Objective: To determine the distribution of mortality in 1 59 month-old children across Iranian provinces in a national mortality surveillance system. Methods: This national survey was conducted in 2009. A questionnaire was designed and standardized for collecting mortality data of children aged 1 - 59 months. The project team, consisting of collaborators from the whole 40 medical universities, filled in the questionnaires and returned them to the Ministry of Health and Medical Education (MOHME). Results: The mortality in 1 - 59 month-old children was unequally distributed across provinces. The mortality was higher among children of less- educated mothers than in children of more- educated mothers. There was a reverse association between 1 - 59 months mortality and socioeconomic status across Iran as a whole and within most provinces. Conclusions: Our results suggest that socioeconomic distribution in mortality of 1 - 59 month-old children favors the better-off in Iran as a whole and in most of its provinces. Investigating why mortality is higher in some provinces deserves special attention. Furthermore, it is advisable to conduct provincially-representative surveys to provide update estimates of different health situations and to allow their monitoring over time
