Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences.
Doi
Abstract
Background: The present study was conducted to assess the trend of geographical disparities in child and maternal mortality rates in 20 districts of East Azerbaijan, in the Northwest of Iran, between 1999 and 2013. Methods: Data on to health indicators between 1999 and 2013, extracted from population registry panels (ZIJ), was made available for the study by the East Azerbaijan Health Center. Disparities were measured by calculating the Index of Disparities (IDisp) and the trend was assessed using the general linear model test. Results: All the four indicators revealed decreasing trends between 1999 and 2013 (P<0.001), while there were no significant differences among the districts studied (P>0.05). The ranges of the IDisp between 1999 and 2013 were 19-32% for Neonatal Mortality Rate (NMR), 16-22% for Infantile Morality Rate (IMR), 14-20% for Under 5 Mortality Rate (U5MR), and 120-143% for Maternal Mortality Rate (MMR), which revealed an increasing trend for all the indices. The trend of health indicators before and after implementation of the family physician program showed no significant difference for MMR (P= 0.228), while significant declining trends were observed for NMR, IMR, and U5MR (P<0.001). Conclusion: The results showed that despite the downtrend in NMR, IMR, U5MR, and MMR indicators, there are still geographical disparities in these indicators among districts of the East Azerbaijan province, in the Northwest of Iran.Keywords: Geography; Infant mortality; Maternal mortality; Registry
