Estimation of a Neonatal Health Production Function for Iran: Secondary Analysis of Iran's Multiple Indicator Demographic and Health Survey 2010

Abstract

Background: Despite constant decrease in rate of neonatal mortality, the rate is still higher than that of other under-five children. One of the first steps towards reduction of neonatal mortality is to identify its determinants using health production function. The aim of the present study was to estimate neonatal health production function for Iran. Methods: In this cross-sectional study, Iranian Multiple Indicator Demographic and Health Survey (Ir-MIDHS) 2010 was used. Four categories of socioeconomic, mother, neonatal demographic and healthcare system factors were entered into the Binomial Logistic Regression model to estimate neonate health production function. Households' economic status was constructed using principal component analysis. Results: History of abortion/stillbirth had the highest significant positive impact on odds of neonatal mortality (odds ratio=1.98; 95 CI=1.55-2.75), indicating that neonates of mothers with such a history had 1.98 times higher chance of death compared to other neonates. Moreover, odds ratio of neonatal death for the poorest quintiles was 1.70 (95 CI=1.08-2.74), indicating that by moving from the poorest quintile to the richest one, the odds of being alive for neonates increased up to 70. However, skilled birth attendant decreased the chance of death up to 58 (odds ratio=0.58; 95 CI=0.36-0.93). Conclusion: Considering the most significant inputs of neonatal health production function in Iran, improvement of economic status of households, provision of appropriate care services for mothers, and improvement of delivery care provided by trained personnel, could be priorities for health policymakers to act and reduce neonatal mortality in Iran.