Inequality in maternal mortality in iran: an ecologic study.

Area of Science:

• Public Health
• Socioeconomic Determinants of Health
• Epidemiology

Background:

• Maternal mortality (MM) is a preventable public health issue with global efforts focused on its reduction.
• Understanding the ecological-level relationship between socioeconomic factors and MM in Iran's provinces is crucial for targeted interventions.

Purpose of the Study:

• To investigate the association between socioeconomic variables and their inequalities with maternal mortality ratio (MMR) across Iranian provinces.
• To identify key socioeconomic determinants influencing MMR at an ecological level.

Main Methods:

• Ecological study analyzing data from Iranian provinces between 2004-2006.
• Variables included provincial literacy rates (men and women), per capita household income, Gini coefficient, and Human Development Index (HDI).
• Pearson correlation and multiple linear regression were used to assess the relationship between MMR and selected socioeconomic factors.

Main Results:

• The average MMR was 24.7 per 100,000 live births.
• MMR showed strong positive correlations with literacy rates and Gini coefficient, and a strong negative correlation with HDI.
• Multivariate regression indicated significant inverse associations between MMR and HDI (standardized B=-0.93) and the literacy rate difference between men and women (standardized B=-0.47).

Conclusions:

• Socioeconomic factors and their inequalities are significantly associated with MMR in Iran at the provincial level.
• Focusing on distal socioeconomic determinants, particularly HDI and gender literacy parity, is essential for reducing maternal mortality.
• Interventions should complement direct obstetric care by addressing broader societal factors influencing maternal health outcomes.