Rural-Urban Disparity of Under-Five Mortality Rate in Iran from 1990 to 2015
Abstract
Background: To estimate under-five mortality rate (U5MR), as one of the sustainable development goals, in rural and urban areas of Iran from 1990 to 2015.
Methods: We used the data collected through two censuses and one Demographic and Health Surveys (DHS). We analyzed the Summary Birth History (SBH) data via 2 approaches including Maternal Age Cohort (MAC) and Maternal Age Period (MAP) methods, and then, Gaussian Process Regression (GPR) was used to combine the three trends and with 95% uncertainty. Finally, Ratio of U5MR in rural to urban was calculated.
Results: At the national level and in urban areas, U5MR in 1990, 2000, 2010, and 2015 was 66, 34, 18, and 13 per 1000 live births, respectively. Corresponding values in rural areas in 1990, 2000, 2010, and 2015 was 129, 64, 31, and 21 per 1000 live births, respectively. Accordingly, the ratio of U5MR in rural to urban at the national level was 1.93, 1.86, 1.72 and 1.63 in the same years. At the sub-national level, U5MR in urban areas ranged from 11.2 per 1000 live births in Isfahan to 18.2 per 1000 live births in Hormuzagn. U5MR in rural areas ranged from 14.1 per 1000 live births in Isfahan to 29.5 per 1000 live births in Sistan and Baluchistan
Conclusion: There is still a gap between rural and urban areas, although it has decreased during the 25 years of the study. To alleviate this gap, health system authorities are advised to plan appropriate actions using multi-sectoral capacities.
References
Mohammadi Y, Parsaeian M, Mehdipour P, Khosravi A, Larijani B, Sheidaei A, et al. Measuring Iran's success in achieving Millennium Development Goal 4: a systematic analysis of under-5 mortality at national and subnational levels from 1990 to 2015. The Lancet Global Health.5(5):e537-e44.
Djalalinia S, Moghadam SS, Peykari N, Kasaeian A, Sheidaei A, Mansouri A, et al. Mortality attributable to excess body mass index in Iran: Implementation of the comparative risk assessment methodology. International Journal of Preventive Medicine. 2015;2015-November.
Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. The Lancet. 2017;388(10063):3027-35.
Farshad Farzadfar M, Mehdipour P, Sheidaei A, Mansouri A, Moghaddam SS, Kamran Yazdani M. Levels and trends of child and adult mortality rates in the Islamic Republic of Iran, 1990-2013; protocol of the NASBOD study. Archives of Iranian medicine. 2014;17(3):176.
Sheidaei A, Gohari K, Kasaeian A, Rezaei N, Mansouri A, Khosravi A, et al. National and Subnational Patterns of Cause of Death in Iran 1990–2015: Applied Methods. Archives of Iranian Medicine. 2017;20(1):2-11.
Rostami M, Mohammadi Y, Jalilian A, Nazparvar B. Modeling spatio-temporal variations of substance abuse mortality in Iran using a log-Gaussian Cox point process. Spatial and Spatio-temporal Epidemiology. 2017;22:15-25.
Rajaratnam JK, Tran LN, Lopez AD, Murray CJL. Measuring Under-Five Mortality: Validation of New Low-Cost Methods. PLOS Medicine. 2010;7(4):e1000253.
Verhulst A. Child mortality estimation: An assessment of summary birth history methods using microsimulation. Demographic Research. 2016;34:1075-128.
Ph F. Manual X. Indirect techniques for Demographic estimations. Population. 1984;39(3):628-9.
Statistical Centre of Iran. Population and Housing Censuses 2017 [cited 2017 May 1]. Available from: https://www.amar.org.ir/english/Population-and-Housing-Censuses.
Rashidian A, Khosravi A, Khabiri R, Khodayari-Moez E, Elahi E, Arab M, et al. Islamic Republic of Iran's Multiple Indicator Demograpphic and Healh Survey (IrMIDHS) 2010. Tehran: Ministry of health and medical education. 2012:83-6.
Cleveland WS. Robust locally weighted regression and smoothing scatterplots. Journal of the American statistical association. 1979;74(368):829-36.
Mehdipour P, Navidi I, Parsaeian M, Mohammadi Y, Moradi Lakeh M, Rezaei Darzi E, et al. Application of Gaussian Process Regression (GPR) in estimating under-five mortality levels and trends in Iran 1990 - 2013, study protocol. Arch Iran Med. 2014;17(3):189-92.
Mohammadi Y, Parsaeian M, Farzadfar F, Kasaeian A, Mehdipour P, Sheidaei A, et al. Levels and trends of child and adult mortality rates in the islamic republic of Iran, 1990-2013; protocol of the nasbod study. Archives of Iranian medicine. 2014;17(3):176-81.
Parsaeian M, Farzadfar F, Zeraati H, Mahmoudi M, Rahimighazikalayeh G, Navidi I, et al. Application of spatio-temporal model to estimate burden of diseases, injuries and risk factors in Iran 1990 - 2013. Archives of Iranian medicine. 2014;17(1):28-32.
Team SD. Rstan: the R interface to Stan, version 2.8. 0. 2015.
Mehrdad R. Health system in Iran. JMAJ. 2009;52(1):69-73.
Shadpour K. Primary health care networks in the Islamic Republic of Iran. 2000.
Malekafzali H. Primary health care in the rural area of the Islamic Republic of Iran. Iran J Public Health. 2009;38(Suppl 1):69-70.
Moradi-Lakeh M, Esteghamati A. National Immunization Program in Iran: Whys and why nots. Human Vaccines & Immunotherapeutics. 2013;9(1):112-4.
Saberi SH, Alimehr M, Amiresmaili M, Seyednezhad M. Identifying the Challenges of Iran’s Health Houses and Presenting a Solution. Electronic Physician. 2016;8(10):3122-6.
Minnery M, Jimenez-Soto E, Firth S, Nguyen K-H, Hodge A. Disparities in child mortality trends in two new states of India. BMC public health. 2013;13(1):779.
Anyamele OD, Akanegbu BN, Ukawuilulu JO. Trends and Disparities in Infant and Child Mortality in Nigeria Using Pooled 2003 and 2008 Demographic and Health Survey Data. SAGE Open. 2015;5(4):2158244015611936.
Mousavi SM, Nemati A, Asar ME, Anjomshoa M, Bahadori M. Inequalities in the Distribution of Health Care Facilities Evidence from Southwestern Iran. Journal of Health Management. 2016:0972063416637743.
Alizadeh M, Laghousi D. Trend of geographical disparities in child and maternal mortality indicators in Northwest Iran. Social Determinants of Health. 2015;1(4):132-40.
Etemad K, Yavari P, Mehrabi Y, Haghdoost A, Motlagh ME, Kabir MJ, et al. Inequality in utilization of in-patients health services in Iran. International journal of preventive medicine. 2015;6.
Lundborg P, Lyttkens CH, Nystedt P. The Effect of Schooling on Mortality: New Evidence From 50,000 Swedish Twins. Demography. 2016;53(4):1135-68.
O'Hare B, Makuta I, Chiwaula L, Bar-Zeev N. Income and child mortality in developing countries: a systematic review and meta-analysis. Journal of the Royal Society of Medicine. 2013;106(10):408-14.
| Files | ||
| Issue | Vol 49 No 4 (2020) | |
| Section | Original Article(s) | |
| Keywords | ||
| Infant mortality/trend; Child mortality/trend; Rural health; Urban health; Iran | ||
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