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Title
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Inequality in Under-Five Mortality in Iran: A National and Subnational Survey Data Analysis
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Type
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JournalPaper
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Keywords
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Under-five mortality, socioeconomic inequality, concentration index, Iran (Islamic Republic of).
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Abstract
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Background: Despite substantial progress in the national average of under-five mortality rate in Iran, distribution of under-five mortality across different socioeconomic groups is unknown. This study measured socioeconomic inequality in under-five mortality in Iran and across its provinces. Method: Using data from provincially representative Multiple Indicator Demographic and Health Survey, conducted in Iran in 2010, we developed an accurate principal component analysis model to construct an indicator of socioeconomic status of Iranian households. Under-five mortality rates at national and subnational level were estimated using full birth history. The indicator then was used to measure inequality in under-five mortality using Wagstaff normalised concentration index (WCI) at national and subnational levels. Results: Estimates of Wagstaff normalised concentration indices showed a pro-rich inequality in under-five mortality at national and subnational levels. The concentration index of under-five mortality in Iran was -0.197. Moreover, the consistent negative values of the concentration indices indicated that under-five mortality inequality disfavored the worst-off in all provinces. However, the inequality varied among provinces and ranged from -0.013 to -0.487. At national level there was a descending trend in the under-five mortality rate as one moves higher up in the socioeconomic quintiles. Conclusions: This study suggests that further reduction in under-five mortality not only requires addressing the national average but also needs considering inequality in under-five mortality. Therefore, child health policy requires looking beyond the average, putting equality and average together at both national and sub national levels.
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Researchers
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Ardeshir Khosravi (Fourth Researcher), (Third Researcher), Arash Rashidian (Second Researcher), Mostafa Amini Rarani (First Researcher), Ezatollah Abbasian (Fifth Researcher)
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