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Background: Exclusive Breast Feeding is one of the most cost effective and simple ways to ensure child health and survival and is the single most instrumental intervention that leads to decreased child mortality and morbidity. This study was done to determine the frequency of exclusive breast feeding among mothers in rural Rawalpindi and to determine the frequency of factors affecting exclusive breast feeding among mothers in rural Rawalpindi. Methods: It was a descriptive cross- sectional study, conducted in 6 months in Union Council Mandra, from November 2014 to April 2015. A sample size of 245was selected through non-probability consecutive sampling. Data was collected on a structured questionnaire from mothers visiting the RHC Mandra facility after taking informed consent. Data was analyzed in the statistical software SPSS 10. Conclusion: Health education by health professionals during antenatal period to initiate and maintain exclusive breast feeding should be strengthened by focusing more on the nutritional aspects of the newborn babies and its benefits in the later life. Results: The frequency of Exclusive Breast Feeding (EBF) determined in the study was 52.2%. 29% mothers had primary level education, 52.7% had deliveries in the public hospitals and 46.5% were house wives. The birth order, age of the child, number of antenatal visits, birth wt. and mode of delivery (p<0.05) were significantly associated with EBF. The association of mother's and father's education level, monthly income, birth interval and mother's occupation with EBF were not statistically significant (p>0.05). Conclusion: Health education by health professionals during antenatal period to initiate and maintain exclusive breast feeding should be strengthened by focusing more on the nutritional aspects of the newborn babies and its benefits in the later life. [ABSTRACT FROM AUTHOR]

Objectives Pakistan is one of five nations contributing to half of the world's child mortality and holds under-five mortality rates which are nearly double global targets. Reasons for this shortfall include civil conflicts, political uncertainty, low education, poverty, rural-urban disparities, and limited health care access. The aim of this study was to explore associations between individual characteristics, community factors, and child mortality in Pakistan. Methods Data were derived from the 2012 to 2013 Pakistan Demographic and Health Survey, and included 7399 live births and 380 child deaths. Multivariate, multilevel logistic regression was used to model risk of neonatal, infant and under-five child deaths. Results Seventy-one percent of child deaths occurred during the neonatal period. Significant factors ( p < 0.05) associated with lower odds of child mortality included adhering to recommended minimum of 24 months interpregnancy interval and higher household wealth. These were significant for neonatal (OR 0.448; 0.871), infancy (OR 0.465; 0.881), and under-five deaths (OR 0.465; 0.879). Employed mothers had higher odds of neonatal (OR 1.479), infant (OR 1.506), and child mortality (OR 1.459). Likewise, women living in consanguineous marriages had higher odds of infant (OR 1.454) and under-five deaths (OR 1.381). Children in Balochistan, Punjab, and Sindh, regions disproportionately poor, rural with low levels of education, were at highest risk of dying. Conclusions for Practice Findings may assist in designing targeted interventions, developing appropriate public health messaging, and implementing policies designed to lower child mortality. Focusing on lowering rates of maternal poverty, increasing opportunities for education, and improving access to health care could assist in reducing child mortality in Pakistan. [ABSTRACT FROM AUTHOR]

Background: This study used data from recent Demographic and Health Surveys (DHS) to examine the impact of short or long preceding birth intervals on neonatal and under-five mortality. In order to minimize the effect of selection issues, we examined child mortality outcomes of the same mother, comparing short or long interval births against births with what had previously been considered optimal intervals. Methods: We analyzed 47 DHS datasets from low- and middle-income countries. For each dataset, we compared neonatal and under-five mortality of short preceding interval births (<18 months, <24 months) to reference interval births (24-<60 months) of a mother, using conditional logistic regression matching on the mother. We also conducted the same matched analysis for long (⩾60 months, ⩾72 months) preceding interval births. These associations were then meta-analyzed. We also stratified the analyses by mothers' completed fertility (fertility at end of reproductive period) to assess whether maternal characteristics highly correlated with completed fertility modify the association between birth interval and child mortality. Results: Children with shorter preceding intervals had increased odds of both neonatal (<24 months, OR: 1.61, 95% CI: 1.52-1.70) and under-five mortality (<24 months, OR: 1.48, 95% CI: 1.40-1.56). When the associations were stratified by the mothers' completed fertility, the impact of short intervals was greatly reduced or eliminated for low fertility mothers. In contrast, mortality associations became stronger for children of high fertility mothers. However, when the births of high fertility mothers were limited to birth orders 2-4, the associations were comparable to those of low fertility mothers. Longer preceding birth intervals had lower odds of mortality than reference intervals (i.e. under-5 mortality for ⩾60 months, OR 0.59, 95% CI: 0.52-0.67). This effect was also mediated by mothers' completed fertility; there was a strong protective effect of longer birth intervals for the high fertility mothers but not for low fertility mothers. Conclusions: These analyses reproduced findings reported in previous literature that shorter birth intervals are associated with higher child mortality. However the negative impact of short birth intervals may only occur in high parity births. Reproductive health interventions that seek to lengthen birth intervals may have larger impact by targeting women with high parity. This finding is consistent with the concept of maternal depletion as the underlying cause of increased adverse child outcomes associated with shorter birth intervals. [ABSTRACT FROM AUTHOR]