Amini-Rarani Mostafa, Rashidian Arash, Bayati Mohsen, Khedmati Morasae Esmaeil
Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Public Health. 2019 Aug;48(8):1488-1495.
Despite constant decrease in rate of neonatal mortality, the rate is still higher than that of other under-five children. One of the first steps towards reduction of neonatal mortality is to identify its determinants using health production function. The aim of the present study was to estimate neonatal health production function for Iran.
In this cross-sectional study, Iranian Multiple Indicator Demographic and Health Survey (Ir-MIDHS) 2010 was used. Four categories of socioeconomic, mother, neonatal demographic and healthcare system factors were entered into the Binomial Logistic Regression model to estimate neonate health production function. Households' economic status was constructed using principal component analysis.
History of abortion/stillbirth had the highest significant positive impact on odds of neonatal mortality (odds ratio=1.98; 95 % CI=1.55-2.75), indicating that neonates of mothers with such a history had 1.98 times higher chance of death compared to other neonates. Moreover, odds ratio of neonatal death for the poorest quintiles was 1.70 (95 % CI=1.08-2.74), indicating that by moving from the poorest quintile to the richest one, the odds of being alive for neonates increased up to 70%. However, skilled birth attendant decreased the chance of death up to 58% (odds ratio=0.58; 95 % CI=0.36-0.93).
Considering the most significant inputs of neonatal health production function in Iran, improvement of economic status of households, provision of appropriate care services for mothers, and improvement of delivery care provided by trained personnel, could be priorities for health policymakers to act and reduce neonatal mortality in Iran.
尽管新生儿死亡率持续下降，但该比率仍高于其他五岁以下儿童。降低新生儿死亡率的首要步骤之一是利用健康生产函数确定其决定因素。本研究的目的是估计伊朗的新生儿健康生产函数。
在这项横断面研究中，使用了2010年伊朗多指标人口与健康调查（Ir-MIDHS）。将社会经济、母亲、新生儿人口统计学和医疗保健系统因素的四类因素纳入二项逻辑回归模型，以估计新生儿健康生产函数。家庭经济状况采用主成分分析法构建。
流产/死产史对新生儿死亡几率的正向影响最为显著（优势比=1.98；95%置信区间=1.55-2.75），这表明有此类病史的母亲所生新生儿的死亡几率比其他新生儿高1.98倍。此外，最贫困五分之一人口的新生儿死亡优势比为1.70（95%置信区间=1.08-2.74），这表明从最贫困五分之一人口到最富裕五分之一人口，新生儿存活几率提高了70%。然而，熟练的助产人员可将死亡几率降低58%（优势比=0.
