This study accesses the impact of lady health worker (LHWs) visits in the community and distance to a healthcare facility on the nutritional status of under-five children. Additionally, it explores the perceptions and attitudes of the community about the performance of LHWs. A self-administered instrument was applied to gather data on different parameters, such as children’s height, age, weight, and socioeconomic status from 384 rural households in a marginalized district of Punjab province with the help of a purposive random sampling technique. The binary logistic regression model was employed for the computation of the probability of malnutrition. The prevalences of stunting, underweight children, and wasting in the district were 34.8%, 46.1%, and 15.5%, respectively. The logistic results illustrate that those households in which LHW visits occur regularly within 15 days (OR = 0.28 with 95% CI: 0.09–0.82) have a lower probability of malnutrition prevalence among their children. The distance to the health facility shows that the odds of malnutrition were higher from 3–4 Kilometers (Km) (OR = 2.61, 95% CI: 0.85–8.14), and odds were also higher for the ≥5 km category (OR = 2.88, 95% CI: 0.94–8.82). Children from richer families had lower chances of being malnourished (OR = 0.28, 95% CI: 0.07–1.14). Furthermore, the respondents show a positive attitude towards LHWs. They have given the first rank to their performance being beneficial to mothers and childcare, especially on checkups and safe deliveries, while they have shown negative responses and given lower ranks to their performance due to irregular visits (6th rank) and poor community awareness (7th rank). We conclude that LHWs’ regular visits to targeted households and less distance to healthcare facilities reduce the malnutrition risk in under-five children.

Capital flow, integral to the global economy, is significantly influenced by business potential and institutional environments. As one of the world’s largest economies, China’s outflow plays a crucial role in the rapid development of its economy. This study examines domestic investment into public and private components to avoid aggregation bias, whether China’s outward foreign direct investment (OFDI) serves as a substitute or complement to local investments, and how local institutional quality mediates this relationship. We employed Dynamic Autoregressive Distributed Lag model ARDL simulation methods for the period of 1996–2021 in order to control endogeneity, auto-correlation, cross-sectional bias, as well as heteroscedasticity issues, which normally arise in time-series datasets. Our findings reveal that OFDI has a dual impact on local economies. Firstly, OFDI has a generally positive effect on private and public investment, but this relationship is nonlinear. Furthermore, institutional quality significantly influences private investment more than public investment. Additionally, higher interest rates are shown to adversely affect both private and public investments by increasing borrowing costs. These results offer valuable insights for policymakers aiming to optimize investment flows and economic stability. Specifically, fostering institutional quality can amplify the positive spillovers of OFDI on private investment, while mitigating its crowding-out effects on public investment.

The COVID-19 pandemic severely disrupted Pakistan’s healthcare system and economic stability, exposing critical vulnerabilities in healthcare financing and growth sustainability. With limited fiscal space, high out-of-pocket expenditures (60.3% of health spending), and strained medical infrastructure, the crisis underscored the need for systemic reforms. This study examines the interplay between healthcare financing and economic growth in Pakistan during the pandemic (2019–2023), Using a mixed-methods cross-sectional approach, the research integrates secondary data from the Pakistan Bureau of Statistics, State Bank of Pakistan, and WHO with primary survey responses from 170 healthcare professionals and policymakers. Regression analysis and Pearson correlation tests were employed to assess relationships between healthcare expenditure, GDP growth, and pandemic-induced disruptions. Findings reveal a significant GDP contraction (-1.5% in 2020), with partial recovery (2.0% in 2021) driven by remittances and agriculture. Public health spending rose marginally (1.2% to 1.8% of GDP), remaining below WHO benchmarks, while out-of-pocket costs strained household incomes. Regression results indicate a weak but positive correlation (r=0.32, p<0.05) between health investment and GDP recovery. Vaccination rates showed a stronger association (r=0.45, p<0.01), highlighting their role in economic stabilization. However, healthcare capacity (ICU beds, doctor density) had no significant impact, reflecting inefficiencies. The study concludes that Pakistan’s economic resilience hinges on sustainable health financing reforms, including expanded public spending (≥3% of GDP), risk-pooling mechanisms, and prioritized vaccination drives. Policy recommendations emphasize universal health coverage (UHC), equitable resource allocation, and integrated fiscal-health strategies to mitigate future shocks.