Determinants of Under-Five Child Mortality in Iran: A Systematic Review

Background: The under-five child mortality is considered as one of the indicators of development and health of a population. The death of many children during this period is preventable. This study reviewed the determinants of child death in Iran. Methods: : A systematic search in seven electronic databases and two search engines of all the studies that identified determinants of child mortality in any part of Iran or in the whole country were included, without any restriction of time or language of studies. To identify the studies, a combination of hand searching, gray literatures and bibliographies was also conducted. These sources and citations yielded a total of 512 articles; nevertheless, finally 32 articles fulfilled the inclusion criteria, then were reviewed and analyzed. Results: : Amongst the 32 studies published between 2000 and 2019 in Iran, 22 studies were cross-sectional and 14 published in Farsi language. The associations between several factors (n=57) and the child mortality were examined. Factors such as ‘birth weight’, ‘mother’s literacy’, ‘socioeconomic status’, ‘delivery type’, ‘gestational age’, ‘pregnancy interval’, ‘place of residence’, ‘Immaturity’, ‘type of nutrition’, ‘father’s literacy’ and ‘child gender’ were the most important determinants of child mortality. Conclusions: : Effective efforts with emphasis on identifying and managing the determinants of child mortality are essential to improve their health indicators.