millennium development goal four; child and infant mortality, achievements in economic cooperation organization countries: an ecological study

background it has been shown that trend of achieving to millennium development goal 4 (mdg 4), varies by region and between countries, indicating the possibility of existing different barriers and/or facilitators. objectives this study aimed to evaluate the trend of under five mortality rate (u5mr), and infant mortality rate (imr) and explore the main challenges to reach mdg 4 by 2015. patients and methods in 2009, we have reviewed the latest countries’ mdg reports. the key stakeholders, from both governmental and international organizations in the country have been visited, and interviewed by the research team as a part of the data triangulation process. the last data on u5mr and imr has been explored, and the achievements were tracked. results the u5mr and imr varied from 257 and 165 deaths per 1000 live births in afghanistan, to 24 and 17 in turkey, respectively. turkey has already reached the u5mr and imr goals. afghanistan, uzbekistan, and pakistan were at risk of not reaching the goals, and iran and tajikistan were a little beyond the time schedule. turkmenistan, kirghizstan and azerbaijan were on the track on mdg on u5mr. regarding imr, afghanistan, uzbekistan, pakistan and iran were at the risk of not reaching the mdgs in 2015, and turkmenistan, kyrgyzstan and azerbaijan were on the track. adult literacy, expenditure on health and out-of-pocket expenditure on heath had a strong association with both u5mr and imr. conclusions it is optimistically expected that few of eco countries would reach the target millennium goals. more focus on the basic needs of communities through a comprehensive primary health care system, and improving health financing are experiences worked in the region, and could help the eco countries to improve more in mdgs health related achievements.