Page 205 - GHES-3-3

Global Health Economics and
Sustainability

ORIGINAL RESEARCH ARTICLE
Impact of place of delivery on neonatal mortality

in Pakistan: Challenges and pathways toward
achieving the sustainable development goals

Amna Noor Asim* , Muhammad Mohsin Latif Kiani , Javed Ali ,
Aysha Sheraz , and Rabia Zafar
Department of Research and Survey, National Institute of Population Studies, Islamabad, Pakistan

Abstract

The United Nations present the Sustainable Development Goals (SDGs) with the
“leave no one behind” principle, with SDG 3 focusing on improving maternal and
child health outcomes to reduce neonatal mortality (NM). Although global NM rates
have declined significantly, NM persists as a pressing public health challenge across
developing regions. This ongoing burden necessitates intensified, multifaceted
interventions to accelerate progress toward SDG targets and enhance child survival
worldwide. This study provides evidence on the impact of place of delivery on NM, an
Academic editor: area that has received limited attention in existing research. The study utilized data
Mihajlo Jakovljevic M.D. Ph.D. MAE
from the Pakistan Demographic and Health Survey 2017 – 2018. A logistic regression
*Corresponding author: model was employed to analyze the association between NM and place of delivery.
Amna Noor Asim
(nooramnaasim@gmail.com) The primary variable of interest was the place of delivery, whereas sociodemographic
factors served as control variables. These factors included the mother’s employment
Citation: Asim, A.N., Kiani, M.M.L.,
Ali, J., Sheraz, A., & Zafar, R. status, child sex, birth order, maternal age, maternal education, residence, region,
(2025). Impact of place of delivery and size of the child. The analysis revealed that the place of delivery is a significant
on neonatal mortality in Pakistan: predictor of NM, with deliveries within facilities substantially reducing the odds
Challenges and pathways
toward achieving the sustainable of NM. Moreover, the study also found that the sex of a child, birth order, working
development goals. Global Health status, and region are highly significant indicators for predicting NM. These findings
Econ Sustain, 3(3):197-205. indicate that most neonatal deaths occur during deliveries outside health facilities in
https://doi.org/10.36922/ghes.5089
Pakistan. It is recommended that the government emphasize accessible healthcare
Received: October 8, 2024 services and develop educational programs that focus on facility-based deliveries,
Revised: March 13, 2025 prenatal care, and postnatal care for expectant mothers.
Accepted: March 17, 2025
Keywords: Neonatal; Mortality; Place of delivery; Health; Sustainable development
Published online: April 21, 2025
Copyright: © 2025 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution 1. Introduction
License, permitting distribution,
and reproduction in any medium, The decline in neonatal mortality rate (NMR) is a major concern for current national and
provided the original work is international policymakers across the government and private sectors. NMR serves as
properly cited. an indicator of both maternal and child health as well as a nation’s overall development.
Publisher’s Note: AccScience However, formulating effective policies and implementing existing interventions to
Publishing remains neutral with reduce newborn deaths remains a significant challenge in many developing nations.
regard to jurisdictional claims in
published maps and institutional Notably, India, Pakistan, and Bangladesh account for one-third of global neonatal
affiliations. mortality (NM) cases.

Volume 3 Issue 3 (2025) 197 https://doi.org/10.36922/ghes.5089