Health Infrastructure Development in Rural and Urban Areas of Iran Between 1976 and 2011

Abstract

Background: Before the revolution, the gap between rural and urban areas of Iran was enormous and the socio-economic condition in rural areas was substantially different from the condition of their urban counterparts. Over the past 35 years, the Islamic Republic of Iran has made a considerable investment in infrastructures to reduce inequalities between rural and urban areas. Therefore, we evaluated the regional status of health infrastructure development between 1976 and 2011 in rural and urban areas. Methods: We selected piped water, electricity, piped gas, bathrooms, and health houses as the investigated variables. We used the national population and housing data in Iran obtained in 1976, 1986, 1996, 2006, and 2011, as well as the health house census data. We constructed variables for consistent geographic areas in STATA software. The share of the variables was calculated at the county level and the mean and standard deviation was calculated at the provincial level. Results: The gap between rural and urban areas and between different regions of the country was great in access to piped water and electricity in 1976 before the Islamic revolution. In addition, the speed of health houses construction was very slow and households of urban and rural areas did not have piped gas, at all. Between the 1986 and 1996 census, infrastructure variables, except piped gas, experienced a good improvement, especially in rural areas. After the war, the ascending trend continued with a higher speed so that the gap between rural and urban areas decreased sharply. Conclusions: Although involved in a war with Iraq between 1980 and 1988, Iran had a great development in infrastructure variables. In that period, simultaneously several voluntary organizations began their activities in the rural areas; therefore, the sharp progress could be a result of these activities. Although the gap between rural and urban areas has decreased over time, inequity between provinces still is high and this issue calls for more attention.