Child health remains a critical concern in developing countries like Pakistan, where social, economic, and systemic disparities deeply influence maternal and child well-being. This thesis comprises three essays that explore interconnected dimensions of child health, employing data from various rounds of the Pakistan Demographic and Health Surveys (PDHS). These essays collectively investigate the roles of intimate partner violence, women’s empowerment, and prenatal care quality in shaping birth outcomes, child malnutrition, and childhood mortality. By addressing these pressing issues, the thesis seeks to contribute to a deeper understanding of the complex factors impacting child health in Pakistan, offering insights into potential interventions that can improve maternal and child well-being across the country.

In the first essay, we examine the association of intimate partner violence in life and during pregnancy with birth outcomes in Pakistan. The birth outcomes include child size at birth, miscarriage, and stillbirth. The secondary objective of this essay is the investigation of the association between two main dimensions, namely physical violence and emotional violence, and birth outcomes. To study the above-mentioned association, the data from the last two surveys is utilized. To investigate the association between domestic violence and birth outcomes, Linear Probability Model is used. The results indicate that exposure to intimate partner violence, whether in lifetime or during pregnancy, is significantly associated with miscarriage and small birth size, while the study does not find any association between exposure to intimate partner violence and stillbirth. Furthermore, the results of this study indicate that women residing in rural areas, those with lower socioeconomic status, and less educated mothers may be significantly affected by the intimate partner violence they are exposed to in their lifetime as well as during pregnancy.

In the second essay, we investigate whether child malnutrition is associated with women empowerment in Pakistan. In addition, we also examine the association of child malnutrition with the three major aspects of women’s empowerment. Child malnutrition is indicated by stunting, wasting, and being underweight. The last two surveys (PDHS 2012-13 and PDHS 2017-18) provide the data used in this essay. For measuring women empowerment, we use three major components of women empowerment: decision making, social independence, and attitude towards violence. For empirical investigation, we use linear probability models. Our findings suggest child malnutrition is significantly associated with each of the three components of women’s viii empowerment. Similarly, the children from mothers who are less educated, live in rural regions, and belong to lower wealth quantiles are at greater risk of being malnourished.

In the third essay, we inquire whether prenatal care quality and childhood mortality are associated in Pakistan. Quality of prenatal care is mainly measured through five indicators that are discussed in the third essay. A prenatal care quality index is created, and we check its association with childhood mortality. We constructed the index by adding up all ‘yes’ responses to the indicators: (1) blood pressure checkups, (2) tests on urine samples, (3) tests on blood samples, (4) tetanus vaccination, and (5) Iron folic supplements they receive during ANC utilization. Besides, we also check the association of each of its indicators with childhood morality. Similarly, we also check the mediation effect of birth endowment (child size at birth) on childhood mortality. To estimate the association between prenatal care quality and childhood mortality, we use Linear Probability Models. Similarly, for investigating the mediation effect of birth endowment, we use path analysis, a structural equation modeling technique. Childhood mortality consists of three main indicators: neonatal mortality, infant mortality, and under-five mortality. Our findings suggest that increased prenatal care quality may lead to reduced childhood mortality. The disaggregated analysis shows that tetanus injection is significantly and negatively associated with childhood mortality.

Together, the three essays in this thesis underscore the multifaceted nature of child health in Pakistan, emphasizing the interplay of social, behavioral, and systemic determinants. The findings reveal the detrimental effects of intimate partner violence on birth outcomes, highlight the pivotal role of women’s empowerment in reducing child malnutrition, and demonstrate the significance of prenatal care quality in lowering childhood mortality. By drawing on comprehensive survey data and employing robust analytical techniques, this research offers valuable evidence for policymakers and stakeholders aiming to design targeted interventions that address these critical issues. Ultimately, the thesis calls for a holistic approach to improving child health in Pakistan, one that prioritizes the empowerment of women, enhances healthcare quality, and mitigates the adverse social factors affecting maternal and child outcomes