Effect of human resources for health distribution to improve maternal and child healthcare outcomes in the public healthcare system of Pakistan

There has been strong evidence that professional, experienced, and accessible human resources for Health (HRH) considerably affect population health. HRH distributional disparity, especially in developing countries, is broadly recognized as a barrier to achieving better healthcare outcomes and targets. To achieve Sustainable Development Goals (SDGs), ensuring equitable access to HRH in the working healthcare system is important. This research aimed to investigate the effect of HRH distribution on maternal and child healthcare (MCH) outcomes. Moreover, this research also identifies the effect of free MCH services on health outcomes in Pakistan. We used the data from the Statistical Bureau of Pakistan reports, the Pakistan Living and Standard Survey (PLSM), and the National Human Development Report (NHDR) for 2017 and 2019. The dependent variables include Antenatal care (ANC), Skilled birth attendant (SBA), and Postnatal care (PNC) service utlization, as well as maternal mortality risk and infant and child mortality (ages 12–59 months). The Poisson Regression Model (PRM) was applied to estimate the effect of HRH on ANC visits, SBA, and PNC visits. Furthermore, the model was used to estimate the impact of HRH on maternal and child mortality outcomes. All investigations were carried out using Stata 17.0 (Stata Corp LP, College Station, Texas, USA). Around 84% and 76% of the deliveries were assisted by trained HRH in 2017 and 2019. The female literacy rate was 37%. After adjusting for the covariates, the PRM results demonstrate that employing one additional doctor will increase the likelihood of the number of ANC visits, SBA deliveries, and PNC visits by 10.5% (AIRR = 1.105; 95% CI = 1.076–1.135; p < 0.001), 6.7% (AIRR = 1.067; 95% CI = 1.031–1.103; p < 0.001), and 14.4% (AIRR = 1.144; 95% CI = 1.112–1.176; p < 0.001) respectively. Similarly, employing one additional nurse will increase the likelihood of SBA deliveries by 6.4% (AIRR = 1.064; 95% CI = 1.038–1.091; p < 0.001). Additionally, employing one additional doctor will decrease the probability of maternal mortality, infant, and under-five mortality by 9.8% (AIRR = 0.902; SE = 0.010; 95% CI = 0.883–0.922; p < 0.001), 5% (AIRR = 0.950; SE = 0.010; 95% CI = 0.929–0.971; p < 0.001), and 4.7% (AIRR = 0.953; SE = 0.088; 95% CI = 0.937–0.968; p < 0.001) correspondingly. Finally, employing one additional nurse will decrease the chances of maternal mortality, infant and under-five mortality by 1.8% (AIRR = 0.982; SE = 0.008; 95% CI = 0.965–0.999; p < 0.05), 2% (AIRR = 0.980; SE = 0.008; 95% CI = 0.962–0.997; p < 0.05), and 1.7% (AIRR = 0.983; SE = 0.006; 95% CI = 0.970–0.995; p < 0.001). Our study findings suggest a positive and significant association between HRH, ANC visits, SBA, and PNC and healthcare outcomes in Pakistan. There is a critical need to address the availability and accessibility of professional HRH. Further investigations could prove how this association varies while providing free maternal and child healthcare service utilization in policies and practices. Without such efforts, the HRH will continue to face challenges in Pakistan and delay the progress for women and children’s better healthcare outcomes to meet the SDGs targets.