |
Khyber Pakhtunkhwa | 2.71 | 2.01-3.66 | <0.01 | 2.27 | 1.64-3.16 | <0.01 | 2.37 | 1.95-2.88 | <0.01 | 2.00 | 1.59-2.50 | <0.01 |
Gilgit Baltistan | - | - | - | - | - | - | 3.27 | 2.62-4.08 | <0.01 | 3.69 | 2.84-4.79 | <0.01 |
Islamabad | - | - | - | - | - | - | 21.01 | 15.97-27.65 | <0.01 | 6.70 | 4.86-9.23 | <0.01 |
Geographical classification | ||||||||||||
Rural | 1 | 1 | 1 | 1 | ||||||||
Urban | 3.52 | 3.12-3.97 | <0.01 | 1.37 | 1.17-1.60 | <0.01 | 3.20 | 2.90-3.52 | <0.01 | 1.20 | 1.04-1.38 | 0.01 |
Respondents age | ||||||||||||
15-24 years | 1 | 1 | 1 | 1 | ||||||||
25-34 years | 1.23 | 1.06-1.41 | <0.01 | 1.17 | 0.96-1.43 | 0.12 | 1.06 | 0.94-1.18 | 0.35 | 1.04 | 0.88-1.24 | 0.62 |
35 years and above | 0.77 | 0.65-0.92 | <0.01 | 1.10 | 0.83-1.46 | 0.51 | 0.74 | 0.64-0.85 | <0.01 | 1.02 | 0.79-1.31 | 0.86 |
Respondents age at first birth | ||||||||||||
Less than 20 years | 1 | 1 | 1 | 1 | ||||||||
20-29 years | 1.48 | 1.31-1.67 | <0.01 | 0.95 | 0.81-1.12 | 0.54 | 1.92 | 1.74-2.13 | <0.01 | 1.18 | 1.04-1.36 | 0.01 |
30 years and above | 1.45 | 1.05-2.00 | 0.02 | 1.12 | 0.73-1.72 | 0.60 | 3.86 | 2.98-5.00 | <0.01 | 1.51 | 1.04-2.19 | 0.03 |
Respondents educational status | ||||||||||||
Uneducated | 1 | 1 | 1 | 1 | ||||||||
Primary | 2.46 | 2.07-2.92 | <0.01 | 1.37 | 1.13-1.67 | <0.01 | 2.85 | 2.47-3.29 | <0.01 | 1.44 | 1.22-1.69 | <0.01 |
Secondary | 5.13 | 4.34-6.06 | <0.01 | 1.92 | 1.56-2.36 | <0.01 | 6.37 | 5.58-7.28 | <0.01 | 2.14 | 1.80-2.54 | <0.01 |
Higher | 14.46 | 11.22-18.62 | <0.01 | 3.63 | 2.67-4.99 | <0.01 | 16.20 | 13.51-19.43 | <0.01 | 3.22 | 2.53-4.09 | <0.01 |
Husbands educational status | ||||||||||||
Uneducated | 1 | 1 | 1 | 1 | ||||||||
Primary | 1.48 | 1.21-1.81 | <0.01 | 0.99 | 0.80-1.23 | 0.95 | 1.76 | 1.49-2.09 | <0.01 | 1.07 | 0.88-1.29 | 0.48 |
Secondary | 2.74 | 2.35-3.20 | <0.01 | 1.36 | 1.13-1.64 | <0.01 | 3.29 | 2.88-3.75 | <0.01 | 1.34 | 1.14-1.57 | <0.01 |
Higher | 5.67 | 4.74-6.77 | <0.01 | 1.53 | 1.21-1.93 | <0.01 | 6.25 | 5.42-7.20 | <0.01 | 1.23 | 1.01-1.49 | 0.03 |
Respondents employment status | ||||||||||||
Unemployed | 1 | 1 | 1 | 1 | ||||||||
Employed | 0.67 | 0.59-0.77 | <0.01 | 0.98 | 0.83-1.16 | 0.85 | 0.68 | 0.62-0.77 | <0.01 | 0.92 | 0.78-1.07 | 0.27 |
Husbands employment status | ||||||||||||
Unemployed | 1 | 1 | 1 | 1 | ||||||||
Employed | 1.18 | 0.84-1.65 | 0.34 | 0.94 | 0.64-1.39 | 0.77 | 1.67 | 1.22-2.29 | 0.01 | 1.22 | 0.84-1.77 | 0.30 |
Parity/Number of children | ||||||||||||
5 children or more | 1 | 1 | 1 | |||||||||
3-4 children | 1.61 | 1.38-1.88 | <0.01 | 0.97 | 0.80-1.18 | 0.82 | 1.97 | 1.73-2.23 | <0.01 | 1.09 | 0.92-1.29 | 0.30 |
1-2 children | 1.89 | 1.64-2.18 | <0.01 | 1.16 | 0.92-1.46 | 0.20 | 3.15 | 2.80-3.55 | <0.01 | 1.66 | 1.35-2.03 | <0.01 |
Respondents autonomy to healthcare decision-making | ||||||||||||
No | - | - | - | - | - | - | 1 | 1 | ||||
Yes | - | - | - | - | - | - | 1.76 | 1.60-1.94 | <0.01 | 1.26 | 1.12-1.42 | <0.01 |
Exposure to mass media | ||||||||||||
No | - | - | - | - | - | - | 1 | 1 | ||||
Yes | - | - | - | - | - | - | 0.48 | 4.24-5.45 | <0.01 | 1.45 | 1.24-1.70 | <0.01 |
Wealth quintile | ||||||||||||
Poorest | 1 | 1 | 1 | 1 | ||||||||
Poorer | 1.54 | 1.21-1.95 | <0.01 | 1.49 | 1.16-1.92 | <0.01 | 1.93 | 1.59-2.32 | <0.01 | 1.41 | 1.14-1.74 | <0.01 |
Middle | 2.32 | 1.84-2.94 | <0.01 | 1.94 | 1.50-2.52 | <0.01 | 2.99 | 2.49-3.58 | <0.01 | 1.83 | 1.46-2.28 | <0.01 |
Richer | 5.25 | 4.21-6.56 | <0.01 | 3.15 | 2.42-4.11 | <0.01 | 6.28 | 5.27-7.50 | <0.01 | 2.64 | 2.08-3.36 | <0.01 |
Richest | 15.42 | 12.33-19.28 | <0.01 | 6.07 | 4.50-8.19 | <0.01 | 20.88 | 17.33-25.14 | <0.01 | 5.27 | 3.98-6.98 | <0.01 |
Distance from health facility for medical care | ||||||||||||
Big problem | - | - | - | - | - | - | 1 | 1 | ||||
Not a big problem | - | - | - | - | - | - | 2.76 | 2.50-3.05 | <0.01 | 0.88 | 0.74-1.04 | 0.13 |
Transport arrangement for medical care | ||||||||||||
Big problem | - | - | - | - | - | - | 1 | 1 | ||||
Not a big problem | - | - | - | - | - | - | 2.92 | 2.65-3.22 | <0.01 | 1.21 | 1.03-1.44 | 0.02 |
Characteristics | Model II (ANC4+ and SBA) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
PDHS (2006/07) | PDHS (2012/13) | |||||||||||
Bivariate | Multivariate | Bivariate | Multivariate | |||||||||
OR | CI (95%) |
p-value | AOR | CI (95%) |
p-value | OR | CI (95%) |
p-value | AOR | CI (95%) |
p-value | |
Regions/Provinces | ||||||||||||
Baluchistan | 1 | 1 | 1 | 1 | ||||||||
Punjab | 4.66 | 3.34-6.51 | <0.01 | 3.06 | 2.10-4.45 | <0.01 | 4.51 | 3.65-5.58 | <0.01 | 2.65 | 2.06-3.42 | <0.01 |
Sindh | 5.22 | 3.72-7.33 | <0.01 | 5.49 | 3.76-8.02 | <0.01 | 6.44 | 5.19-7.99 | <0.01 | 5.45 | 4.23-7.01 | <0.01 |
Khyber Pakhtunkhwa | 3.09 | 2.16-4.42 | <0.01 | 2.74 | 1.84-4.07 | <0.01 | 2.82 | 2.26-3.53 | <0.01 | 2.29 | 1.77-2.96 | <0.01 |
Gilgit Baltistan | - | - | - | - | - | <0.01 | 3.91 | 3.04-5.01 | <0.01 | 4.46 | 3.32-6.00 | <0.01 |
Islamabad | - | - | - | - | - | <0.01 | 25.80 | 19.46-34.20 | <0.01 | 7.80 | 5.59-10.89 | <0.01 |
Geographical classification | ||||||||||||
Rural | 1 | 1 | 1 | 1 | ||||||||
Urban | 4.45 | 3.88-5.10 | <0.01 | 1.55 | 1.29-1.85 | <0.01 | 3.55 | 3.21-3.93 | <0.01 | 1.19 | 1.02-1.37 | 0.02 |
Respondents age | ||||||||||||
15-24 years | 1 | 1 | 1 | 1 | ||||||||
25-34 years | 1.24 | 1.05-1.45 | 0.01 | 1.16 | 0.92-1.45 | 0.21 | 1.04 | 0.93-1.18 | 0.44 | 1.04 | 0.87-1.24 | 0.67 |
35 years and above | 0.69 | 0.57-0.85 | <0.01 | 1.08 | 0.78-1.51 | 0.64 | 0.73 | 0.63-0.85 | <0.01 | 1.09 | 0.84-1.42 | 0.51 |
Respondents age at first birth | ||||||||||||
Less than 20 years | 1 | 1 | 1 | 1 | ||||||||
20-29 years | 1.88 | 1.64-2.16 | <0.01 | 1.12 | 0.93-1.35 | 0.22 | 2.07 | 1.86-2.31 | <0.01 | 1.16 | 1.00-1.35 | 0.05 |
30 years and above | 2.10 | 1.49-2.96 | <0.01 | 1.59 | 0.99-2.54 | 0.05 | 4.79 | 3.70-6.21 | <0.01 | 1.68 | 1.14-2.47 | 0.01 |
Respondents educational status | ||||||||||||
Uneducated | 1 | 1 | 1 | 1 | ||||||||
Primary | 2.89 | 2.38-3.51 | <0.01 | 1.49 | 1.20-1.86 | <0.01 | 3.09 | 2.65-3.61 | <0.01 | 1.42 | 1.18-1.69 | <0.01 |
Secondary | 6.37 | 5.33-7.62 | <0.01 | 2.08 | 1.66-2.60 | <0.01 | 7.46 | 6.49-8.56 | <0.01 | 2.15 | 1.80-2.58 | <0.01 |
Higher | 21.37 | 16.65-27.43 | <0.01 | 4.62 | 3.35-6.37 | <0.01 | 20.80 | 17.39-24.88 | <0.01 | 3.48 | 2.73-4.44 | <0.01 |
Husbands educational status | ||||||||||||
Uneducated | 1 | 1 | 1 | 1 | ||||||||
Primary | 1.64 | 1.29-2.09 | <0.01 | 1.03 | 0.79-1.34 | 0.81 | 1.94 | 1.60-2.35 | <0.01 | 1.10 | 0.89-1.38 | 0.36 |
Secondary | 3.44 | 2.86-4.15 | <0.01 | 1.44 | 1.16-1.79 | <0.01 | 3.92 | 3.38-4.54 | <0.01 | 1.45 | 1.22-1.74 | <0.01 |
Higher | 7.65 | 6.25-9.35 | <0.01 | 1.56 | 1.20-2.03 | <0.01 | 8.35 | 7.15-9.74 | <0.01 | 1.43 | 1.16-1.77 | <0.01 |
Respondents employment status | ||||||||||||
Unemployed | 1 | 1 | 1 | 1 | ||||||||
Employed | 0.56 | 0.48-0.66 | <0.01 | 0.89 | 0.73-1.08 | 0.23 | 0.58 | 0.51-0.67 | <0.01 | 0.76 | 0.64-0.90 | <0.01 |
Husbands employment status | ||||||||||||
Unemployed | 1 | 1 | 1 | 1 | ||||||||
Employed | 1.20 | 0.82-1.76 | 0.34 | 0.97 | 0.61-1.51 | 0.88 | 1.72 | 1.22-2.41 | <0.01 | 1.24 | 0.82-1.87 | 0.31 |
Parity/Number of children | ||||||||||||
5 children or more | 1 | 1 | 1 | 1 | ||||||||
3-4 children | 1.96 | 1.64-2.34 | <0.01 | 1.05 | 0.83-1.31 | 0.68 | 2.25 | 1.96-2.58 | <0.01 | 1.20 | 0.99-1.45 | 0.05 |
1-2 children | 2.60 | 2.20-3.06 | <0.01 | 1.42 | 1.09-1.85 | <0.01 | 3.81 | 3.35-4.34 | <0.01 | 1.99 | 1.59-2.48 | <0.01 |
Respondents autonomy to healthcare decision-making | ||||||||||||
No | - | - | - | - | - | - | 1 | 1 | ||||
Yes | - | - | - | - | - | - | 1.85 | 1.68-2.05 | <0.01 | 1.30 | 1.15-1.48 | <0.01 |
Exposure to mass media | ||||||||||||
No | - | - | - | - | - | - | 1 | 1 | ||||
Yes | - | - | - | - | - | - | 5.82 | 5.04-6.73 | <0.01 | 1.43 | 1.19-1.71 | <0.01 |
Wealth quintile | ||||||||||||
Poorest | 1 | 1 | 1 | 1 | ||||||||
Poorer | 1.90 | 1.36-2.66 | <0.01 | 1.72 | 1.21-2.44 | <0.01 | 2.64 | 2.10-3.33 | <0.01 | 1.83 | 1.42-2.36 | <0.01 |
Middle | 3.23 | 2.35-4.44 | <0.01 | 2.40 | 1.70-3.40 | <0.01 | 4.03 | 3.23-5.04 | <0.01 | 2.31 | 1.78-3.01 | <0.01 |
Richer | 7.87 | 5.84-10.61 | <0.01 | 3.86 | 2.73-5.47 | <0.01 | 9.22 | 7.44-11.42 | <0.01 | 3.52 | 2.66-4.66 | <0.01 |
Richest | 25.91 | 19.33-34.73 | <0.01 | 7.57 | 5.21-10.99 | <0.01 | 31.61 | 25.42-39.29 | <0.01 | 6.79 | 4.95-9.31 | <0.01 |
Distance from health facility for medical care | ||||||||||||
Big problem | - | - | - | - | - | - | 1 | 1 | ||||
Not a big problem | - | - | - | - | - | - | 3.21 | 2.88-3.58 | <0.01 | 0.94 | 0.78-1.13 | 0.53 |
Transport arrangement for medical care | ||||||||||||
Big problem | - | - | - | - | - | - | 1 | 1 | ||||
Not a big problem | - | - | - | - | - | - | 3.35 | 3.01-3.72 | <0.01 | 1.25 | 1.04-1.49 | 0.01 |
Characteristics | Model III (ANC4+, SBA and PNC) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
PDHS (2006-07) | PDHS (2012-13) | |||||||||||
Bivariate | Multivariate | Bivariate | Multivariate | |||||||||
OR | CI (95%) |
p-value | AOR | CI (95%) |
p-value | OR | CI (95%) |
p-value | AOR | CI (95%) |
p-value | |
Regions/Provinces | ||||||||||||
Baluchistan | 1 | 1 | 1 | 1 | ||||||||
Punjab | 4.27 | 2.91-6.26 | <0.01 | 2.60 | 1.72-3.95 | <0.01 | 4.90 | 3.91-6.15 | <0.01 | 2.88 | 2.21-3.75 | <0.01 |
Sindh | 5.39 | 3.66-7.93 | <0.01 | 5.36 | 3.52-8.15 | <0.01 | 6.46 | 5.13-8.13 | <0.01 | 5.01 | 3.85-6.52 | <0.01 |
Khyber Pakhtunkhwa | 2.59 | 1.72-3.92 | <0.01 | 2.20 | 1.41-3.44 | <0.01 | 2.60 | 2.04-3.31 | <0.01 | 1.99 | 1.52-2.62 | <0.01 |
Gilgit Baltistan | - | - | - | - | - | <0.01 | 1.95 | 1.46-2.60 | <0.01 | 1.74 | 1.25-2.43 | <0.01 |
Islamabad | - | - | - | - | - | <0.01 | 20.72 | 15.64-27.44 | <0.01 | 5.56 | 3.99-7.74 | <0.01 |
Geographical classification | ||||||||||||
Rural | 1 | 1 | 1 | 1 | ||||||||
Urban | 4.39 | 3.76-5.11 | <0.01 | 1.45 | 1.19-1.76 | <0.01 | 3.35 | 3.01-3.73 | <0.01 | 1.14 | 0.98-1.33 | 0.09 |
Respondents age | ||||||||||||
15-24 years | 1 | 1 | 1 | 1 | ||||||||
25-34 years | 1.31 | 1.10-1.57 | <0.01 | 1.18 | 0.92-1.51 | 0.18 | 1.03 | 0.91-1.17 | 0.66 | 0.91 | 0.76-1.10 | 0.34 |
35 years and above | 0.67 | 0.53-0.84 | <0.01 | 1.02 | 0.71-1.46 | 0.92 | 0.76 | 0.65-0.88 | <0.01 | 1.07 | 0.82-1.41 | 0.61 |
Respondents age at first birth | ||||||||||||
Less than 20 years | 1 | 1 | 1 | 1 | ||||||||
20-29 years | 2.10 | 1.79-2.46 | <0.01 | 1.28 | 1.04-1.57 | 0.02 | 2.28 | 2.03-2.55 | <0.01 | 1.26 | 1.08-1.48 | <0.01 |
30 years and above | 2.11 | 1.43-3.09 | <0.01 | 1.64 | 0.98-2.72 | 0.059 | 5.38 | 4.15-6.97 | <0.01 | 1.74 | 1.19-2.56 | <0.01 |
Respondents educational status | ||||||||||||
Uneducated | 1 | 1 | 1 | 1 | ||||||||
Primary | 2.84 | 2.27-3.54 | <0.01 | 1.46 | 1.14-1.88 | <0.01 | 3.32 | 2.81-3.91 | <0.01 | 1.54 | 1.28-1.87 | <0.01 |
Secondary | 5.98 | 4.91-7.29 | <0.01 | 1.92 | 1.50-2.46 | <0.01 | 7.01 | 6.07-8.09 | <0.01 | 2.09 | 1.73-2.52 | <0.01 |
Higher | 17.45 | 13.69-22.24 | <0.01 | 3.44 | 2.48-4.77 | <0.01 | 20.05 | 16.84-23.86 | <0.01 | 3.73 | 2.92-4.76 | <0.01 |
Husbands educational status | ||||||||||||
Uneducated | 1 | 1 | 1 | 1 | ||||||||
Primary | 1.56 | 1.18-2.08 | <0.01 | 0.98 | 0.72-1.33 | 0.92 | 2.05 | 1.67-2.53 | <0.01 | 1.18 | 0.93-1.49 | 0.16 |
Secondary | 3.32 | 2.68-4.12 | <0.01 | 1.42 | 1.11-1.83 | <0.01 | 4.11 | 3.50-4.82 | <0.01 | 1.61 | 1.33-1.95 | <0.01 |
Higher | 7.67 | 6.13-9.60 | <0.01 | 1.60 | 1.20-2.14 | <0.01 | 8.54 | 7.24-10.08 | <0.01 | 1.60 | 1.28-2.00 | <0.01 |
Respondents employment status | ||||||||||||
Unemployed | 1 | 1 | 1 | 1 | ||||||||
Employed | 0.63 | 0.53-0.75 | <0.01 | 1.03 | 0.83-1.26 | 0.81 | 0.64 | 0.56-0.74 | <0.01 | 0.81 | 0.68-0.96 | 0.02 |
Husbands employment status | ||||||||||||
Unemployed | 1 | 1 | 1 | 1 | ||||||||
Employed | 1.61 | 1.01-2.60 | 0.05 | 1.29 | 0.76-2.19 | 0.35 | 2.13 | 1.44-3.16 | <0.01 | 1.38 | 0.87-2.19 | 0.16 |
Parity/Number of children | ||||||||||||
5 children or more | 1 | 1 | 1 | 1 | ||||||||
3-4 children | 2.19 | 1.78-2.68 | <0.01 | 1.16 | 0.90-1.49 | 0.25 | 2.34 | 2.02-2.72 | <0.01 | 1.23 | 1.01-1.50 | 0.04 |
1-2 children | 2.81 | 2.32-3.39 | <0.01 | 1.49 | 1.11-1.99 | 0.01 | 3.96 | 3.45-4.55 | <0.01 | 1.91 | 1.51-2.39 | <0.01 |
Respondents autonomy to healthcare decision-making | ||||||||||||
No | - | - | - | - | - | - | 1 | 1 | ||||
Yes | - | - | - | - | - | - | 1.77 | 1.59-1.96 | <0.01 | 1.19 | 1.04-1.36 | 0.01 |
Exposure to mass medias | ||||||||||||
No | - | - | - | - | - | - | 1 | 1 | ||||
Yes | - | - | - | - | - | - | 6.35 | 5.40-7.48 | <0.01 | 1.48 | 1.21-1.81 | <0.01 |
Wealth quintile | ||||||||||||
Poorest | 1 | 1 | 1 | 1 | ||||||||
Poorer | 1.62 | 1.09-2.41 | 0.02 | 1.55 | 1.03-2.34 | 0.03 | 2.29 | 1.76-2.97 | <0.01 | 1.53 | 1.15-2.03 | <0.01 |
Middle | 3.12 | 2.16-4.50 | <0.01 | 2.51 | 1.69-3.74 | <0.01 | 3.93 | 3.07-5.02 | <0.01 | 1.98 | 1.49-2.64 | <0.01 |
Richer | 6.99 | 4.96-9.85 | <0.01 | 3.73 | 2.51-5.56 | <0.01 | 8.92 | 7.05-11.28 | <0.01 | 2.79 | 2.07-3.78 | <0.01 |
Richest | 22.48 | 16.14-31.32 | <0.01 | 7.38 | 4.83-11.27 | <0.01 | 31.02 | 24.55-39.19 | <0.01 | 5.37 | 3.85-7.49 | <0.01 |
Distance from health facility for medical care | ||||||||||||
Big problem | - | - | - | - | - | - | 1 | 1 | ||||
Not a big problem | - | - | - | - | - | - | 3.30 | 2.94-3.70 | <0.01 | 1.04 | 0.85-1.25 | 0.71 |
Transport arrangement for medical care | ||||||||||||
Big problem | - | - | - | - | - | - | 1 | 1 | ||||
Not a big problem | - | - | - | - | - | - | 3.36 | 3.00-3.75 | <0.01 | 1.11 | 0.92-1.34 | 0.26 |