Exploration of Household Socioeconomic Factors Related to Fertility and Child Mortality in Pakistan

INTRODUCTION: Fertility and child mortality remain critical public health and development concerns in Pakistan, reflecting deep-rooted socioeconomic disparities at the household level. This narrative review synthesizes empirical evidence on patterns of child fertility and mortality and examines the socioeconomic, demographic, and contextual factors shaping these outcomes in Pakistan. METHODS: A design to synthesize empirical evidence on the following established narrative review guidelines, peer-reviewed studies published over the past two decades were identified through major academic databases, including those focusing on fertility behavior, child survival, and household-level determinants. FINDING: Gender norms, son preference, and women's autonomy also emerge as significant contributors influencing reproductive decision-making and child health outcomes. Furthermore, regional inequalities and limited utilization of maternal and child healthcare services exacerbate risks among socioeconomically disadvantaged households. The findings underscore the interconnected nature of fertility behavior and child survival within broader structural and sociocultural contexts. The reviewed literature consistently demonstrates that child mortality and child fertility rates are strongly associated with household socioeconomic conditions, particularly parental education, household wealth status, maternal employment, place of residence, and access to health services. CONCLUSION: This review highlights the need for integrated policy interventions that address socioeconomic inequalities, strengthen maternal and child health systems, and promote female education and empowerment to achieve sustained improvements in child survival and fertility regulation in Pakistan.