Progress towards Health Equity in I.R. of Iran through Last Three Decades

Abstract

Background: After the Islamic Revolution, the Iranian government aimed to improve the health status and reduce the inequality simultaneously. This study was conducted to explore the impact of the implemented programs.
Methods: we extensively reviewed published papers in Persian and English journals and explored grey literature, mainly the formal reports of relevant organizations to find appropriate and valid statistics, which show the health status of Iranian population classified by sex, living in rural and urban areas and different provinces.
Results: We found that safe delivery index had been improved in the past 3 decades (delivery with unskilled birth atten­dance was decreased from 30.1 % to 10.4 %) and its standard deviation decreased from 15.3 to 10.9. Prenatal care visits in rural and urban inhabitants are comparable and their difference is around 5% now. The standard deviation of Infant Mortal­ity Rate between provinces has decreased from 6.2 to 4.9 in recent decades as well. The adult literacy rate as one of the main social determinants of health has been raised from 54% to more than 80%, such a progress was observed in rural and urban areas, in nearly all provinces and in males, females, and more importantly the gaps have decreased. The positive trend of Human Development Index was also significant in recent years.
Conclusion: Constant improvement of main health indicators and fewer gaps between subgroups are promising. In addition, improvement in the literacy rate may imply sustainable improvement in following decade since it is one of the main health determinants. Nonetheless, more attention to remote areas is a sensible recommendation.