Minimum dietary diversity and associated determinants among children aged 6-23 months in Pakistan.

Pakistan is facing a high prevalence of malnutrition and Minimum Dietary Diversity (MDD) is one of the core indicators that remain below the recommended level. This study assesses MDD and its associated factors among children aged 6 to 23 months in Pakistan. The study uses a cross-sectional study using the dataset of the latest available Multiple Indicators Cluster Survey (MICS) for all provinces of Pakistan. Multistage sampling is used to select 18,699 children aged 6 to 23 months. The empirical method is the Logistic Regression Analysis and Chi-Square Test. The dataset is freely and publicly available with all identifier information removed, and no ethics approvals are required. About one-fifth (20%) of infants and young children aged 6 to 23 months had met MDD, this number varies from 17 to 29%, highest in Baluchistan and lowest in Punjab province of Pakistan. The age group (18-23) indicates a 2.45 times greater chance of having MDD. Age (< 0.001), diarrhea (0.01), prenatal care (0.06), mother's education (< 0.001), computer access (< 0.001), wealth quantile (< 0.001), and residence (< 0.001) were significantly associated with meeting MDD. However, gender (0.6) and mother's age (0.4) both were statistically insignificant in meeting MDD. Regarding mothers' education, compared to no education, the chance of MDD is 1.45 times greater for highly educated mothers in the Punjab province. Dietary diversity among children aged 6 to 23 months in Pakistan is low. It is recommended that mothers should be aware and encouraged to use dietary diverse food for infants and younger children.

Determinants of the food insecurity at household level in Pakistan: A multilevel model approach.

Food insecurity is a major concern for the developing world and around 37% of the population of Pakistan is food insecure. This paper utilizes the Food Insecurity Experience Scale (FIES) to assess the population prevalence of food insecurity and to identify their risk factors and determinants at the household level in Pakistan. This study employs a multi-level random coefficient model, using the Pakistan Panel Household Survey (PPHS-2010) dataset; representative data from 4,130 households. Factors like; income of the household, gender, education, household size, land ownership, and shocks of food insecurity allow the incidence of idiosyncratic shocks (injuries and/or casualties) at the community level, which affects the food insecurity situation of the community, rather differently were included. The study confirms a statistically significant inverse relationship between household income, household size, and household head education with food insecurity and a positive association of shocks and inflation with food insecurity at the household level. Specifically, with increasing per capita income of the household, food insecurity declines (coefficient: -0.083, statistically significant at 1%) and food insecurity increases with shocks (coefficient: 0.058, statistically significant at 1% significance level). The study also reveals a significant heterogeneity at a one percent significance level in the determinants of food insecurity at the district, community, and household levels. The income of the household, household head gender and education level, household size, household assets, shocks, injuries, and inflationary pressure are important determinants of food insecurity in Pakistan.

Perceptions of health care workers on maternal and child health services in Pakistan during COVID-19: A cross-sectional study.

Background: Maternal and child healthcare service delivery in vulnerable and fragile health systems has suffered a tremendous impact owing to the shift in focus to curtail the COVID-19 pandemic. We aimed to evaluate the impact of the COVID-19 pandemic on maternal and child healthcare services to inform policy advice for a more resilient maternal and child healthcare service delivery in Pakistan. Methods: A descriptive cross-sectional study was conducted. A structured and validated questionnaire was transformed into an online version and a link was first sent to about 300 healthcare professionals to achieve a sample size of 203, including medical doctors, nurses, and other paramedical staff working in public sector health facilities of the four provinces of Pakistan. The questionnaire was responded to by 195 participants. The Chi-Square test was used to determine the statistical differences between the categorical variables. Results: Although about two-thirds of the participants reported a moderate adherence to protocols and procedures to prevent COVID-19 in their health facilities, the maternal and child health service delivery-related indicators declined during the pandemic. For instance, 66.8% and 62.4% of the participants, respectively, did not agree that a Neonatal Intensive Care Unit and an Intensive Care Unit to admit sick newborns and women with obstetric complications during the COVID-19 pandemic were available during the COVID-19 pandemic. In addition, 23% and 20% of the participants, respectively, reported that staff availability and the provision of cesarean section were moderate to extremely affected. The association between job designation and the impact of COVID-19 was statistically significant (χ2 p = 0.038). Conclusions: The study suggests that maternal and child healthcare services including C-Section, perinatal care, and inpatient care of newborns in Pakistan may have been moderately affected by the COVID-19 pandemic.