Determinants of Neonatal, Infant and Child Mortalities in Iran: A Systematic Review.

BACKGROUND: Children mortality is considered as one of the main indicators of population development and health, while most of the children's deaths are preventable. This study systematically reviewed the determinants of children mortality in Iran.

METHODS: This systematic review was conducted to summarize all the factors associated with children mortality in three age groups; Neonate (0-28 d), Infant (28 d-1 yr old) and children (<5 yr old), based on the PRISMA guideline. Many of the electronic international and national databases, in addition to hand searching of reference of selected articles, grey literature, formal and informal reports and government documents were screened to identify potential records up to Jan 2022. We included all studies that identified determinants of child mortality in any province of Iran or the whole country, without any restriction.

RESULTS: Overall, 32 studies were included, published between 2000 and 2022, of which 23 were cross-sectional and 15 published in Farsi language. The associations between several risk factors (n=69) and the child mortality were examined. Among the identified factors, 'birth weight', 'mother's literacy', 'socioeconomic status', 'delivery type', 'gestational age', 'pregnancy interval', 'immaturity', 'type of nutrition', and 'stillbirth' were the most important mentioned determinants of child mortality in Iran.

CONCLUSION: Appropriate interventions and policies should be developed and implemented in Iran, addressing the main identified associated factors, resulting from this review study, with the aim of minimizing preventable child deaths, based on their age categories.