Showing papers in "The Pakistan Development Review in 1994"

Who Gets Primary Schooling in Pakistan: Inequalities among and within Families

Abstract: This multivariate analysis is an examination of factors affecting primary school attendance among and within families in Pakistan. Data were obtained from the 1991 Pakistan Integrated Household Survey on a national sample of 4711 households and 6872 children. Pakistan is described as experiencing rapid growth in per capita income despite low levels of investment in education. Development policy is slow to recognize the need for guaranteeing at least a primary education. Additional problems are the inability to keep pace with facilities particularly in rural areas. Schooling is not compulsory. Access is limited and parents must pay expenses. School enrollment was reported as 49.3% in 1989-90. The enrollment reflects a slight increase and a wider gap between genders (64% for boys and 34% for girls). The Punjab reports the highest enrollment and the lowest gender differences. In urban areas completion of primary school is the same for both genders (60-61%) but in rural areas there is a gap (53% for boys and 43% for girls). Primary school costs may be 5-20% of a familys average annual income. 18% of urban girls and 5% of boys lack access to any school within one kilometer of home. 21% of rural girls either lack access or have access only to a public facility. Private facilities are lacking in rural areas. The statistically significant findings indicate that maternal schooling and household consumption increase the probability of completion of primary school and the probability of school enrollment for both sexes in urban and rural areas. The quality and accessibility of single sex schools for girls is a significant determinant of girls schooling. The number of siblings does not affect enrollment but does reduce parents investment in educational quality. Access to a private school increases the likelihood of girls completing primary school in urban and rural areas while additional children reduces the probability of completion of school. The determinants of educational quality are maternal education household consumption and fathers literacy.

Economic Determinants of Foreign Direct Investment in Less Developed Countries

Abstract: This study examines the economic determinants of private foreign direct investment (FDI) by using a single-equation econometric model for 36 LDCs for the year 1983. The market size of the host country as measured by per capita GDP is found to be the most important factor in attracting FDI. The other important variables which influence FDI are found to be the cost factor (such as wage cost) and the investment climate in the host country (represented by such variables as per capita debt). The inflow of per capita public aid and economic instability, proxied by the volatility of prices, are other important factors affecting the flow of FDI. While larger market size and increased inflow of public aid attract FDI, the higher wage cost, poor investment climate, and economic instability in the host countries reduce the inflow of FDI. The model used to obtain these results is found to be structurally stable across countries.

Impact of devaluation on Pakistan's external trade : an econometric approach

Abstract: Exchange rate policy to improve external competitiveness has now become the centre piece of any adjustment effort. It is expected that a nominal devaluation will result in expenditure switching, increased production of tradeable, higher exports, and in an improvement of the external accounts of the country in question. Recently, the traditional stabilisation packages, and especially their devaluation component, have come under attack by a number of authors.! It has been argued that devaluation can be counterproductive because exports and imports are relatively insensitive to price and exchange rate changes, especially in developing and semi-industrialised countries.2.3 If the price elasticities of imports and exports are sufficiently low, the trade balance expressed in domestic currency may worsen. Grubel (1976) has argued that a country's persistent payments imbalances can be due only to faulty monetary policy and cannot be corrected by either devaluation (exchange rate policy) or the use of fIscal policy. In a recent article, Miles (1979) claims to have provided the requisite evidence to support Grubel's argument. Miles (1979) shows that devaluation does not improve the trade balance but improves the balance of payments. This results implies that the improvement comes through the capital account.

Structural adjustment, employment, income distribution and poverty

Abstract: The Structural Adjustment and Stabilisation Programmes of the IMF, World Bank and other international financial institutions for Pakistan have called for a reduction in the fiscal deficit, a restricted role of government in the economy, rationalisation of tax structure, removal of subsidies on consumption and production, etc. with a view to fostering efficiency, higher levels of output, stability of prices, etc. To what extent these objectives have been realised has rarely been examined. Firoze (1986) is probably the only exception who concludes that because of the structural weakness and adherence to just financial criteria these programmes have resulted in accumulating structural problems rather than alleviating them. These programmes also have significant implications for employment, poverty and income distribution.

Mincerian Earnings Function for Pakistan

Abstract: Due to its central role in various debates about the detenninants of individual earnings, the Mincerian earnings function (MEF) as given in Mincer (1974) has attracted the attention of many economists. The MEF has been estimated virtually for every country except Pakistan, where a necessary condition has been missing, i.e., national level data on the exact number of years of schooling completed has not been available; instead, in a majority of the relevant micro-level surveys, schooling has been measured only in terms of a 'categorical' variable with possible values being 'Primary and Incomplete Middle', 'Middle and Incomplete Matric', etc. At best, this data deficiency has restricted the existing estimated earnings functions to what we refer to as the 'Dummies earnings functions' (DEF) since they are constrained to specify schooling in terms of a set of dichotomous dummy variables. Using a nationally representative data on male eameG, this study tries to fill the above gap by estimating the MEF both in its 'strict' as well as the 'extended' forms. In terms of the 'strict' MEF, i.e., the one analogous to Mincer's (1974) specification which essentially treats earnings as a function of schooling and job-market experience, the main fmdings are that the marginal rate of return to schooling is 8 percent, the experience- earnings profile is consistent with the pattern suggested by the human capital theory and as much as 41 percent of the variance in log earnings is accounted for by the strictly defined MEF. By and large, these findings are consistent with those implied by estimated MEFs for comparable LDCs. Further, the present study also estimates 'extended' MEF, whose specification supplements that of the 'strict' MEF by adding variables to control for urban vs rural background, occupational categories, employment status, and provincial heterogeneity. The 'extended' MEFs are also estimated separately for urban and rural samples and for each province. Formal 'Chow-type F tests' conducted to test for homogeneity of the parameters of MEF across different sub-samples reveal 'pervasive' segmentation across the above strata.

Consanguineous marriages in Pakistan.

Abstract: Data were collected on the occurrence of marriages between close relatives including cousins as well as between nonrelatives from 6611 ever married women as part of the 1990-91 Pakistan Demographic and Health Survey (PDHS). The patterns of age at marriage fertility child mortality and urban and rural residence would help authenticate the hypothesis that genetic risks to child health are higher among children of parents closely related. The PDHS indicated that more than half of ever married women aged 15-49 were married to their first cousins. The inclusion of second cousins raised the percentage of consanguineous marriages from 50.3 to 61.2. Another 1.3% were married to other relations and the rest (over 37%) were married to non-relatives. The PDHS also showed that compared to the women who married at <18 years of age the percentage of those who were married to first cousins was slightly lower among those married at older ages. Distinct urban-rural differentials emerged. In the urban areas the marriages to cousins amounted to 51.3% and 53.1% when other relatives were also counted. In contrast 65.6% and 66.9% respectively were the figures in rural areas. First cousin marriages were higher in the provinces of Baluchistan and Punjab (53% and 54.4% respectively) than those in Sindh (49.7%) and the North-West Frontier Province (38.8%). Among females the educational status was important with respect to marriages to first cousins: 52.2% had no education 48.9% had primary education 43.1% had middle level education and 32.5% had secondary education. The mean age at marriage of women where the spouse was the cousin was less than when they were married to others. The PDHS demonstrated that only 1.3% of ever married women aged 15-49 were divorced or separated. In addition child mortality was higher for women married to cousins than those married to others. Child morbidity was also somewhat higher among these marriages except for those living in urban areas where the reverse was true. This peculiarity requires further study of the problem of consanguinity.

Are Government Budget Deficits Inflationary? Evidence from Pakistan

Abstract: In academia as well as policy-making institutions, there has been a long standing interest in analysing the phenomenon of inflation. Amongst the possible determinants of inflation, budget deficits may be one whose importance might have grown since the oil price hikes of 1973-74 and in 1979. For many a developing countries these increases in oil price have been responsible for the massive current account deficits as well as rapidly increasing domestic budget deficits of the last decade or so. During the 1980s, the budget deficit for Pakistan also grew rapidly reaching a record high of 8.6 percent of the G D P in 1987-88. Lately in the backdrop of the recent structural adjustment programmes, there has been much interest in determining the optimal size and the macro economic role of the budget deficits. However, despite its growing importance, the effects of budget deficits are not well understood.

Macroeconomic effects of adjustment lending in Pakistan

Abstract: During the 1970s and early 1980s, many developing countries faced macroeconomic problems, notably large fiscal deficits, vulnerable balance of payments positions, increasing inflation rates, lower rates of domestic savings, and as a consequence lower capital formation and economic growth rates. The major financial lending institutions, preeminently the W orId Bank and the International Monetary Fund (IMF), argue that the present macroeconomic problems in less developed countries (LDCs) are due to structural maladjustments-poor economic policies and weak institutions. Therefore, since 1980, these donor agencies have been proposing Structural Adjustment Programmes (SAPs) and Sectoral Adjustment Programmes (SECAPs) associated with Structural Adjustment Lending (SALs) and Sectoral Adjustment Lending (SECALs), respectively. These programmes focus on broader macroeconomic adjustment policies. The disbursement of SALs and SECALs are, how~ver, conditional upon the recipient countries adopting economic policies specified by the staff of the World Bank and the IMF.

Mother's education and utilisation of health care services in Pakistan.

Abstract: Education is one of the crucial social development variables especially for mothers which enriches their mind about their social and reproductive experiences and broadens their understanding to make better choices for themselves and rearing and bearing of their children. In many developing countries there is evidence that mother's education plays an important role in determining child mortality even in situations where the medical facilities are scanty [Berrera (1990); Caldwell (1979, 1981)]. Education, it is argued influences women's beliefs about the good health, causes and cures of diseases that increases the demand of the utilisation of modern health care facilities. Therefore, educated mothers are more likely to seek medical treatment for themselves and for their children resulting in higher intensity of the use of a better quality modern care that grows with the advancement of education. Evidence from the research done elsewhere suggests that mother's education has individual positive effect on the use of health care facilities Abbas and Walker (1986); Berrera (1990) and Caldwell (1979) have pointed out that educated mothers are more likely to take advantage of the modern health facilities than their uneducated counterparts in compliance to the recommended treatments primarily due to the different attitudes in regard to the knowledge and perceptions of the importance of the modern medicine in the care of their children. Berrera (1990) in a study of child nutrition in the Philippines found that the children of educated mothers took more advantage of the public health care facilities than the children of uneducated mothers.

Proximate determinants of fertility in Pakistan.

Abstract: The total fertility rate (TFR) in Pakistan ranged between 6.0 to 5.4 and the crude birth rate between 42 to 34 in the early 1970s. An attempt was made to decompose the TFRs using the Bongaarts model and data obtained in the Pakistan Fertility Survey/PFS (1974-75) the Pakistan Contraceptive Prevalence Survey/PCPS (1984-85) the Pakistan Demographic and Health Survey/PDHS (1990-91) and the Population and Family Planning Indicators Survey/PFPI (1993). There was a decline of 4% in the crude birth rate between the PFS and the PCPS and 2.6% between PCPS and PFPI. The age specific fertility rates produced TFRs of 6.3 6.0 5.4 and 5.38 births per woman in the respective surveys. The PFS indicated that 98% of women were married by the time they reached the age of 35-39. The age at first marriage also showed a rising trend during this period of 19 years. Women with no education married 4 years earlier than women with secondary or higher education according to a 1984 study. Contraceptive prevalence also increased considerably during this period. 20.7% of currently married nonpregnant women used modern methods and 4.7% used traditional methods in 1993. Contraceptive prevalence increased from 5.2% according to the PFS to 25.4% according to the PFPI. Pakistani mothers breastfed their children for 16.5 months 18.5 months and 19.5 months according to the PFS PCPS and PDHS. Utilizing a model developed by Bongaarts the effects of 4 most significant proximate determinants of fertility were assessed for the period of 1974-93. These were marriage contraceptive use abortion and postpartum infecundability. The fertility-inhibiting effect of lactational infecundability was the most significant in all 4 surveys followed by the effect of proportion of women married while contraception was the least significant determinant of TFR. Lactational infecundability reduced fertility to about 32-37%. The fertility-inhibiting effect of age at first marriage increased from 22% to 33% during this period of 19 years.

The Structural Adjustment Process and Agricultural Change in Pakistan in the 1980s and 1990s (The Distinguishedl Lecture)

Abstract: Pakistan has gone through many eventful political and economic changes since the late 1970s. Some of them have been transient, but many were deep and structural, hence even irreversible. Their consequences have been both promising and disturbing. The political system, since at least the mid-1980s, has been gradually democratised, but it is by no means stabilised as the events of 1993 clearly indicate. The economy has grown and transformed, but its management has been erratic. Many of the changes in the economy have come with the growth of the informal sector, both visible and invisible (illicit), which remains unaccounted for in the official statistics. In several urban and rural areas, persuasive though mainly anecdotal evidence suggests that the average standard of living far exceeds the impressions one gets from the national income accounts, household income and expenditure surveys. The growth of rent-seeking in the public and private sectors, illicit trade in drugs and smuggling across borders, informal activities in the rural and urban areas, and evasion of taxes have all contributed to the growth of the economy and distribution of assets and income.

Factors affecting fertility in Pakistan.

Abstract: PIP: Data of the Pakistan Contraceptive Prevalence Survey of 1984-85 were used to determine whether there are any differentials in fertility levels by age at marriage, educational level, work status, region of residence (province), and place of residence (urban or rural) in Pakistan. Both bivariate and multivariate analyses examined the effects of these factors on fertility. The technique of Multiple Classification Analysis (MCA) was used to determine the net effect of each factor. Among the predictors, age at marriage was the most significant variable, followed by the husband's education, woman's education, husband's occupation, woman's work status, region, and place of residence. Among the demographic variables, age and age at marriage were the most important determinants of fertility. Among the socioeconomic variables, the educational level of both husband and wife were important determinants of cumulative fertility. Age at marriage was inversely related to fertility. The mean number of children ever born was 5.1 for those who married below age 16 vs. 4.1 for age at marriage 16-19, and 3.6 for 20-24. In the multivariate analysis the effect of age at marriage was the strongest as a predictor. Education had a negative effect on fertility. The mean number of children ever born to women with no education was 4.5; to women with primary education, 3.6; to women with secondary education, 3.2; and to women with tertiary education, 2.3. Women working as salaried employees had higher fertility (5.0) compared to women working in family business or at home (4.2). Women whose husbands worked as salaried employees had comparatively lower fertility than those whose husbands were working in their own business or in agriculture. The region of residence did not yield wide differentials. Furthermore, place of residence did not reveal any significant difference in fertility. The mean number of children was marginally higher among urban women (4.4) compared to their rural counterparts (4.2), indicating that the fertility transition has not started yet.

The role of Infaq in poverty alleviation in Pakistan

Abstract: A number of studies such as Naseem (1973, 1977); Allaudin (1975); Mujahid (1978); Irfan and Amjad (1984); Kruijk and Leeuwan (1985); Cheema (1985); Malik (1988); Akhtar (1988); Ercelawn (1988, 1989, 1990); Ahmad and Ludlow (1990); Havinga et al. (1990, 199Oa); Malik (1992) and Zaidi and de Vos (1993) have been undertaken to analyse the phenomena of poverty in Pakistan. The general picture that emerges from these studies is that although poverty is widespread in Pakistan, it is more prevalent in rural areas. Poverty increased during the 1960s, but it has been declining ever since 1970. The change in agrarian structure during the 1960s contributed towards the higher rural poverty. A respectable rate of economic growth and the increase In foreign remittances are generally mentioned as factors responsible for the decline in poverty since the 1970s. The introduction of zakat and ushr system in 1980 also played its role in this regard. However, poverty still remains One of the most serious problems in the country.

Intra-family distribution in developing countries.

Abstract: Intra-household allocations are important in the determination of time use human resource investments and intra- and inter-generation of transfers in developing countries. During the 1980s through the mid-1990s there has been substantial progress in modeling intra-household allocations despite data limitations regarding the nature of the allocation of unobserved variables and the impact of unobserved heterogeneous endowments. The economic models of intra-household allocations include the pure parental altruism models with unified preferences and within this the wealth model which states that parents are concerned with each childs total wealth but are not concerned with the sources of wealth. The next model is the separable earnings-transfers (SET) model in which the parental welfare function is separable between their childrens distribution of income from labor earnings and their childrens distribution of income from physical and financial transfers received from their parents. The wealth model and the SET model have implications for identifying returns to schooling as well as implications for the interpretation of schooling as child quality. Models of qualified parental altruism include the rotten kid theorem which states that variations in parental transfers to selfish children force such children to consider their parents interests as each beneficiary maximizes the total family income available to the altruistic benefactor. Under the strategic bequest or exchange model the parents influence the behavior of their children by holding wealth in bequeathable form. Collective models of household behavior which focus on decisions between husbands and wives include Nash bargaining models of intra-household allocations which generalize the comparative statics of a unified preference constrained maximization. The Pareto-efficient collective household models assume that allocations are Pareto-efficient without assuming any explicit solution process.

Nonlinear Dynamics and Chaos: Application to Financial Markets in Pakistan*

Abstract: Recently there has been an increased interest in the theory of chaos by macroeconomists and fmancial economists. Originating in the natural sciences, applications of the theory have spread through various fields including brain research, optics, metereology, and economics. The attractiveness of chaotic dynamics is its ability to generate large movements which appear to be random, with greater frequency than linear models. Two of the most striking features of any macro-economic data are its random-like appearance and its seemingly cyclical character. Cycles in economic data have often been noticed, from short-run business cycles, to 50 years Kodratiev waves. There have been many attempts to explain them, e.g. Lucas (1975), who argues that random shocks combined with various lags can give rise to phenomena which have the appearance of cycles, and Samuelson (1939) who uses the familiar multiplier accelerator model. The advantage of using non-linear difference (or differential) equation models to explain the business cycle is that it does not have to rely on ad hoc unexplained exogenous random shocks.

Comparative Study of Insurance and Takafol (Islamic Insurance)

Abstract: Ibn Abidin (1784-1836) was the first scholar in the Muslim world to discuss the meaning and legal character of insurance.1 Islamicity of insurance has been under discussion since then. Opinions regarding legitimacy, adoption, and adaptability of insurance are numerous. Recently, however, a consensus was emerging for adapting insurance in the name of takafol and solidarity. As a result, several Islamic takafols and solidarity companies have been established since 1979. During the last decade the Council of Islamic Ideology Pakistan (ClIP) reviewed the operations of the existing takafols in order to find a suitable model for Pakistan.2 While declaring all of them incompatible with the injunctions of Islam, the ClIP proposed its own model of takafol, instead. Its rejection of existing takafols is a little paradoxical since the operations of all the takafols are claimed to be compatible with the Shariah. Each takafol guarantees Shariah compatibility of its operations by sUbjecting itself to the dictates of a Shariah Supervisory Board, which are empowered to review the company's practices, contracts, transactions and operations. This paper attempts to delineate the points of contact and convergence between insurance and takafol, and to .make recommendations for possible improvement in the takafol concept. The study is organised as follows: Islamic debate on insurance, with special reference to its application to takafols, is reviewed in Section II. Pertinent operational features of takafols are compared with insurance in Section III. The ClIP model is examined in Section IV. The final section features proposals meant to augment the conformity of takafol with the principles of Shariah.

An assessment of warabandi (irrigation rotation) in Pakistan : a preliminary analysis

Abstract: A significant feature of Pakistan's agriculture is that it is served by the Indus irrigation system, which is one of the largest contiguous irrigation systems in the world. The system comprises of the Indus River and its tributaries, three major storage reservoirs, 19 barrages/headworks, 43 canals, and 12 link canals and 43 canals covering about 43,000 chaks or village settlements. The total length of the canal system is about 40,000 miles with over 80,000 water courses, field channels and ditches running for another million miles. About 100-106 million acre feet (MAP) of surface irrigation supplies are diverted annually into the canal system. Only 60 percent of this water reaches the farmgate due mainly to low efficiency in the delivery of water. The historical review of the area, production and yield trends shows that agricultural production in the past has increased mainly due to expansion in irrigated acreage while the contribution of changes in yields has been insignificant. In general, agricultural production can be increased by either expanding the irrigated cropped area or by raising the crop yields. It is highly unlikely that Pakistan will be able to satisfy the food needs of the rapidly increasing population through yield increases alone. This means that there ia a need to increase the irrigated cropped area through additional water supplies and by improving the efficiency of water use through using the water resources in a scientific manner. The possibilities of increasing irrigated area by developing more land and new surface water supplies in the short-run are limited as it requires huge capital

Private Tubewell Development and Groundwater Markets in Pakistan: A District-level Analysis

Abstract: Groundwater irrigation, which was developed in the 1960s to increase vertical drainage to prevent waterlogging and salinisation in canal commands, has now become a major component of the overall irrigation sector in Pakistan. An estimated 37 percent of total irrigation supplies at the farm gate comes from groundwater [NESPAK (1991)]. Along with the shift in purpose for groundwater development from providing drainage to providing irrigation supplies, has come a shift from public to private tubewells as the primary source of groundwater in Pakistan. The increase in private tubewells has not only increased the total availability of water for crop production, but also provided farmers with greater control over irrigation supplies. Because groundwater from private tubewells is generally not tied to the rigid warabandi schedule of canal deliveries, water applications can be more closely matched to crop requirements. The result is higher yields and higher economic returns to irrigated agriculture [Meinzen-Di<;k and Sullins (1993); Shah (1993)]. However, the number of private tubewells is still limited. In 1991 there were approximately 286,300 private tubewells, with only 6 percent of farmers owning tubewells [Government of Pakistan (1991)].

A micro analysis of urban child labour : some determinants of labour and its conditions

Abstract: This paper focuses on (1) The estimation of urban child labour, (2) Analysis of its determinants, (3) Analysis of some of its conditions and their sectoral determinants, and finally puts forward some possible solutions. This paper is divided into four sections. Section 2 explains the conceptual and analytical framework and describes the data set. Section 3 analyses the empirical evidence and finally Section 4 gives the conclusions and recommendations.

Why Children do not Go to School in PakistanSome Estimates and a Theoretical Framework

Abstract: Pakistan has a grave problem of human capital. The majority of our children tend not to go to school. Instead they go to work. Policy on education and child labour has been clearly deficient in Pakistan. This policy failure, we feel is due to analytical deficiency in understanding the determinants and impact of children's schooling and labour. The theoretical framework of this study is based on five arguments. 1. Schooling, and child labour, are two aspects of the the same problem, the problem of why children do not go to school. Schooling and child labour are both the result of one decision-making process, whether to send a child to school, or to work. 2. Mainstream literature on Pakistan does not consider the impact of this household decision-making about children's schooling and labour on the aggregate labour market. 3. Mainstream literature on Pakistan further does not consider the impact of child labour on the labour market for women. 4. Mainstream literature also does not consider yet another impact of household decision-making about children's schooling and labour on fertility behaviour. ·5. These three processes, household decision-making about children, the impact on the labour market, and the impact on fertility, combine to give a perverse signalling mechanism that tends to depress children's schooling, increase child labour, depress adult employment especially for women, and increase fertility rates. So policy failure in Pakistan, may in large part be due to the inability to understand these three processes, and their combination in a perverse signalling mechanism.

Dynamic Budgetary Consequences of the 1991 NFC Award

Abstract: The National Finance Commission (NFC) award of 1991 has been acclaimed to be a historic achievement of the previous elected government. It has come after a gap of many years (due since 1979) and some abortive attempts earlier.! Meanwhile, the provinces had run into large, chronic deficits on the current account, indicating the growing inadequacy of divisible pool transfers as per the provisions of the 1974 award. Consequently, as an ad hoc provision, deficit grants and other subventions had been used increasingly to support the on-going operations of the provinces. At their peak in 1987-88, these grants were Rs 17 billion (see Table 1), equivalent to about 2 percent of the Gross Domestic Product (GDP) and financed over one-fourths of the provincial current expenditure. Also, the federal government took over the responsibility of provision of some provincial responsibilities as contained in the Concurrent List of the Constitution like SCARPS, flood control, fertiliser subsidy, universities, etc.

Cost Effectiveness in Primary Education: A Study of Pakistan

Abstract: The Government of Pakistan prepared the second Perspective Plan in 1987- 88 for the next ftfteen years to set the long-term social and economic policy framework. The Plan identifted that the long-term objectives could only be achieved if the education, skills, nutrition and health of the people were improved. These objectives have recently been operationalised in the donor supported Social Action Programme (SAP). However, there is general recognition of the resource constraint within which these objectives are to be achieved, especially given the low priority that has been attached traditionally to allocations to the social sectors. Therefore, the p{ogramme envisages the expansion of primary infrastructure through an accelerated school construction programme using cost -effective approaches to delivery including need-based criteria for school location and changes in the pattern of allocation of funds among sector inputs.

Health care determinants of child survival in Pakistan.

Abstract: The health and survival status of children which are important indicators of social well-being, have become a subject of great concern in Pakistan in recent years. The available literature suggests that infant and child death rates in Pakistan are high even in the context of the Asian region and progress in health and survival of children has been much less than the desired level [World Bank (1993)]. Although estimates of infant and child mortality rates as derived from various data sources in Pakistan show great variation, 1 the available evidence indicates· that nearly 58 percent of all deaths occur among children under five years of age, 36 percent die during infancy and more than half of all infant deaths occur within the first four weeks of their birth [Irfan (1986); Afzal et al. (1988); Rukanuddin and Parooqui (1988); Sathar (1994)]. Recognising the fact that most of these deaths could be prevented, it is important to study the processes that are likely to influence the survival chances of children, the health care factors in particular, which are important components of mortality change.