Volume 15, Issue 3 (5-2017)                   IJRM 2017, 15(3): 147-154 | Back to browse issues page


XML Persian Abstract Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Tourani S, Zarezadeh M, Raadabadi M, Pourshariati F. Association of regional disparity of obstetrics and gynecologic services with children and infants mortality rates: A cross-sectional study. IJRM 2017; 15 (3) :147-154
URL: http://ijrm.ir/article-1-807-en.html
1- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
2- School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran , zamomehdi@gmail.com
3- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
4- Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (2741 Views)
Background: Equity in distribution of resources is considered as an importantpriority in health care systems. Equitable distribution of obstetrics and gynecology(Ob/Gyn) services in the country level is critical in maternal and neonatal health forqualitative promotion of maternal care in pregnancy, delivery, and post-deliveryperiods.
Objective: The present study aimed at determining regional disparity of obstetricsand gynecology services and its association with children and infants mortality rates.
Materials and Methods: This was a descriptive-analytical study conducted in 2015to investigate distribution of Ob/Gyn services using three indicators of number ofnursing and midwifery personnel, total Ob/Gyn specialists, and total delivery bedsamong 30 provinces of the country. Equity criteria in the present study includedpopulation, normal vaginal deliveries, cesarean sections, and total deliveries. Datawere gathered using a researcher-made form and Stata 12 was used to calculate Ginicoefficient. The association of Ob/Gyn services with children and infant mortalityrates was investigated using SPSS package and linear regression test.
Results: The lowest Gini coefficient was observed in distribution of nursing andmidwifery personnel in delivery wards in terms of vaginal delivery (0.38 from 1)and the highest value was related to distribution of Ob/Gyn specialists in terms ofvaginal delivery (0.73 from 1). Infant mortality was significantly associated withnumber of nursing and midwifery personnel in delivery wards, and total number ofOb/Gyn specialists.
Conclusion: Considering new population policies in Iran and increased fertility rate,it is recommended to facilitate accessibility of the required services for the women,particularly those of reproductive age.
Full-Text [PDF 352 kb]   (680 Downloads) |   |   Full-Text (HTML)  (413 Views)  
Type of Study: Original Article |

References
1. Rashad H, Khadr Z. Measurement of health equity as a driver for impacting policies. Health Prom Int 2014; 29 (Suppl.): 68-82. [DOI:10.1093/heapro/dau045]
2. Glorioso V, Subramanian S. Equity in access to health care services in Italy. Health Serv Res 2014; 49: 950-970. [DOI:10.1111/1475-6773.12128]
3. McGrail KM, Van Doorslaer E, Ross NA, Sanmartin C. Income-related health inequalities in Canada and the United States: a decomposition analysis. Am J Public Health 2009; 99: 1856-1863. [DOI:10.2105/AJPH.2007.129361]
4. Mobaraki H, Hassani A, Kashkalani T, Khalilnejad R, Chimeh EE. Equality in distribution of human resources: the case of Iran's Ministry of Health and Medical Education. Iran J Public Health 2013; 42: 161-165.
5. Amuzegar J. Iran's economy under the Islamic Republic. IB Tauris; 1997: P38.
6. Zyaambo C, Siziya S, Fylkesnes K. Health status and socio-economic factors associated with health facility utilization in rural and urban areas in Zambia. BMC Health Serv Res 2012; 12: 1-8. [DOI:10.1186/1472-6963-12-389]
7. Van der Heyden J, Demarest S, Tafforeau J, Van Oyen H. Socio-economic differences in the utilisation of health services in Belgium. Health Policy 2003; 65: 153-165. [DOI:10.1016/S0168-8510(02)00213-0]
8. Palència L, Espelt A, Rodríguez-Sanz M, Rocha KB, Pasarín MI, Borrell C. Trends in social class inequalities in the use of health care services within the Spanish National Health System, 1993-2006. Eur J Health Economic 2013; 14: 211-219. [DOI:10.1007/s10198-011-0362-7]
9. Dahlgren G, Whitehead M. A framework for assessing health systems from the public's perspective: the ALPS approach. Int J Health Serv 2007; 37: 363-378. [DOI:10.2190/U814-6X80-N787-807J]
10. Song HJ, Han HR, Lee JE, Kim JY, Kim KB, Ryu JP, et al. Does access to care still affect health care utilization by immigrants? Testing of an empirical explanatory model of health care utilization by Korean American immigrants with high blood pressure. J Immigrant Minor Health 2010; 12: 513-519. [DOI:10.1007/s10903-009-9276-1]
11. Shin H, Song H, Kim J, Probst JC. Insurance, acculturation, and health service utilization among Korean-Americans. J Immigrant Health 2005; 7: 65-74. [DOI:10.1007/s10903-005-2638-4]
12. Rivo M. 2008 World Health Report Emphasizes Importance of Primary Health Care. Am Fam Physic 2009; 79: 1051-1053.
13. Majdzadeh R, Nedjat S, Keshavarz H, Rashidian A, Eynollahi B, Larijani B, et al. A new experience in medical student admission in Iran. Iran J Public Health 2009; 38 (Suppl.): 36-39.
14. Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Quarter 2005; 83:1-28. [DOI:10.1111/j.1468-0009.2005.00428.x]
15. Movahedi M, Hajarizadeh B, Rahimi A, Arshinchi M, Amirhosseini K, Motlagh M. Trend and geographical inequality pattern of main health indicators in rural population of Iran. Hakim Res J 2008; 10: 1-10.
16. Gressani D, Saba J, Fetini H, Rutkowski M, Maeda A, Langenbrunner J. Islamic Republic of Iran health sector review, volume I: main report. The World Bank Group. Hum Dev Sector, Middle East North Afr 2007: 1575-1581.
17. Oza S, Lawn JE, Hogan DR, Mathers C, Cousens SN. Neonatal cause-of-death estimates for the early and late neonatal periods for 194 countries: 2000-2013. Bullet World Health Organ 2015; 93: 19-28. [DOI:10.2471/BLT.14.139790]
18. Figueiredo PPd, Lunardi Filho WD, Lunardi VL, Pimpão FD. Infant mortality and prenatal care: contributions of the clinic in the light of Canguilhem and Foucault. Rev Latino-Am Enfermagem 2012; 20: 201-210. [DOI:10.1590/S0104-11692012000100026]
19. Khabiri r, khosravi a, elahi e, khodayari me, rashidian a. Maternal health care based on iran'multiple indicator demographic and health survey (irmidhs-2010). Hakim Health Sys Res 2014; 17: 67-77.
20. Brown MC. Using Gini-style indices to evaluate the spatial patterns of health practitioners: theoretical considerations and an application based on Alberta data. Soc Sci Med 1994; 38: 1243-1256. [DOI:10.1016/0277-9536(94)90189-9]
21. Pilerudi S. Health Network of City. Tehran, Iran: Razavie Publication; 2006: 87.
22. Mirsaeid G, Javad S, Mirzaie M, Haghshenas E, Dargahi H. Human resources distribution among Tehran university of Medical Sciences Hospitals. Payavard Salamat 2014; 7: 432-446.
23. de Bruin AM, Bekker R, van Zanten L, Koole GM. Dimensioning hospital wards using the Erlang loss model. Ann Oper Res 2010; 178: 23-43. [DOI:10.1007/s10479-009-0647-8]
24. Horev T, Pesis-Katz I, Mukamel DB. Trends in geographic disparities in allocation of health care resources in the US. Health Policy 2004; 68: 223-232. [DOI:10.1016/j.healthpol.2003.09.011]
25. Olsen ØE, Ndeki S, Norheim OF. Human resources for emergency obstetric care in northern Tanzania: distribution of quantity or quality? Hum Resourc Health 2005; 3: 1-12. [DOI:10.1186/1478-4491-3-5]
26. Matsumoto M, Inoue K, Farmer J, Inada H, Kajii E. Geographic distribution of primary care physicians in Japan and Britain. Health Place 2010; 16: 164-166. [DOI:10.1016/j.healthplace.2009.07.005]
27. Martins EF, Rezende EM, Almeida MCdM, Lana FCF. Perinatal mortality and socio-spatial inequalities. Rev Latino-Am Enfermagem 2013; 21: 1062-1070. [DOI:10.1590/S0104-11692013000500008]
28. Pinheiro CE, Peres MA, E DO. Increased survival among lower-birthweight children in Southern Brazil. Rev Saude Publica 2010; 44: 776-784. [DOI:10.1590/S0034-89102010005000031]
29. Souza JP, Cecatti JG, Faundes A, Morais SS, Villar J, Carroli G, et al. Maternal near miss and maternal death in the World Health Organization's 2005 global survey on maternal and perinatal health. Bulet World Health Organ 2010; 88: 113-119. [DOI:10.2471/BLT.08.057828]
30. Barría-Pailaquilén RM, Mendoza-Maldonado Y, Urrutia-Toro Y, Castro-Mora C, Santander-Manríquez G. Trends in infant mortality rate and mortality for neonates born at less than 32 weeks and with very low birth weight. Rev Latino-Am Enfermagem 2011; 19: 977-984. [DOI:10.1590/S0104-11692011000400017]
31. Calman K. The ethics of allocation of scarce health care resources: a view from the centre. J Med Ethics 1994; 20: 71-74. [DOI:10.1136/jme.20.2.71]
32. Asada Y. Assessment of the health of Americans: the average health-related quality of life and its inequality across individuals and groups. Pop Health Metr 2005; 3: 1-11. [DOI:10.1186/1478-7954-3-7]
33. Lai D, Huang J, Risser JM, Kapadia AS. Statistical properties of generalized Gini coefficient with application to health inequality measurement. Soc Indicat Res 2008; 87: 249-258. [DOI:10.1007/s11205-007-9170-y]
34. Grobler L, Marais BJ, Mabunda S, Marindi P, Reuter H, Volmink J. Interventions for increasing the proportion of health professionals practising in rural and other underserved areas. Cochrane Database Syst Rev 2009; 1: 1-25. [DOI:10.1002/14651858.CD005314.pub2]
35. Rabinowitz HK, Diamond JJ, Markham FW, Rabinowitz C. Long-term retention of graduates from a program to increase the supply of rural family physicians. Acad Med 2005; 80: 728-732. [DOI:10.1097/00001888-200508000-00004]
36. Pathman DE, Taylor Jr DH, Konrad TR, King TS, Harris T, Henderson TM, et al. State scholarship, loan forgiveness, and related programs: the unheralded safety net. JAMA 2000; 284: 2084-2092. [DOI:10.1001/jama.284.16.2084]
37. Pathman DE, Konrad TR, King TS, Taylor Jr DH, Koch GG. Outcomes of states' scholarship, loan repayment, and related programs for physicians. Med Care 2004; 42: 560-568. [DOI:10.1097/01.mlr.0000128003.81622.ef]
38. Enkin M, Keirse MJ, Neilson J, Crowther C, Duley L, Hodnett E, et al. Effective care in pregnancy and childbirth: a synopsis. Birth 2001; 28: 41-51 [DOI:10.1046/j.1523-536x.2001.00041.x]

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb