Volume 6 - Issue 4 by Mostafa Amini Rarani
Middle East/Africa, respectively . Another study reported an IBS prevalence of 10 to 15% and 5 to... more Middle East/Africa, respectively . Another study reported an IBS prevalence of 10 to 15% and 5 to 10% in Western and Asian countries, respectively . A systematic review also reported that the prevalence of IBS ranged from 1.1 to 25% in Iran . IBS has various adverse effects on a patient's social life and work, such as increased absenteeism, reduced quality of life, and substantial medical costs .
Kazim Hospital, Isfahan, Iran During a 4-year period. Materials and Methods: The current descript... more Kazim Hospital, Isfahan, Iran During a 4-year period. Materials and Methods: The current descriptive-analytic study was performed using data from all burned patients hospitalized in Imam Musa Kazem Hospital in Isfahan during 4 years between 2014-2017. The data used for the burn patients records and the HIS system were collected, prepared, and analyzed in two descriptive and inferential analyses. Results: Of the 3,290 burn patients, 22.49% died. The highest number of burns occurred in 2014 (27.08%) in 26-40 year-old (33.59%), married (49.91%), illiterate (30.42%), low income (48.63%), unemployed (34.66%), and Shia (98.24%) men (67.29%) patients. Moreover, most of patients came from cities from the other provinces (42.1%), lived in urban areas (54.59%), had social security insurance (41.52%), and third degree burns (98.33%), burnt at home (70.09%), and the total body surface area burned (TBSA) was ≤30% (49.76%). The correlation of all variables with mortality caused by burn were statistically significant (P<0.001) except for years of admission (P= 0.784) and religion (P= 0.516). Conclusion: The burning and the mortality caused by burn, in addition to healthcare and medicine aspects, is a social phenomenon. Therefore, the recognition of social factors as the causes behind the causes of burns can lead to the appropriate and effective policies aimed to reduce burns and related mortalities.
Background: We aimed to measure changes in socioeconomic inequality in child mortality in Iran. M... more Background: We aimed to measure changes in socioeconomic inequality in child mortality in Iran. Methods: A secondary data analysis of two Demographic and Health Surveys (DHS 2000 and was undertaken. Neonatal, infant and under-5 mortality rates were estimated directly from complete birth history. Economic quintiles were constructed using principal component analysis. Changes in inequality were measured using odds ratios, mortality rates, and concentration curves and indices. Results: Based on the compared measures, inequalities in neonatal, infant, and under-5 mortality declined between the two surveys. The poorest-to-richest neonatal, infant and under-5 mortality odds ratios in 2000 were 1.69 (95% CI= 1.3-2.07), 2.85 (95% CI= 1.96-4.1) and 1.98 (95% CI= 1.64-2.3), respectively. Whereas these mortality odds ratios in 2010 had fallen to 1.65 (95% CI= 0.95-2.9), 1.47 (95% CI=0.5-4) and 1.85 (95% CI=1.13-3), respectively. Moreover, mortality rates in all economic quintiles experienced a decreasing trend. Neonatal, infant, and under-5 mortality concentration indices in 2000 were -0.15, -0.26, and -0.17 respectively. Whereas concentration indices in 2010 had dropped to -0.13, -0.11, and -0.14, respectively. Concentration curves dominance test revealed that there was a statistically significant reduction in inequality in infant and under-5 mortalities. Conclusion: Despite substantial reduction in child mortality rates and narrowing of the gap between poor and rich people, socioeconomic inequality in child mortalities disfavoring worse-off groups still exists. Combination of child health-related efforts that aim to reach to those children born in poor households alongside with pro-equity programs in other sectors of society may further reduce infant, under-5, and particularly neonatal mortality across economic quintiles in Iran.
Iran's trends indicate that substantial reductions have been made in under-five mortality rates. ... more Iran's trends indicate that substantial reductions have been made in under-five mortality rates. Whether this progress has been accompanied by an increasing or decreasing of the under-five mortality inequality between socioeconomic quintiles is unknown.
Background: Exploring changes in health inequality and its determinants over time is of policy in... more Background: Exploring changes in health inequality and its determinants over time is of policy interest. Accordingly, this study aimed to decompose inequality in neonatal mortality into its contributing factors and then explore changes from
Background: Social health is a fundamental dimension of health, and plays an important role in pr... more Background: Social health is a fundamental dimension of health, and plays an important role in promoting social well-being. Research in social health needs reliable and valid tools, which should be also applicable to any type of social context. This study was aimed to develop an effective social health questionnaire for the social context of Iranian society. Methods: The study was conducted in three phases: 1) A preliminary 43-item questionnaire was created based on an extensive literature review; 2) The questionnaire was validated. Firstly, social health experts evaluated content validity; secondly, an exploratory factor analysis and Cronbach's coefficient test were used; 3) The questionnaire was tested in a representative sample of 500 persons, who were selected through a multistage sampling in Tehran, Iran, in 2015. All analyses were carried out using SPSS software (version 22). Results: We developed the Iranian Social Health Questionnaire (IrSHQ) consisting of a 29-item questionnaire organized in seven subscales -'Social interaction', 'social responsibility', 'conscientiousness', 'attitude to society', 'empathy', 'family relationship', and 'social participation'−. Internal consistency using Cronbach's alpha coefficient was 0.86. Validity and reliability of our questionnaire were confirmed. Conclusion: Due to the size and diversity of participants, validity of results, compliance with Iranian culture, and its relative shortness, the IrSHQ appears to be a very useful instrument for measuring individual's social health in the Iranian social context. Introduzione: La salute sociale è una dimensione fondamentale della salute e gioca un ruolo importante nella promozione del benessere sociale. La ricerca sulla salute sociale necessita di strumenti validi ed affidabili, che dovrebbero anche essere applicabili in ogni tipo di contesto sociale. Questo studio è stato ideato per sviluppare un efficace questionario sulla salute sociale adatto al contesto sociale iraniano. Metodi: Lo studio è stata condotto in tre fasi: 1) una versione preliminare a 43 item del questionario è stata preparata sulla base di un' estesa revisione della letteratura. 2) Il questionario è stato validato. Per prima cosa, esperti del settore hanno valutato la validità del contenuto; poi sono state effettuate l'analisi fattoriale esplorativa ed il calcolo del coefficiente di Cronbach. 3) Il questionario è stato testato su di un campione rappresentativo della popolazione iraniana composto da 500 persone selezionate attraverso un campionamento multi-stadio effettuato nella città di Teheran, in Iran, nel 2015. Tutte le analisi sono state effettuate utilizzando il software SPSS (versione 22). Risultati: Abbiamo sviluppato il questionario "Iranian Social Health Questionnaire" (IrSHQ), composto da 29 item organizzati in sette sottoscale denominate "Interazione sociale", "Responsabilità sociale", "Coscienziosità", "Attitudine verso la società", "Empatia", "Relazioni familiari" e "Partecipazione sociale". La consistenza interna usando l'alpha di Cronbach è stata pari a 0,86. La validità e l'affidabilità del nostro questionario sono state confermate. Conclusione: In considerazione delle dimensioni del campione, della diversità dei partecipanti, della validità dei risultati, della conformità alla cultura iraniana e della sua relativa brevità, il questionario "IrSHQ" sembra essere uno strumento molto utile per misurare il grado di salute sociale dell'individuo nella società iraniana.
Background: Health and nutrition are important aspects in the analysis of
households’ multidimens... more Background: Health and nutrition are important aspects in the analysis of
households’ multidimensional poverty. The present research investigated poverty
in Tehran’s households through a cohort approach. In this regard, households’
financial participation about health costs and food intake calories were analyzed.
Methods: Households’ data of costs – income survey were then collected. Health
and nutrition poverty trend was investigated through generational approach, index
of poverty "Foster, Greer, Turbak", and in the period of 1984-2014 by dividing
Tehrany families into eight various age groups. Excell and Stata11 were applied to
process and calculate the indices.
Results: During the study years, the highest level of health poverty (29%) in 1999
was in age range of 21-26 and the highest level of nutrition poverty in 1984 (65%)
was in age range of 42-46. There has been an ascending trend of health and
nutrition poverty at the end of the Fourth Development Plan (2009) up to 2013 for
all age groups.
Conclusion: Generally, rate and severity of health and nutrition poverty had many
fluctuations among different age groups of Tehrani households’ heads. This rate
has raised during recent years which indicates lack of stable and coherent social
policies to reduce households’ exposures with catastrophic health care costs and
funding of the food aid needs
Background: Social health is a fundamental dimension of health, and plays an important role in
pr... more Background: Social health is a fundamental dimension of health, and plays an important role in
promoting social well-being. Research in social health needs reliable and valid tools, which should
be also applicable to any type of social context. This study was aimed to develop an effective social
health questionnaire for the social context of Iranian society.
Methods: The study was conducted in three phases: 1) A preliminary 43-item questionnaire was
created based on an extensive literature review; 2) The questionnaire was validated. Firstly, social
health experts evaluated content validity; secondly, an exploratory factor analysis and Cronbach’s
coefficient test were used; 3) The questionnaire was tested in a representative sample of 500 persons, who were selected through a multistage sampling in Tehran, Iran, in 2015. All analyses were
carried out using SPSS software (version 22).
Results: We developed the Iranian Social Health Questionnaire (IrSHQ) consisting of a 29-item
questionnaire organized in seven subscales – ‘Social interaction’, ‘social responsibility’, ‘conscientiousness’, ‘attitude to society’, ‘empathy’, ‘family relationship’, and ‘social participation’−. Internal
consistency using Cronbach’s alpha coefficient was 0.86. Validity and reliability of our questionnaire were confirmed.
Conclusion: Due to the size and diversity of participants, validity of results, compliance with
Iranian culture, and its relative shortness, the IrSHQ appears to be a very useful instrument for
measuring individual’s social health in the Iranian social context.
Background
Exploring changes in health inequality and its determinants over time is of policy in... more Background
Exploring changes in health inequality and its determinants over time is of policy interest. Accordingly, this study aimed to decompose inequality in neonatal mortality into its contributing factors and then explore changes from 1995-2000 to 2005-2010 in Iran.
Methods
Required data were drawn from two Iran’s demographic and health survey (DHS) conducted in 2000 and 2010. Normalized concentration index (CI) was used to measure the magnitude of inequality in neonatal mortality. The contribution of various determinants to inequality was estimated by decomposing concentration indices in 1995-2000 and 2005-2010. Finally, changes in inequality were investigated using Oaxaca-type decomposition technique.
Results
Pro-rich inequality in neonatal mortality was declined by 16%, ie, the normalized CI dropped from -0.1490 in 1995-2000 to -0.1254 in 2005-2010. The largest contribution to inequality was attributable to mother’s education (32%) and household’s economic status (49%) in 1995-2000 and 2005-2010, respectively. Changes in mother’s educational level (121%), use of skilled birth attendants (79%), mother’s age at the delivery time (25-34 years old) (54%) and using modern contraceptive (29%) were mainly accountable for the decrease in inequality in neonatal mortality.
Conclusion
Policy actions on improving households’ economic status and maternal education, especially in rural areas, may have led to the reduction in neonatal mortality inequality in Iran.
Papers by Mostafa Amini Rarani
Proceedings of Singapore Healthcare
Objective The Bring Your Own Device (BYOD) approach has promoted the usage of personal mobile dev... more Objective The Bring Your Own Device (BYOD) approach has promoted the usage of personal mobile devices for organizational and carrier purposes. Applying a BYOD approach might provide various challenges for healthcare organizations. This study endeavored to identify the attributes of hospitals readiness in applying BYOD and to rank these attributes in order to develop appropriate policies for dealing with challenges. Materials and methods This study is an explanatory sequential mixed method design that was carried out in two qualitative and quantitative phases for identifying the BYOD attributes and ranking them, respectively. Semi-structured interviews with 15 experts in the BYOD field were performed through in the qualitative phase. Purposive and snowball sampling approaches were used to choose experts. Thematic analysis was used to analyze qualitative data. The identified attributes were ranked in a quantitative phase by asking 10 experts using fuzzy hierarchical analysis. Results ...
The Journal of Tolooebehdasht
Introduction: The Integrated Health System (SIB) is the latest electronic health record system in... more Introduction: The Integrated Health System (SIB) is the latest electronic health record system in Iran, with the goal of integrating health information and providing health services in the form of health system reform plan throughout the country starting to function in 2018-2019. The purpose of this study was to identify the advantages and problems of using the SIB system from the perspective of employees of the health center of Yazd and its subsidiaries and providing solutions. Methods: This study is a qualitative study which was conducted using content analysis method with conventional approach. The population of the study consisted of all employees of Yazd health center and affiliated units using SIB system. The sampling was purposeful and continued until data saturation, and a semi-structured interview was conducted to collect information. Results: Based on the findings of the study, the advantages of using the SIB system in the form of eight general categories include: manageri...
International Journal of Ayurvedic Medicine
Objective: As Iran has started to experience population ageing, it is important to consider the e... more Objective: As Iran has started to experience population ageing, it is important to consider the elderly needs and health. The purpose of this study was to examine the structural relationships between social support, quality of life and social health in Iranian older adults. Method: The research was a survey-based cross-sectional study. The sample consisted of 800 non-institutionalized older adults living in Lorestan province in Iran in 2018. Three questionnaires were employed to collect data including social health, social support and quality of life. Data were analyzed by SPSS 22 and Amos 8 softwares. Results: The majority of the participants were men (51%) and 62% of the participants were married. The most of older adults had moderate or poor economic status. Having insurance and higher income significantly correlated with higher quality of life and social health (p<0.05). The direct effect of all three variables including social support on social health, and social support on ...
Eastern Mediterranean Health Journal
Background: Injuries are a major cause of disease, long-term disability and death. Injury-related... more Background: Injuries are a major cause of disease, long-term disability and death. Injury-related damage accounts for 12% of the burden of disease worldwide. Recently, significant improvements in child health have been achieved in the Islamic Republic of Iran: under-5 mortality was reduced substantially from 1990 to 2013. Nevertheless, injury is still a significant cause of mortality in this age group. Aims: Because of their vulnerability and the high rates of injury-related mortality among children under-5, this study aimed at investigating explanatory social variables of injury-related mortality. Methods: The study was conducted using the Commission on Social Determinants of Health conceptual framework among children aged under-5 years in Isfahan Province. Using the national child mortality surveillance system 1433 under-5 mortalities during 2010-2015 were secondary analysed. Results: We found 403 (28%) cases were related to injury. Most of the deaths occurred in 706 infants (49.2%), among boys (54.8%) and urban residents (78.9%). Multivariate logistic regression showed that mothers' low education level, age 1-5 years', living in a supportive centre and having financial problems increased the odds of under-5 mortality caused by injury (odds ratio > 1, P-value ≤ 0.05). Conclusion: Considering the importance and impacts of social factors on injury-related mortality among children, health policy-makers should initially consider the social determinants of health approach in child health programmes to inform interventions aimed at reducing injury-related mortality.
Evidence Based Health Policy, Management and Economics
Resource generation in health system provides mechanisms for training efficient and effective wor... more Resource generation in health system provides mechanisms for training efficient and effective workforce and supplies facilities and equipment for delivering health services. Iran’s Health Transformation Plan is one of the major reforms implemented in 2014 designed to realize the scientific authority of the country among the countries in the region in horizon 2025 (Solar Year 1404). Therefore, the state of function of resource generation in the areas of education, research, and infrastructure suitable for provision of health services may provide valuable policy implications for informed decision-making. Therefore, the status of resource generation in the areas of education, research and infrastructure (focusing on human resources and medicine as two expensive and effective drivers) from the lens of productivity and equity can provide invaluable policy implications for informed decision-making. The function of resource generation in the three areas of education, research, and infrastr...
Archives of Iranian Medicine
Health Scope
Background: While child health inequality is emerging as one of the main issues in child health p... more Background: While child health inequality is emerging as one of the main issues in child health policies, the identification of factors which intensify this kind of inequality via the qualitative method has attracted little attention. Objectives: The aim of the study was to identify the equality issues in child health policies in Iran. Methods: Data were collected using semi-structured interviews with 19 key informants from July 2015 to December 2016. A purposeful and snowball sampling method was used to select participants. Using MAXQDA 12, the recorded interviews were transcribed verbatim and thematically analyzed. Results: Four themes and fifteen subthemes were extracted in terms of equality issues in child health policies, including: (1) implementation of child health policies (rational distribution, addressing rural and underserved regions and full access), (2) strengths of child health policies (comprehensive and integrated healthcare, educating mothers, and targeting programs based on the burden of disease), (3) challenges of child health policies (health information system and faults in data registration, complications in child health education, traditional beliefs and believing in fate, and ignoring social determinants of health), and (4) priority actions (improving fathers' health literacy, promoting socioeconomic and cultural status, enhancing health information system, suburban and rural areas, and regional planning). Conclusions: Reliance on comprehensive and integrated care, health education and targeting program and diminishing challenges and weaknesses can be considered as a policy guide aiming to reduce inequality in child health outcomes. Also, besides addressing executive issues, challenges, and strengths; priorities as policy entry points should be considered simultaneously.
Public Health Nutrition
Objective:The present study aimed to assess and decompose the socio-economic inequality in unheal... more Objective:The present study aimed to assess and decompose the socio-economic inequality in unhealthy snacks consumption among adolescent students in Kerman, Iran.Design:The data were obtained from a cross-sectional study. Principal component analysis was done to measure the socio-economic status (SES) of the adolescents’ families and the normalized concentration index (NCI) was used to measure the inequality in unhealthy snacks consumption among adolescent students of different SES. The contributions of environmental and individual explanatory variables to inequality were assessed by decomposing the concentration index.Setting:Forty secondary schools of Kerman Province in Iran in 2015.Participants:Eighth-grade adolescent students (n 1320).Results:The data of 1242 adolescent students were completed for the current study. Unhealthy snacks consumption was unequally distributed among adolescent students and was concentrated mainly among the high-SES adolescents (NCI = 0·179; 95 % CI 0·0...
Environmental Science and Pollution Research
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Volume 6 - Issue 4 by Mostafa Amini Rarani
households’ multidimensional poverty. The present research investigated poverty
in Tehran’s households through a cohort approach. In this regard, households’
financial participation about health costs and food intake calories were analyzed.
Methods: Households’ data of costs – income survey were then collected. Health
and nutrition poverty trend was investigated through generational approach, index
of poverty "Foster, Greer, Turbak", and in the period of 1984-2014 by dividing
Tehrany families into eight various age groups. Excell and Stata11 were applied to
process and calculate the indices.
Results: During the study years, the highest level of health poverty (29%) in 1999
was in age range of 21-26 and the highest level of nutrition poverty in 1984 (65%)
was in age range of 42-46. There has been an ascending trend of health and
nutrition poverty at the end of the Fourth Development Plan (2009) up to 2013 for
all age groups.
Conclusion: Generally, rate and severity of health and nutrition poverty had many
fluctuations among different age groups of Tehrani households’ heads. This rate
has raised during recent years which indicates lack of stable and coherent social
policies to reduce households’ exposures with catastrophic health care costs and
funding of the food aid needs
promoting social well-being. Research in social health needs reliable and valid tools, which should
be also applicable to any type of social context. This study was aimed to develop an effective social
health questionnaire for the social context of Iranian society.
Methods: The study was conducted in three phases: 1) A preliminary 43-item questionnaire was
created based on an extensive literature review; 2) The questionnaire was validated. Firstly, social
health experts evaluated content validity; secondly, an exploratory factor analysis and Cronbach’s
coefficient test were used; 3) The questionnaire was tested in a representative sample of 500 persons, who were selected through a multistage sampling in Tehran, Iran, in 2015. All analyses were
carried out using SPSS software (version 22).
Results: We developed the Iranian Social Health Questionnaire (IrSHQ) consisting of a 29-item
questionnaire organized in seven subscales – ‘Social interaction’, ‘social responsibility’, ‘conscientiousness’, ‘attitude to society’, ‘empathy’, ‘family relationship’, and ‘social participation’−. Internal
consistency using Cronbach’s alpha coefficient was 0.86. Validity and reliability of our questionnaire were confirmed.
Conclusion: Due to the size and diversity of participants, validity of results, compliance with
Iranian culture, and its relative shortness, the IrSHQ appears to be a very useful instrument for
measuring individual’s social health in the Iranian social context.
Exploring changes in health inequality and its determinants over time is of policy interest. Accordingly, this study aimed to decompose inequality in neonatal mortality into its contributing factors and then explore changes from 1995-2000 to 2005-2010 in Iran.
Methods
Required data were drawn from two Iran’s demographic and health survey (DHS) conducted in 2000 and 2010. Normalized concentration index (CI) was used to measure the magnitude of inequality in neonatal mortality. The contribution of various determinants to inequality was estimated by decomposing concentration indices in 1995-2000 and 2005-2010. Finally, changes in inequality were investigated using Oaxaca-type decomposition technique.
Results
Pro-rich inequality in neonatal mortality was declined by 16%, ie, the normalized CI dropped from -0.1490 in 1995-2000 to -0.1254 in 2005-2010. The largest contribution to inequality was attributable to mother’s education (32%) and household’s economic status (49%) in 1995-2000 and 2005-2010, respectively. Changes in mother’s educational level (121%), use of skilled birth attendants (79%), mother’s age at the delivery time (25-34 years old) (54%) and using modern contraceptive (29%) were mainly accountable for the decrease in inequality in neonatal mortality.
Conclusion
Policy actions on improving households’ economic status and maternal education, especially in rural areas, may have led to the reduction in neonatal mortality inequality in Iran.
Papers by Mostafa Amini Rarani
households’ multidimensional poverty. The present research investigated poverty
in Tehran’s households through a cohort approach. In this regard, households’
financial participation about health costs and food intake calories were analyzed.
Methods: Households’ data of costs – income survey were then collected. Health
and nutrition poverty trend was investigated through generational approach, index
of poverty "Foster, Greer, Turbak", and in the period of 1984-2014 by dividing
Tehrany families into eight various age groups. Excell and Stata11 were applied to
process and calculate the indices.
Results: During the study years, the highest level of health poverty (29%) in 1999
was in age range of 21-26 and the highest level of nutrition poverty in 1984 (65%)
was in age range of 42-46. There has been an ascending trend of health and
nutrition poverty at the end of the Fourth Development Plan (2009) up to 2013 for
all age groups.
Conclusion: Generally, rate and severity of health and nutrition poverty had many
fluctuations among different age groups of Tehrani households’ heads. This rate
has raised during recent years which indicates lack of stable and coherent social
policies to reduce households’ exposures with catastrophic health care costs and
funding of the food aid needs
promoting social well-being. Research in social health needs reliable and valid tools, which should
be also applicable to any type of social context. This study was aimed to develop an effective social
health questionnaire for the social context of Iranian society.
Methods: The study was conducted in three phases: 1) A preliminary 43-item questionnaire was
created based on an extensive literature review; 2) The questionnaire was validated. Firstly, social
health experts evaluated content validity; secondly, an exploratory factor analysis and Cronbach’s
coefficient test were used; 3) The questionnaire was tested in a representative sample of 500 persons, who were selected through a multistage sampling in Tehran, Iran, in 2015. All analyses were
carried out using SPSS software (version 22).
Results: We developed the Iranian Social Health Questionnaire (IrSHQ) consisting of a 29-item
questionnaire organized in seven subscales – ‘Social interaction’, ‘social responsibility’, ‘conscientiousness’, ‘attitude to society’, ‘empathy’, ‘family relationship’, and ‘social participation’−. Internal
consistency using Cronbach’s alpha coefficient was 0.86. Validity and reliability of our questionnaire were confirmed.
Conclusion: Due to the size and diversity of participants, validity of results, compliance with
Iranian culture, and its relative shortness, the IrSHQ appears to be a very useful instrument for
measuring individual’s social health in the Iranian social context.
Exploring changes in health inequality and its determinants over time is of policy interest. Accordingly, this study aimed to decompose inequality in neonatal mortality into its contributing factors and then explore changes from 1995-2000 to 2005-2010 in Iran.
Methods
Required data were drawn from two Iran’s demographic and health survey (DHS) conducted in 2000 and 2010. Normalized concentration index (CI) was used to measure the magnitude of inequality in neonatal mortality. The contribution of various determinants to inequality was estimated by decomposing concentration indices in 1995-2000 and 2005-2010. Finally, changes in inequality were investigated using Oaxaca-type decomposition technique.
Results
Pro-rich inequality in neonatal mortality was declined by 16%, ie, the normalized CI dropped from -0.1490 in 1995-2000 to -0.1254 in 2005-2010. The largest contribution to inequality was attributable to mother’s education (32%) and household’s economic status (49%) in 1995-2000 and 2005-2010, respectively. Changes in mother’s educational level (121%), use of skilled birth attendants (79%), mother’s age at the delivery time (25-34 years old) (54%) and using modern contraceptive (29%) were mainly accountable for the decrease in inequality in neonatal mortality.
Conclusion
Policy actions on improving households’ economic status and maternal education, especially in rural areas, may have led to the reduction in neonatal mortality inequality in Iran.