Department of Health Services Management, School of Management, North Tehran Branch, Islamic Azad University, Tehran, Iran.
Department of Health Policy, Economics and Management and Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Public Health. 2023 Aug 29;23(1):1659. doi: 10.1186/s12889-023-16521-x.
Social determinants of health have a key role in the growth and development of children, particularly in early childhood which is mentioned from infancy to the age of six years old. These factors might cause disparities in living conditions and consequently bring about inequities regarding different aspects of development such as emotional, psychological, social, psychological, and intellectual. This research aimed to provide a model for prioritizing social factors affecting the development of children under six years.
We used quantitative-qualitative (mixed) method to perform data analysis. The statistical population included 12 medical experts and professionals in the field of children's development and social determinants of health that were selected using the snowball method. In the quantitative section, a Delphi technique was applied to screen the extracted indicators. Then through applying a decision-making trial and evaluation laboratory (DEMATEL) method, the cause-and-effect interactions among main social determinants were identified. To analyze data, super decision software was used.
According to literature review and the results obtained from focus group discussions, five dimensions including individual factors, family factors, environmental factors, governance, and global factors were identified. Based on the study findings, the criterion of "family factors" was mentioned as the most important priority affecting childhood development. Furthermore, the sub-criterion of "International Programs and Policies" received the greatest priority among other sub-criteria with a profound impact on children's healthy growth and development.
Despite the current knowledge about social determinants of health, it is required to identify the most influential socioeconomic factors on childhood development. In such a manner, political strategies for improving the health condition of children can be implemented based on scientific evidence. Due to the crucial role of family factors, environmental factors and other socio-economic conditions, health policy makers and public health practitioners should be informed of the importance of these factors in shaping the health condition of children.
健康的社会决定因素在儿童的成长和发展中起着关键作用，尤其是在幼儿期，即从婴儿期到六岁。这些因素可能导致生活条件的差异，并因此在发展的各个方面造成不平等，如情感、心理、社会、心理和智力。本研究旨在为优先考虑影响 6 岁以下儿童发展的社会因素提供一个模型。
我们使用定量-定性（混合）方法进行数据分析。统计人群包括 12 名医学专家和儿童发展及社会决定因素健康领域的专业人员，他们是通过滚雪球法选择的。在定量部分，采用德尔菲技术筛选提取的指标。然后通过应用决策试验和评估实验室（DEMATEL）方法，确定主要社会决定因素之间的因果相互作用。使用超级决策软件分析数据。
根据文献回顾和焦点小组讨论的结果，确定了五个维度，包括个人因素、家庭因素、环境因素、治理和全球因素。根据研究结果，“家庭因素”标准被认为是影响儿童发展的最重要的优先事项。此外，“国际计划和政策”子标准在其他子标准中获得了最大的优先考虑，对儿童的健康成长和发展有着深远的影响。
尽管目前已经了解了健康的社会决定因素，但仍需要确定对儿童发展影响最大的社会经济因素。这样，就可以根据科学证据制定改善儿童健康状况的政治战略。由于家庭因素、环境因素和其他社会经济条件的重要作用，卫生政策制定者和公共卫生从业人员应该了解这些因素在塑造儿童健康状况方面的重要性。
