Child’s disability status and postnatal healthcare utilization among forcibly displaced women in Pakistan: A Secondary data analysis

The World Health Organization (WHO) estimates that about half of maternal and 40% of neonatal deaths occur within 24 hours of childbirth. Many women and newborns, especially among forcibly displaced populations, lack timely access to essential care. While research has examined antenatal and postnatal care (PNC) utilization in low-resource settings, little is known about displaced women raising children with disabilities. This study explores factors influencing PNC utilization among forcibly displaced women in Pakistan, focusing on displacement, maternal health, and childhood impairment. Using secondary data from the 2022 UNHCR Health and Utilization Survey (HAUS), this study examined the relationship between a child's disability and maternal PNC utilization among 2,847 displaced mothers aged 18-49 who had given birth within the past year. Multivariable logistic regression assessed how child impairment influenced PNC use while controlling for socioeconomic, demographic, and healthcare access factors. Among respondents, 65% utilized PNC services, and 17.6% reported having a child with an impairment. Most were married (85.9%), had completed primary education (88.9%), and delivered in public health facilities. Two-thirds had at least one antenatal care (ANC) visit. Child impairment significantly influenced maternal PNC utilization (OR = 1.24; 95% CI: 1.02-1.76). Mothers with tertiary education and children with impairments were less likely to use PNC compared with those with primary education (OR = 0.21; 95% CI: 0.09-0.52). ANC strongly predicted PNC use (OR = 9.99; 95% CI: 3.32-30.05). Other significant predictors included place of delivery, healthcare authorization, and ability to pay. Women who accessed antenatal care were nearly ten times more likely to use postnatal services. Findings highlight the need to strengthen ANC-PNC continuity and address financial, structural, and legal barriers limiting equitable, disability- and displacement-sensitive maternal healthcare in Pakistan.