All Theses and Dissertations

Impact of exclusive breastfeeding and consultation with lady health workers on diarrhea in children under 5 years of age in Pakistan

Kiran Naseem, Institute of Business Administration


This study analyzes the impact of the exclusive breastfeeding and consultation by Lady Health Worker (LHW) on the prevalence of diarrhea in children under five years of age in Pakistan. Given the severity of the situation of diarrhea in Pakistan and its associated costs on the entire community, there is a dire need of an in-depth investigation of the matter and, accordingly, implementation of a cost effective and in-context policy to minimize its burden. This research, using cross-sectional data (2012-2013 and 2017-2018) from Pakistan Demographic and Health Survey, inspects the determinants of childhood diarrhea, examines the role of breastfeeding and consultation with Lady Health Worker in contracting diarrheal rates in children, and tests the significance of this role. The sample size consists of 11,763 respondent households in the year 2012-2013 and 12,708 households in the year 2017-2018 respectively. A combination of covariates is used for breastfeeding based on whether the child receives exclusive or non-exclusive breastfeeding, and for Lady Health Worker (LHW) Care provided accounting for whether the mother consults a Lady Health Worker for her child suffering from diarrhea. A multiple logistic model is applied to work out a modified Grossman’s Health Production Function while controlling for other factors like child, mother and environmental characteristics. Other unobserved factors are also controlled across different Primary Sampling Units (PSUs). The study concludes that children who are exclusively breastfed are 0.402 times less likely to contract diarrhea compared to those who are not exclusively breastfed in the year 2012-2013. Additionally, children whose mothers consult lady health workers for their health and wellbeing are 0.802 times less likely to suffer from diarrhea. The preventive effect of these practices is also seen in the year 2017-2018 where children who receive exclusive breastfeeding are 0.811 times less likely to have diarrhea. We also find that children with above average size at the time of birth are at a lower risk of diarrhea. Females are less exposed to the risk of diarrhea than males, and as the mother’s increase in age, they can look after their children better which helps reduce their vulnerability to diarrhea. To conclude, awareness programs should be launched, digital and otherwise, to impart information about exclusive breastfeeding and lady health workers in the society so that a larger portion of the population can benefit. Offices should incorporate daycare centers to facilitate lactating mothers, and a separate space should be provided to allow breastfeeding at work. Lady Health Worker program should be revamped, and priority should be given to supplying timely remuneration and tool kits to lady health workers. Budget for this program should be revised and appropriate auditing should be carried out annually.