Ranjbar Mohammad, Shafaghat Tahereh, Lotfi Mohammad Hasan, Alimondegari Maliheh, Kalantari Forouzandeh, Bazyar Mohammad
National Center for Health Insurance Research, Tehran, Iran.
Health Policy & Management Research Center, Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
BMC Public Health. 2025 Feb 28;25(1):821. doi: 10.1186/s12889-025-21938-7.
In response to the unprecedented decline in birth rates in Iran, a range of incentives has been introduced to encourage higher fertility among couples. This study aims to elicit Iranian families' preferences regarding proposed childbearing incentives through a discrete choice experiment. Data were collected in 2023 from a sample of 1,687 respondents. Five key attributes-economic, social, employment, healthcare, and cultural-recreational attributes-were identified through a systematic scoping review, 16 individual interviews, a focus group discussion, and a consensus development process. Utilizing an orthogonal design in SPSS software, 48 scenarios were initially generated, which were subsequently reduced to 24 choice sets for the final analysis. Preferences were analyzed using a conditional logit regression model in STATA17. The findings reveal significant preferences for incentives such as "provision of housing or government land," "full coverage of prenatal diagnostic services," "allocation of livelihood baskets," and "extended maternity leave." In contrast, the "allocation of stock shares" was the least preferred economic incentive (P < 0.0001, β = -0.3958). Notably, childbearing preferences varied between rural and urban respondents. Rural families prioritized support for home-based businesses and housewives, while urban families showed a stronger preference for housing and land-related incentives. This study provides valuable insights into the factors shaping childbearing preferences in Iran and offers important implications for policymakers. By considering the socio-economic and political context of the country, targeted policies can be designed to effectively encourage higher fertility and address the challenges posed by the declining birth rate.
为应对伊朗出生率前所未有的下降,伊朗推出了一系列激励措施,以鼓励夫妇提高生育率。本研究旨在通过离散选择实验,了解伊朗家庭对拟议的生育激励措施的偏好。2023年从1687名受访者样本中收集了数据。通过系统的范围审查、16次个人访谈、一次焦点小组讨论和一个共识达成过程,确定了五个关键属性——经济、社会、就业、医疗保健和文化娱乐属性。利用SPSS软件中的正交设计,最初生成了48个情景,随后将其减少到24个选择集用于最终分析。使用STATA17中的条件逻辑回归模型分析偏好。研究结果显示,对“提供住房或政府土地 ”、“产前诊断服务全额覆盖 ”、“分配生活篮子 ”和“延长产假 ”等激励措施有显著偏好。相比之下,“分配股票份额 ”是最不受欢迎的经济激励措施(P < 0.0001,β = -0.3958)。值得注意的是,农村和城市受访者的生育偏好存在差异。农村家庭优先考虑对家庭企业和家庭主妇的支持,而城市家庭对与住房和土地相关的激励措施表现出更强的偏好。本研究为塑造伊朗生育偏好的因素提供了有价值的见解,并为政策制定者提供了重要启示。通过考虑该国的社会经济和政治背景,可以设计有针对性的政策,以有效鼓励提高生育率,并应对出生率下降带来的挑战。