Objectives: To determine Under Five Mortality Rate (U5MR) in Gambat and to identify causes of and factors associated with it.Methods: The study was conducted in taluka Gambat of Sindh, Pakistan from December 2002 to August 2003. The sample of at least 510 mothers was needed to capture expected 1020 live births. We interviewed mothers to elicit information about live births in the past five years, under-five mortality and its cause. Additionally, the mothers were also asked about their mobility and availability of husband\u27s support in child\u27s rearing, other than economic support. Approval was sought from Aga Khan University\u27s Ethical Committee. Pre structured questionnaire was used. Data were double entered, validated and cleaned using Epi-Info 6 and analysed with Statistical Package for Social Sciences (SPSS) version 11.5.Results: We included 647 mothers, who reported 997 births in the past five years. The reported number of deaths was 169, with the estimated U5MR of 170/1000 live births/year. The five major causes of mortality were tetanus (17.8%), diarrhoea (11.8%), measles (6.5%), delivery related morbidities (6.5%) and Acute Respiratory Infections (4.5%). Fever was identified as a cause by 19.1% mothers. About 20% did not know the cause of death. The regression analysis showed father\u27s literacy level (AOR 1.8, 95% CI 1.1-2.8) and father\u27s support in child rearing (AOR 5.6, 95% CI 3.6-8.6) as factors significantly associated with mortality.Conclusion: Increasing education among parents in rural areas like Gambat is important to reduce child mortality. Father\u27s involvement in child rearing can play a role
