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

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Child mortality, program evaluation, public health surveillance, Iran