Explanatory social variables of under-5 mortality caused by injury in Isfahan Province, Islamic Republic of Iran

Abstract

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.