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

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 determi-nants using health production function. The aim of the present study was to estimate neonatal health produc-tion function for Iran. 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 sys-tem factors were entered into the Binomial Logistic Regression model to estimate neonate health production function. Households’ economic status was constructed using principal component analysis. History of abortion/stillbirth had the highest significant positive impact on odds of neonatal mortali-ty (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 de-creased the chance of death up to 58% (odds ratio=0.58; 95 % CI=0.36-0.93). Considering the most significant inputs of neonatal health production function in Iran, im-provement of economic status of households, provision of appropriate care services for mothers, and im-provement of delivery care provided by trained personnel, could be priorities for health policymakers to act and reduce neonatal mortality in Iran.