Determinants of Neonatal, Infant and Child Mortalities in Iran: A Systematic Review
Badriyeh Karami1, Mahya Abbasi2, Maryam Tajvar2
1Behavioral Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Insights
Child mortality in Iran is influenced by factors like birth weight, maternal literacy, and socioeconomic status. Addressing these determinants is crucial for reducing preventable deaths in neonates, infants, and children under five.
Area of Science:
- Public Health
- Demography
- Pediatrics
Background:
- Child mortality is a key indicator of population health and development.
- A significant proportion of child deaths are preventable.
- Understanding determinants of child mortality in Iran is essential for targeted interventions.
Purpose of the Study:
- To systematically review and summarize factors associated with child mortality in Iran.
- To identify key determinants across neonatal (0-28 days), infant (28 days-1 year), and under-five age groups.
- To inform public health policies aimed at reducing child mortality.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Comprehensive search of national and international databases, grey literature, and government documents up to January 2022.
- Inclusion of all studies identifying child mortality determinants in Iran without geographical or language restrictions.
Main Results:
- 32 studies published between 2000 and 2022 were included.
- Sixty-nine risk factors were examined, with 'birth weight', 'mother's literacy', 'socioeconomic status', 'delivery type', 'gestational age', 'pregnancy interval', 'immaturity', 'type of nutrition', and 'stillbirth' identified as most significant.
- A majority of included studies were cross-sectional (23) and published in Farsi (15).
Conclusions:
- Key determinants of child mortality in Iran have been identified.
- Policy and intervention development should focus on addressing these identified factors.
- Targeted strategies are needed to minimize preventable child deaths across different age categories.
Background:
Children mortality is considered as one of the main indicators of population development and health, while most of the children's deaths are preventable. This study systematically reviewed the determinants of children mortality in Iran.
Methods:
This systematic review was conducted to summarize all the factors associated with children mortality in three age groups; Neonate (0-28 d), Infant (28 d-1 yr old) and children (<5 yr old), based on the PRISMA guideline. Many of the electronic international and national databases, in addition to hand searching of reference of selected articles, grey literature, formal and informal reports and government documents were screened to identify potential records up to Jan 2022. We included all studies that identified determinants of child mortality in any province of Iran or the whole country, without any restriction.
Results:
Overall, 32 studies were included, published between 2000 and 2022, of which 23 were cross-sectional and 15 published in Farsi language. The associations between several risk factors (n=69) and the child mortality were examined. Among the identified factors, 'birth weight', 'mother's literacy', 'socioeconomic status', 'delivery type', 'gestational age', 'pregnancy interval', 'immaturity', 'type of nutrition', and 'stillbirth' were the most important mentioned determinants of child mortality in Iran.
Conclusion:
Appropriate interventions and policies should be developed and implemented in Iran, addressing the main identified associated factors, resulting from this review study, with the aim of minimizing preventable child deaths, based on their age categories.
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