Introduction: The United Nations report in 2021 ranks Pakistan 21st among countries with the highest infant and child mortality rate in the world. It is the fifth most populous country in the world with a growth rate of 2% annually. Therefore, understanding child mortality is crucial to reducing the child mortality burden.

Method: The research utilized two waves of the Pakistan Demographic and Health Survey (PDHS), 2012-13 and 2017-18. The data are analyzed using logistic regression with interaction effects of household wealth status and propensity score matching techniques.

Results: The study reveals a positive link between polygyny and infant and child mortality. The odd ratios higher than "1" indicate increased mortality risk for infants and children belonging to polygynous families taking monogamous families as a reference category. Mortality risk is higher among children (OR 1.50 CI 0.18-12.63) as compared with infants (OR 1.28 CI 0.37-4.45). The main effect of household shows a negative association with infant and child mortality while after interacting with polygyny it turns out to be positive. The mortality risks increase with increasing wealth status. It can be translated as a positive link between household wealth status, and infant and child mortality in the context of polygyny.

Conclusion: Infants and children belonging to polygynous families experience increased mortality risk as compared with monogamous families. The household wealth status may not help improve child mortality.

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http://dx.doi.org/10.1002/ajhb.24168DOI Listing

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