Social determinants of acute respiratory infections in babies and infants in Pakistan: a population based study

Acute Respiratory Infection (ARI) is a leading cause of infant and child mortality in Pakistan. Studies on respiratory infections in Pakistan have largely been clinical or community based. There is almost no large scale population based study on the socio-economic and cultural aspects of ARI in Pakistan. We used data from Pakistan Demographic Health Survey 2005-06. Children under two years of age were our study sample (n=3135). Logistic regression was used to estimate the effects of factors on the incidence and treatment of ARI. Maternal education and ethnicity had significant impact on the incidence of ARI. The odds of ARI was substantially lower among children of mothers with secondary [OR 0.63, CI 0.41-0.95, p value 0.03] and university level education [OR 0.64, CI 0.36-1.16, p value 0.14] compared to children of mothers without any education. Sindhi, Siraiki and Balochi children had higher odds of incidence and treatment of ARI. Household wealth had no influence on the incidence of ARI. But poor children had lower odds of receiving treatment [OR 0.16, CI 0.08-0.33, p value .001] than children from wealthier families. There is an urgent need for multi-pronged policies and programmes aimed at increasing access to and utilisation of modern education and health care services, betterment of economic conditions of the poor and social and economic empowerment of women to improve the health of children in Pakistan.