Child Health Policies from the Lens of Equality in Iran: A Qualitative Study

Abstract

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 socio-economic 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.