Overview

The Iranian health system has gone through considerable changes during the past four decades. Improvements were made through implementing a set of policies and plans aimed at improving healthcare access and quality and in result, Iran has made significant progress on neonatal and child health and has already achieved Millennium Development Goal (MDG) 4 and Sustainable Development Goal (SDG) 3 (target 2). However, substantial variation continues to exist across regions of the country and among different socioeconomic groups and the decline in children mortality rate is disproportionate and the fraction of neonatal and infants’ death has been increasing constantly. Previously published systematic reviews have discussed determinants of child survival and range of interventions to improve child health. However, these suggested strategies need to be adjusted based on the unique context of each country and with respect to the current situation, predictive determinants, available resources and cultural background. ... Therefore, through this investment case, we aimed to provide evidence to sketch a comprehensive picture of neonatal and child health status in Iran and to recognize where and how needs to be intervened. For analyzing the current situation, we investigated the outcome of neonatal and child health alongside their determinants, categorized in the continuum of case, using Death Registration System, Demographic and Health Survey, Censuses, Family Physician Survey, Household Income and Expenditure Surveys, Communicable Diseases report, National Health Accounts, Iran Registry of Births and Outcomes (IMAN), Vital Horoscope, Fertility health monitoring and evaluation system (IMES), National Integrated Micronutrient Survey (NIMS), and National and Subnational Burden of Diseases, Injuries, and Risk Factors (NASBOD) study. Iranian neonates and, in some provinces, children are far from the ideal condition regarding equitable and sustainable utilization of the benefits of the economic growth in Iran. The current situation analysis aims to take stock of the previous improvements to ensure the wellbeing of every child in Iran. To do so, it employs the factors and determinants of children’s wellbeing status and transitions to frame the facilitative pathways toward the goal of sustainable and equitable health for all. This situation analysis presents the factors hindering or facilitating the progress toward neonatal and child health improvement in Iran. Above all, it provides an opportunity to recognize where effective and efficient investments could take place. Thus, this report is a comprehensive reference on the status of Iranian children health and its determinants in the continuum of care, starting from when Iranian girls become biologically capable of getting pregnant till when the child gets 5 years old; up to where the data permit. The presented situation analysis used all the available valid data to describe the main indicators of child health including maternal mortality, neonatal mortality, child mortality, and child stunting, followed by the factors that determine the current situation including preconception factors, antenatal, and prepartum elements, intrapartum aspects, neonatal and child health details, and finally the general factors that affect child health through more than one route during her life course. Above all, we calculated the cost of child mortality and health expenditure for public health services, including maternal and child health services, in Iran, we compared the health status and its determinants in Afghan refugees’ children and Iranian children and mothers, and finally, we assessed whether the undesirable conditions are equitably distributed among poor and rich provinces in Iran. Read more