title: Mortality inequality in 1-59 months children across Iranian provinces: referring system and determinants of death based on hospital records.
abstract: BACKGROUND
  To determine inequality in mortality in 1-59 months children across Iranian provinces focusing on referring system and determinants of death.
  
  
  METHODS
  After designing and examining a national questionnaire for mortality data collection of children 1-59 months, 40 medical universities have been asked to fill in the questionnaires and return to the main researcher in the health ministry in 2009.
  
  
  RESULTS
  Mortality in 1-59 months children was unequally distributed across provinces (universities). The recommended refer was 3466 but only 1620 patients were referred. The first five important determinants of death were congenital (671 children or 20.9%), accident (547 children or 17.1%), pulmonary diseases (370 children or 11.5%), cardiovascular (266 children or less than 8.3%), central nervous system (263 children or 8.2%), and infectious and parasitic diseases (245 children or 7.6%), respectively.
  
  
  CONCLUSIONS
  Our results suggest that inequality in 1-59 months mortality based on the hospital records, and specially referring system, needs more attention in Iran. In addition, it is advisable to conduct provincially representative surveys to provide recent estimates of hospital access inequalities and to allow monitoring over time.
authors.affiliation: Social Health Determinants Research Canter and Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Amiri
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Lornejad
authors.forename: Sayyed Hamed
authors.initials: SH
authors.lastname: Barakati
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.forename: Parinaz
authors.initials: P
authors.lastname: Poursafa
keywords: Children mortality; Iran; hospital records; national mortality registration system; referring system