All Theses and Dissertations


Master of Science in Economics


Department of Economics

Date of Award

Fall 2020


Dr. Heman Das Lohano

Committee Member 1

Dr. Heman Das Lohano, Professor, Institute of Business Administration, Karachi

Project Type


Access Type

Restricted Access

Document Version



vii, 29


Health Economics


Despite huge advancements in medical science and continuous focus on health issues and suggested interventions by local and international agencies, child mortality is still endemic. The world has experienced tremendous declines in under-five mortality since the 1960s but the disparity, however, is so profound and vivid that at the global level, there exist almost 60-fold variation in infant mortality rates between high and low mortality countries (Schell et al., 2007). The world Mortality Report 2017 by the UN explains that part of the reason for these huge disparities lies in the disproportionate progress in health and development, which manifests itself in inequalities in access to safe drinking water, food, sanitation, medical care, and other basic facilities. This research endeavor is an attempt to quantify the role of such policy variables like breastfeeding and immunization in reducing under-five mortality in the context of Pakistan. The study controls various determinants including skilled medical care, maternal factors and like. For this objective, data from the most recent rounds (2012-13 and 2017 18) of Pakistan Demographic and Health Survey (PDHS) is pooled. The sample in this survey is representative of the national and provincial levels. All children under the age of five born five years before each survey are the unit of analysis for this study. The instrumental variable-probit model was used to examine the association of breastfeeding and immunization with under-five mortality on a sample of 26,613 births across two age groups (infants aged 0-11 months and under-five aged 0-59 months). The results indicate that breastfeeding has a strong and highly significant negative impact on both infant and under-five mortality even after controlling for factors such as child characteristics, mother characteristics and household characteristics. This study finds that for every increase in the average number of vaccinations of children under five at the household level the under-five mortality decreases by 1.1 percent and infant mortality by 0.6 percent. Also, every child who is ever breastfed as compared to never breastfed has about a 33 percent lesser probability of succumbing to death. The results of the study signify an important role of these policy variables in reducing under-five mortality and to bringing mortality rates in line with the Sustainable Development Goals targets.

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