Background: Child mortality is one of the most important indicators of population health. No systematic review has explored the leading causes of death among under-five children in Iran. This study reviewed the causes of child death by different age groups on the basis of ICD-10. Methods: A systematic search in seven electronic databases and two search engines of all the studies that identified causes 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 817 articles; nevertheless, finally 30 articles fulfilled the inclusion criteria, then were reviewed and analyzed. Results: Amongst the 30 studies published between 2000 and 2019 in Iran, 25 studies were cross-sectional and 19 published in Farsi language. Overall, 71244 child deaths in different age ranges were reviewed in this study. The most common causes of “neonatal mortality” were prenatal conditions (57.8%), congenital malformations, deformations, and chromosomal abnormalities (17%) and disorders of length of gestation and fetal growth (5.9%). “Infant mortalities” were also mainly happened as a result of congenital malformations (22.8%), remainder of prenatal condition (21.2%) and remainder of diseases of the respiratory system (9%). In the age range of 28 days to 5 years, transport accidents (21.1%), congenital malformations (18.1%) and neoplasms (9.3%) were common leading causes of’ deaths. Overall, certain conditions originating in the perinatal period (29.3%), all other disease (26.1%) and external diseases (5.6%) were the leading cause of death in under-five children. Conclusions: This study, provided an updated summary of evidences on the causes of child death in Iran, which is highly critical for the development of interventions and reduction of the burden of under 5 mortality and morbidities.
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.
Background: Population aging is usually associated with increased health needs and designing an age-friendly health system with dedicated features, structure, and functions to improve the health status and quality of life of older adults. There is no evidence of such a conceptual framework developed based on scoping review and expert opinion before. Therefore, this study presents an age-friendly health system design. Methods: The selected models include Arksey and O'Malley’s models. After reviewing 49 health system models and conceptual frameworks, Van Olmen's model was selected as the basic model. Then, by reviewing published articles and other credible resources, the characteristics of an age-friendly health system were extracted and an initial conceptual framework was designed. Then, the expert’s opinions were used to improve and validate this framework. Results: This study systematically reviews the literature contributions on the age-friendly health system. At first, 12316 documents were found. In the final stage, the findings of 140 studies by two reviewers were independently extracted into a data extraction form. Most studies were conducted between 2016 to 2020. In addition, most published articles were conducted in the United States (33.6%). The results showed that an age-friendly health system should include interventions in its components, functions, and goals to provide better services to older adults. This system aims to provide evidence-based care through trained workforces and involves older people and their families. Its consequences include better health for older people, reduction of waste, and increased use of cost-effective health services. Conclusion: To meet the needs of older individuals, health systems should make interventions in all their sub-sections. Also, in line with these changes, other parts of society should work in harmony and set the health of older people as a top priority to ensure they can have a successful aging.
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