Assessing Maternal Health Efficiency and Predicting Mortality: An Empirical Analysis of Clinical determinants and Health system efficiency.

Abstract

Objectives:

Purpose: The paper explores the complicated relationships among the fundamental determinants of maternal health and their impacts on the maternal mortality rate (MMR) and the Neonatal mortality rate (NMR) in 2000-2024 in Pakistan. The study is appropriate in filling in key knowledge gaps about the synergistic interaction of skilled birth attendance, health expenditure, adolescent fertility, anemia prevalence, and lifetime risk of maternal death to determine the outcome of reproductive health in a low-resource context.

Methodology: The paper has used advanced econometric modeling as multivariate linear regression with interaction terms and longitudinal time-trend analysis. Two predictive models were constructed on the basis of 25 years (annual data 2000-2024) of analysis including direct effects, interaction modifiers (SBAxCHE and AFRxAnemia), and the trend of secular improvement. Heteroscedasticity, autocorrelation, multicollinearity, and normality tests were all performed in comprehensive diagnostic tests and proved model assumptions.

Results: Pakistan demonstrated substantial improvements with MMR declining 51% (from 305 to 150 deaths per 100,000 live births) and NMR decreasing from 50.3 to 32.7 deaths per 1,000 live births. Skilled birth attendance increased dramatically from 37% to 70%, while adolescent fertility declined from 78.6 to 40.5 births per 1,000 women aged 15-19. Both models achieved strong explanatory power (R² = 0.975 for MMR model) with all coefficients significant at the 5% level. Key interactions revealed synergistic benefits when skilled attendance and health expenditure increased together, while combined adolescent fertility and anemia showed compounded adverse effects.