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Int J Prev Med. 2019 Nov 28;10:205. doi: 10.4103/ijpvm.IJPVM_452_18. eCollection 2019.

Evaluation of Timeliness, Simplicity, Acceptability, and Flexibility in Child Mortality Surveillance System for Children Aged 1-59 Months in Iran.

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Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Department of Biostatistics and Epidemiology, School of Public Health, Golestan University of Medical Sciences, Gorgan, Iran.
Child Health Office, Ministry of Health and Medical Education, Tehran, Iran.
Mental Health Research Center, Tehran Institute of Psychiatry- School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
Family and Population Health Office, Ministry of Health and Medical Education, Tehran, Iran.
Pediatric Gastroenterology Division, Ali-Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.
Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences (IUMS), Tehran, Iran.



Child mortality surveillance system (CMSS) for children aged 1-59 months is a critical issue in the prevention of mortality. This surveillance system like other health programs needs to be evaluated. Therefore, this study aims to evaluate CMSS in Iran.


This evaluation was performed from March 2015 to March 2016 based on selected criteria for assessing the public health surveillance system proposed by the Centers for Disease Control and Prevention. Selected criteria examined in this study included timeliness, simplicity, acceptability, and flexibility. These criteria were evaluated in two ways. First, it included the use of a researcher-made questionnaire. The questionnaires were completed by 100 experts on CMSS. Second, to perform a more exact evaluation of these criteria, 24 of these experts were selected for the focus group.


In this study, the response rate was 91% (42% hospital-based and 49% primary care-based). In the timeliness section, 49% of the experts believed that approvals of the child mortality committees have not been sent within the designated time frame; hardware, software, and questionnaires were reported as effective factors in this respect. The structural and administrative problems were effective in simplicity domain and the experts of mortality registration and mood of relatives were effective in acceptability domain. The flexibility of the system was high and appropriate.


The findings of the present study reveal that CMSS has some limitations and problems in the timeliness, simplicity, and acceptability criteria, which can be resolved. But this program has an appropriate situation in terms of flexibility.


Child mortality; Iran; program evaluation; public health surveillance

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