Page 190 - GHES-3-2

Global Health Economics and
Sustainability
Post-partum modern contraceptive use in Pakistan

in 2017 – 2018. The PDHS Program is a 5-year initiative information communication and technology indicators to
designed to help organizations gather and analyze data for assess the effect of technology. The detailed definition and
population, health, and nutrition programs that are planned, construction of the variables are given in Table 1.
tracked, and evaluated. The U.S. Agency for International
Development provides funding for the Demographic and 2.2. Methodology
Health Surveys (DHS) program through ICF International, The bivariate and multivariate analyses were used to
while other development partners also contribute to measure the association between the dependent and
funding the PDHS 2017-18. The sample design used in the independent variables and examine their significance levels.
2017 – 2018 PDHS was stratified in two stages. A two-stage Cross-tabulations were computed as part of the bivariate
selection procedure was used to select samples separately analysis to display the frequencies and percentages of key
for each stratum. socioeconomic and demographic characteristics and MCH
The survey covered 13,118 ever-married reproductive indicators in relation to the usage of modern contraceptive
women aged 15 – 49 years, of whom 12,363 eligible women methods. Furthermore, in the multivariate analysis, a
were successfully interviewed. The outcome variable was multinomial logistic regression model was employed to
the utilization of a modern contraceptive method within evaluate the effect of the utilization of MCH services on
the 12 months after the delivery of the recent child. the early initiation of modern contraceptive methods.
Therefore, the analysis is based on 5,990 women who gave
birth in the 5 years preceding the survey. 3. Results
The main independent variable was the utilization of Table 2 shows the percentages of women who were using
MCH services, defined as the utilization of MCH services the MCH service index and other sociodemographic
from the time of pregnancy through the post-partum time, indicators with respect to the early initiation of
including complete child immunization (Das et al., 2020). contraceptive methods. Therefore, Table 2 shows that
The MCH index was created by aggregating different among women who did not use MCH services, 79% did not
indicators for maternal (antenatal care, facility-based use any contraceptive method within 12 months following
delivery, post-natal care, and tetanus injection) and child birth, 16% used a modern method, and the remaining 5%
(complete child immunization) healthcare indicators. The used a traditional method. In contrast, 60% of women in
study also used several control variables such as a place Pakistan who utilized the MCH service did not use any
of residence, region, wealth index, women’s age at the method, 29% were using modern methods, and 11% were
time of the survey, educational status, media exposure, using traditional contraceptive methods. Thus, women
own mobile phone, use of the internet, and desire for who utilize MCH services are more aware of using modern
another child (Seiber et al., 2005; Dixit et al., 2017; Kumar contraceptive methods. Compared with those without
et al., 2020; Bansal et al., 2022). This study incorporates media exposure (18%), women who had media exposure

Table 1. Definition of the variables
Variable Definition
Use of modern The utilization of modern contraceptives was measured through the questions asked to currently married women
contraceptives aged 15 – 49 years using any contraceptive method. Modern contraceptive methods: Female sterilization, pill, intrauterine
(dependent variable) device, injectable, implants, condom, diaphragm, foam/jelly, and lactational amenorrhea method
Maternal and child healthcare index is composed of the given variables
1. ANC ANC was measured based on the respondent’s visits during their pregnancies in the 5 years preceding the survey and
received at least four antenatal care visits from any skilled personnel during pregnancy for the most recent birth
2. Facility-based All births that took place in medical facilities 5 years preceding the survey for the most recent birth were taken into account
deliveries when determining institutional delivery
3. Post-natal care Post-natal care is received by the respondent within 41 days after giving birth
4. Tetanus injection Respondent has received tetanus injections during pregnancy
5. Child immunization Full immunization is defined as those children aged 12 – 23 months receiving one dose of bacillus Calmette – Guerin, three
doses of diphtheria pertussis, and tetanus, an oral polio vaccine, and one dose of the measles vaccine.
Socioeconomic and Age of women, education of women, employment status, place of residence, media exposure, own mobile phone, use of the
demographic indicators internet, wealth index, region, and desire for more children, as ascertained at the time of the survey.
Notes: The definitions of the variables are taken from the Pakistan Demographic and Health Survey 2017 – 2018.
Abbreviation: ANC: Antenatal care.

Volume 3 Issue 2 (2025) 182 https://doi.org/10.36922/ghes.5090