Socio-economic determinants of inequality in child mortality rate among Iranian provinces: An ecological study

Abstract

Background: To identify the determinants of the inequality in child mortality it is vital to take interventional measures to improve survival of children. Objective:To estimate child mortality rate (CMR) for Iranian provinces and then assess the share of medical and socio-economic factors in CMR among Iranian provinces.Methods: First, we estimated CMR for Iranian provinces from several sources. Then, we extracted socio-economic status of provinces from Iranian centre of statistics. We used correlation and multivariate linear regression for assessing association of CMR with socio-economic status.Results: South Khorasan with 51 per 1000 live births and Mazandaran with 13 per 1000 live births had the highest and the lowest CMR among Iranian provinces. Correlation analysis showed that cost of health (-0.52) and literacy rate (-043) had the strongest association and the number of doctors with -0.24 had the weakest association with CMR. Results of multivariate analysis revealed that literacy rate and cost of health were statistically significant and explained about the 45% difference among Iranian provinces.Conclusions: There is inequality in child mortality among Iranian provinces. However, literacy rate, cost of health and income per capita are the most effective determinants of inequality.