Comparing Sociodemographic, Health Status and Resources, Macroeconomic Status, and Environmental Factors on Infant Mortality Rates in Bahrain, Kuwait, and Oman: Longitudinal Time-Series Study.

Background: The United Nations considers children a crucial national asset and makes their welfare a top priority. However, infant mortality remains a persistent challenge, notably in Arab nations. Bahrain, Kuwait, and Oman, despite sharing similar income brackets and health care systems, differ in health policies, demographics, and maternal-child resource allocation. These countries also faced sharp fiscal deficits during the 2020 COVID-19 crisis. Compared to wealthier nearby nations like the United Arab Emirates, their lower gross domestic product further complicates efforts to reduce the Infant Mortality Rate (IMR) and sustain effective, equitable child health strategies. Objective: This study aimed to identify factors contributing to the IMR in Bahrain, Kuwait, and Oman by establishing an interpretative framework to examine the influence of sociodemographic, macroeconomic, health status and resource, and environmental factors. Methods: A longitudinal study collected annual time-series data (1990-2022) for Bahrain, Kuwait, and Oman from international open sources. To counterbalance the time-series effects on both IMR and explanatory factors, a generalized least squares model based on the Cochrane-Orcutt procedure with a first-order autoregressive model was used. Results: Generalized least squares shows that the total fertility rate has a strong effect on IMR among the 3 countries (Oman: β=1.138, P<.001; Kuwait: β=.429, P=.006; Bahrain: β=.610, P=.03). Health status and resources, such as female life expectancy at birth, had an inconsistent impact on the IMR, with a positive effect (β=.103, P=.002) for Oman and a negative effect (β=-4.0697, P<.001) for Kuwait. Macroeconomic factors, such as female unemployment, were significant in decreasing the IMR only for Kuwait (β=-.076, P=.008). Gross domestic product per capita is significant only for Bahrain (β=-.398, P<.001). Environmental factors included CO2 emissions, which negatively impacted Oman's IMR (β=-.077, P=.03), and N2O had a positive effect on Bahrain's IMR (β=.420, P=.04). Conclusions: This study indicated the substantial effects of sociodemographics, health status and resources, macroeconomics, and environment on the IMR in 3 Arab countries. Sociodemographic and health-related factors like female life expectancy, fertility regulation, and female unemployment level were identified as key determinants of infant mortality.