Al Saidi Moossa Amur Nasser, Eltayib Rawaa Abubakr Abuelgassim, Wirayuda Anak Agung Bagus, Al Sumri Hana Harib, Chan Moon Fai
Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman.
Faculty of Medicine and Health, Institut Teknologi Sepuluh Nopember, Surabaya 60111, Indonesia.
Eur J Investig Health Psychol Educ. 2025 Feb 21;15(3):26. doi: 10.3390/ejihpe15030026.
Worldwide, there has been a notable decline in the infant mortality rate (IMR) in the last 20 years. Regionally, the Gulf Cooperation Council (GCC) countries echo the global trends to a certain extent. This study aims to explore the impact of social determinants of health (SDOH), health resources (HRS), and environmental (ENV) factors on the IMR in Bahrain, Qatar, and Kuwait. It is a retrospective time-series study using yearly data from 1990 to 2022. Partial Least Square Structural Equation Model (PLS-SEM) was utilized to construct an exploratory model of the IMR for each country. The results showed that SDOH, HRS, and ENV factors influenced IMRs in three GCC countries. In all three countries' models, only HRS exerted a direct effect on the IMR (Bahrain: -0.966, 95% CI -0.987 to -0.949; Kuwait: -0.939, 95% CI -0.979 to -0.909; and Qatar: -0.941, 95% CI -0.976 to -0.910). On the other hand, ENV factors and SDOH only influenced the IMR indirectly and negatively. Their beta coefficients ranged from -0.745 to -0.805 for ENV factors and -0.815 to -0.876 for SDOH. This study emphasizes the importance of adopting multi-faceted public health strategies that focus on improving socioeconomic conditions, expanding healthcare resources, and reducing environmental degradation. By adopting these multi-dimensional approaches, Bahrain, Qatar, and Kuwait can continue to progress in reducing IMRs and improving overall public health outcomes.
在过去20年里，全球婴儿死亡率（IMR）显著下降。在区域层面，海湾合作委员会（GCC）国家在一定程度上呼应了全球趋势。本研究旨在探讨健康的社会决定因素（SDOH）、卫生资源（HRS）和环境（ENV）因素对巴林、卡塔尔和科威特婴儿死亡率的影响。这是一项回顾性时间序列研究，使用了1990年至2022年的年度数据。采用偏最小二乘结构方程模型（PLS-SEM）为每个国家构建婴儿死亡率的探索性模型。结果表明，SDOH、HRS和ENV因素影响了三个海湾合作委员会国家的婴儿死亡率。在所有三个国家的模型中，只有HRS对婴儿死亡率有直接影响（巴林：-0.966，95%置信区间-0.987至-0.949；科威特：-0.939，95%置信区间-0.979至-0.909；卡塔尔：-0.941，95%置信区间-0.976至-0.910）。另一方面，ENV因素和SDOH仅对婴儿死亡率有间接的负面影响。ENV因素的β系数范围为-0.745至-0.805，SDOH的β系数范围为-0.815至-0.876。本研究强调了采取多方面公共卫生战略的重要性，这些战略侧重于改善社会经济状况、扩大医疗资源和减少环境退化。通过采用这些多维度方法，巴林、卡塔尔和科威特可以在降低婴儿死亡率和改善总体公共卫生成果方面继续取得进展。
