Estimation of Child Mortality Rate in Sistan and Baluchistan Province, Eastern Iran, From 1962 to 2015

Child mortality rate (CMR) is one of the most important health and socio-economic indicators and one of the targets for sustainable development goals to be achieved by 2030. However, due to incomplete registration of deaths in most of the developing countries there is limited knowledge on child mortality. The current study aimed at indirectly estimating the trend of CMR in Sistan and Baluchistan Province of Iran using summary birth history (SBH) method. The SBH data were extracted from censuses 1986, 1996, 2006, and 2011 and demographic and health survey (DSH) 2000. The collected data were analyzed using maternal age cohort (MAC) and maternal period (MAC) methods. These two estimates were smoothed using Loess regression. Finally, the final trend of CRM (with an uncertainty level of 95%) was obtained using Gaussian process regression (GPR). Trend of CMR in Sistan and Baluchistan Province had a decreasing trend from 1962 to 2015; the rate of CRM was 336 per 1000 live births (95% confidence interval (CI): 306 - 366); it was 247 (95% CI: 264 - 279) and 182 (95% CI: 177 - 187) per 1000 live births in 1970 and 1980, respectively. Moreover, CRM in 1990 was 115 (95% CI: 114 - 118) per 1000 live births and in 2000 it reached 67 (95% CI: 66 - 70) per 1000 live births. In 2005, CMR in Sistan and Baluchistan Province was 50 (95% CI: 48 - 53), while it reached 35 (95% CI: 31 - 40) per 1000 live births in 2010 and 22 (95% CI: 17 - 29) per 1000 live births in 2015. Based on the results of analysis of annual reduction rate (ARR), the median ARR during 52 years was approximately 5%. The results of the current study showed that the survival of children in Sistan and Baluchistan Province considerably improved during 53 recent years and achieved the MDG 4, as CMR reduced by over two-thirds. Nevertheless, according to sustainable development goals (SDG), CMR should be decreased further in the years to come in Sistan and Baluchistan Province to reach a favorable level.