Bahardoust Mansour, Rajabi Abdolhalim, Barakati Seyyed-Hamed, Naserbakht Morteza, Ghadami Shila, Talachian Elham, Motevalian Seyed Abbas
Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Department of Biostatistics and Epidemiology, School of Public Health, Golestan University of Medical Sciences, Gorgan, Iran.
Int J Prev Med. 2019 Nov 28;10:205. doi: 10.4103/ijpvm.IJPVM_452_18. eCollection 2019.
Child mortality surveillance system (CMSS) for children aged 1-59 months is a critical issue in the prevention of mortality. This surveillance system like other health programs needs to be evaluated. Therefore, this study aims to evaluate CMSS in Iran.
This evaluation was performed from March 2015 to March 2016 based on selected criteria for assessing the public health surveillance system proposed by the Centers for Disease Control and Prevention. Selected criteria examined in this study included timeliness, simplicity, acceptability, and flexibility. These criteria were evaluated in two ways. First, it included the use of a researcher-made questionnaire. The questionnaires were completed by 100 experts on CMSS. Second, to perform a more exact evaluation of these criteria, 24 of these experts were selected for the focus group.
In this study, the response rate was 91% (42% hospital-based and 49% primary care-based). In the timeliness section, 49% of the experts believed that approvals of the child mortality committees have not been sent within the designated time frame; hardware, software, and questionnaires were reported as effective factors in this respect. The structural and administrative problems were effective in simplicity domain and the experts of mortality registration and mood of relatives were effective in acceptability domain. The flexibility of the system was high and appropriate.
The findings of the present study reveal that CMSS has some limitations and problems in the timeliness, simplicity, and acceptability criteria, which can be resolved. But this program has an appropriate situation in terms of flexibility.
1至59个月儿童的儿童死亡率监测系统（CMSS）是预防儿童死亡的关键问题。与其他卫生项目一样，这个监测系统需要进行评估。因此，本研究旨在评估伊朗的CMSS。
本评估于2015年3月至2016年3月进行，依据美国疾病控制与预防中心提出的评估公共卫生监测系统的选定标准。本研究中考察的选定标准包括及时性、简易性、可接受性和灵活性。这些标准通过两种方式进行评估。首先，采用研究者自制的问卷。问卷由100名CMSS专家填写。其次，为了对这些标准进行更精确的评估，从这些专家中挑选了24人参加焦点小组。
在本研究中，回复率为91%（42%基于医院，49%基于初级保健）。在及时性方面，49%的专家认为儿童死亡委员会的批准未在指定时间内发出；硬件、软件和问卷在这方面被报告为有效因素。结构和管理问题在简易性方面有影响，死亡登记专家和亲属情绪在可接受性方面有影响。该系统的灵活性较高且适宜。
本研究结果表明，CMSS在及时性、简易性和可接受性标准方面存在一些局限性和问题，这些问题可以得到解决。但该项目在灵活性方面情况良好。
