نوع مقاله : پژوهشی
موضوعات
عنوان مقاله English
نویسندگان English
Mortality is one of the most vital events, and its analysis plays significant importance in population policy-making. This study aimed to evaluate the quality of mortality data in Iran during 2006–2024 using the World Health Organization (WHO)'s ten-step method. Its data sources included the 2006, 2011, and 2016 censuses, as well as population projetiondata from the Statistical Center of Iran for the years 2021–2024. The findings indicate that mortality rates in Iran are lower than global standards;for instance, the urban male mortality rate is approximately 5 per 1,000, while the rates for rural men and women are reported to be below 5 per 1,000. According to international criteria, a mortality rate less than 5 per 1,000 suggests under-registration in the data. The results also reveal unusual declines in mortality rates among childern under five and underone (infants) year of age in both urban and rural areas during the study years. Fluctuations in the data were also observed indicating errors and under-reporting in mortality data, particularly in rural areas among infants. Moreover, the level of under-registration in female mortality data is higher than males. Overall, women and children show the highest levels of under-registration in country’smortality registry data, highlighting the need to improve the vital registration system in Iran.
کلیدواژهها English
Extended Abstract
Introduction
Mortality is one of the most important vital events, and its study plays a crucial role in demographic policymaking. The examination, registration, and documentation of this phenomenon provide a clear picture of a society’s health status. Therefore, the precise measurement of mortality levels and patterns, disaggregated by age and sex over time,using relevant indicators, is considered one of the main components of health and medical planning for controlling and identifying the burden of diseases.The responsibility for collecting information related to mortality lies with the Civil Registration Organization. Hence, improving the quality of mortality data depends on strengthening the vital registration system within this organization. Establishing and maintaining a comprehensive vital registration system capable of covering all moratality eventsrequires political will, long-term investment in administrative infrastructure, and encouragingpublic participation in the registration process. Nevertheless, even in contexts wherecivil registration system achieve broad coverage, challenges such as inaccurate reporting and misclassification of causes of death persist.In many developing countries, weak vital registration systems and alack of reliable data make it difficult for demographers and policymakers to accurately estimate and analyze fertility and mortality indicators. Despite recent improvements in vital event registration, Iran’sstatistical system continues to face issues such as data errors, under-registration, and delays in reporting deaths. Accordingly, this study aims to assess the quality of mortality data in Iran during the period 2006–2024 (1385–1403), using the analytical framework of the World Health Organization.
Method and Data
This research adopts a quantitative approach based on secondary data analysis. Italso utilizesdata from the national population and housing censusesof2006, 2011, and 2016, as well as population projections from the Statistical Center of Iran for the years 2021–2024. Moreover, an exponential interpolation method was used to estimate the population between censuses. Annual registered mortality data from the Civil Registration Organization, disaggregated by age, sex, and place of residence (urban and rural), for the period 2006–2024 were also employed. The quality of the mortality data was evaluated according to the ten-step WHO’s ten-step framework entitled “Mortality Statistics: A Tool to Improve Data Quality and Understanding”. This framework includesten steps for assessing the levels and causes of mortality, the first five steps focus on the data quality: Step 1 involves data examination and categorization, Step 2 pertains to the evaluation of crude death rates, Step 3 involves the examinations of age- and sex-specific mortality rates, Step 4 entails the assessment of age ratios, and Step 5 is dedicated to the examination ofchild or infant mortality rates.
Finding
Preliminary assessments based onthe size, distribution, and composition of Iran’s population between 2006 and 2024 years, disaggregated by sex, age, and place of residence, suggest that the mortality data are of relatively acceptable quality, asno widespread illogical fluctuations or gross errors areobserved. Thesedata allow for analysis both at the individual level and within age-groupsaggregated three- and five-year intervals. However, the presence of fluctuations and relatively low crude death rates, compared toUnited Nations standards and Coale–Demeny model life tables, indicate under-registration in Iran’s mortality data.Findings show that the crude death rates in 2006, 2011, 2016, 2020, and 2024 were 3.4, 5.4, 3.4, 8.5, and 2.5 per 1000population, respectively. For urban males, the rates were 5.2, 5.3, 5.0, and 7.6; for rural males, 6.4, 3.4, 6.4, 2.6, and 2.5; for urban females, 8.3, 0.4, 8.3, 1.5, and 6.4; and for rural females, 3.3, 5.3, 7.3, 0.5, and 2.5 per 1000population, respectively. According to global standards, a crude death rate below 5 per 1000indicates under-registration in the mortality data.
Fluctuations were also observed in younger age groups, particularly among urban males aged 20–35 and rural females aged 15–30. Temporally, the year 2020 displayed the greatest fluctuationsin mortality data. Variations in sex ratios arealso evident during these years, especially in rural areas. For example, in 2011 and 2016, the sex ratio in the 25–29 age group declined sharply, suggesting a higher female than male mortality rates in these ages—a phenomenon attributable to the data error rather than explainable demographic realities.At the same time, the under-five mortality rate in urban areas in 2006, 2011, 2016, and 2020 was reported at 20, 10, 7, and 7 per 1,000 live births, respectively. In rural areas, the corresponding figures were 14, 13, 9.6, and 9. In contrast, United Nations data estimates for the same years were considerably higher;63, 45, 34, and 29 per 1,000 live births, respectively. Moreover, according to the Civil Registration data,the under-five mortality rate was reported as lower than the mortality rate among the elderly agedover 75, which also strongly points to severe under-registration in mortality data.
Discussion and Conclusion
Despite efforts made by the Civil Registration Organization of Iran and notable progress in recent years, including the adequate collection of mortality data that can be analyzed at various levels, shortcomings and problems in mortality reporting still persist. and the data suffer from under-registration and accuracy issues. Unusual reductions in mortalityamong under-five year of age and infant in both urban and rural areas during the study period, along with observable fluctuations in the data, highlight under-reporting and data errors in mortality data, particularly among infants under one year in rural regions. Furthermore, the level of under-registration of female mortality appears greater than that of males. Overall, women and children exhibitthe highest rates ofunder-registerationin Iran’s registrymortality data, underscoring the urgent need to improve the country’s vital registration system.
