Rostami Mehran, Jalilian Abdollah, Hamzeh Behrooz, Laghaei Zahra
Deputy of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Statistics, Faculty of Sciences, Razi University, Kermanshah, Iran.
Epidemiol Health. 2015 Jan 22;37:e2015003. doi: 10.4178/epih/e2015003. eCollection 2015.
The target of the Fourth Millennium Development Goal (MDG-4) is to reduce the rate of under-five mortality by two-thirds between 1990 and 2015. Despite substantial progress towards achieving the target of the MDG-4 in Iran at the national level, differences at the sub-national levels should be taken into consideration.
The under-five mortality data available from the Deputy of Public Health, Kermanshah University of Medical Sciences, was used in order to perform a time series analysis of the monthly under-five mortality rate (U5MR) from 2005 to 2012 in Kermanshah province in the west of Iran. After primary analysis, a seasonal auto-regressive integrated moving average model was chosen as the best fitting model based on model selection criteria.
The model was assessed and proved to be adequate in describing variations in the data. However, the unexpected presence of a stochastic increasing trend and a seasonal component with a periodicity of six months in the fitted model are very likely to be consequences of poor quality of data collection and reporting systems.
The present work is the first attempt at time series modeling of the U5MR in Iran, and reveals that improvement of under-five mortality data collection in health facilities and their corresponding systems is a major challenge to fully achieving the MGD-4 in Iran. Studies similar to the present work can enhance the understanding of the invisible patterns in U5MR, monitor progress towards the MGD-4, and predict the impact of future variations on the U5MR.
第四个千年发展目标（千年发展目标4）的指标是在1990年至2015年间将五岁以下儿童死亡率降低三分之二。尽管伊朗在国家层面朝着实现千年发展目标4的指标取得了重大进展，但仍应考虑到国家以下各级的差异。
为了对伊朗西部克尔曼沙阿省2005年至2012年的每月五岁以下儿童死亡率（U5MR）进行时间序列分析，使用了克尔曼沙阿医科大学公共卫生副主任提供的五岁以下儿童死亡率数据。经过初步分析，根据模型选择标准，选择了季节性自回归积分滑动平均模型作为最佳拟合模型。
对该模型进行了评估，结果证明该模型足以描述数据的变化。然而，在拟合模型中意外出现的随机上升趋势和周期为六个月的季节性成分很可能是数据收集和报告系统质量不佳的结果。
本研究是伊朗首次对五岁以下儿童死亡率进行时间序列建模，结果表明，改善卫生设施及其相应系统中五岁以下儿童死亡率的数据收集工作是伊朗全面实现千年发展目标4的一项重大挑战。与本研究类似的研究可以增进对五岁以下儿童死亡率中无形模式的理解，监测千年发展目标4的进展情况，并预测未来变化对五岁以下儿童死亡率的影响。
