Geographical Disparities in the Health of Iranian Women: Health Outcomes, Behaviors, and Health‑care Access Indicators

Abstract

Background: Women’s health is a key factor affecting the health of the whole population. Tackling inequality in determinants of health is recognized as the main path toward reducing the inequality in health outcomes. This study aimed to analyze the provincial inequality in determinants of women's health and health care in Iran.

Methods: Using the Moss’s model (2002) as a comprehensive framework of determinants of women’s health, including “geopolitical environment,” “culture, norms, sanctions,” “women’s roles in reproduction and production,” “health‑related mediators,” and “health outcome” categories, we chose 13 indicators. Afterward, using data sources including the Iranian Multiple Indicators of Demographics and Health Survey, the National Organization for Civil Registration, and Statistics
Centre of Iran, we analyzed provincial inequality in these indicators in Iran (2011). Gini coefficient and Lorenz curve were used for measuring inequality.

Results: Gini coefficients calculated as follows; life satisfaction level (0.027), literate women (0.398), women with proper knowledge about HIV/AIDS prevention (0.483), unemployed women (0.380), women without an income (0.384), women who use at least one type of mass media (0.389), women who used computer or internet (0.467), women who had received pregnancy care from a skill birth attendant (SBA) (0.420), women who had delivered with the help of an SBA (0.426), women who currently smoke cigarettes (0.603), women who currently consume hookah (0.561), women with at least one chronic disease (0.438), and women’s deaths in 2010 and 2011 (0.393 and 0.359, respectively).

Conclusions: We found large provincial disparities in determinants of women’s health in Iran. Determinants such as lifestyle, health behavior, health knowledge, and health‑care services availability should be considered by health policymakers in addressing the inequality in women’s health at a provincial level.

Keywords: Demographic and health survey, health behavior, health care inequalities, social determinants of health, women’s health