Determining the Contribution of Policy Factors and Access to Health Care Services in Infant Mortality Control in Iran from the Perspective of Experts

Background and Objectives: To reduce infant mortality, attention must be paid to all levels of the health care system. This study aimed to determine the contribution of policy-making factors and access to health services in controlling infant mortality in Iran.

Material and Methods: This applied cross-sectional analytical study was conducted using factor analysis based on 4 neonatal mortality reduction patterns. After examining different texts and patterns, the common and non-common dimensions of these patterns were set in a comparative table. The results of the comparative studies were designed in a questionnaire and sent to 20 experts for reliability and validity. Validity was confirmed by CVI and CVR and reliability by Cronbach's alpha method. For validation of the model, the final questionnaire was completed by multi-stage interviews with 535 individuals from 11 provinces using two-stage interviews with multistage random sampling. Collected data were analyzed using SPSS 25 and AMOS-18 software.

Results: The 83 primary variables were reduced to 48 items after expert opinion survey and 5 factors were extracted after exploratory factor analysis that included "access to health care, policy-making, community participation, technologies and types of health information systems and technologies". The share of each factor in the explained variance were 15.052%, 11.30%, 10.73%, 10.23%, 8.72%, respectively. A deeper examination found that the 13 items related to accessibility (with 52.47% of total variance) and 10 policy items with 45.9% had a single-factor structure.

Conclusion: According to the findings of the study, the infrastructure needed to provide access as well as policy should be provided to control infant mortality. This study can provide sufficient and appropriate evidence for future macroeconomic policy-making and decision-making in reducing infant mortality.