Abstract
Worldwide, there has been a notable decline in the infant mortality rate (IMR) in the last 20 years. Regionally, the Gulf Cooperation Council (GCC) countries echo the global trends to a certain extent. This study aims to explore the impact of social determinants of health (SDOH), health resources (HRS), and environmental (ENV) factors on the IMR in Bahrain, Qatar, and Kuwait. It is a retrospective time-series study using yearly data from 1990 to 2022. Partial Least Square Structural Equation Model (PLS-SEM) was utilized to construct an exploratory model of the IMR for each country. The results showed that SDOH, HRS, and ENV factors influenced IMRs in three GCC countries. In all three countries' models, only HRS exerted a direct effect on the IMR (Bahrain: -0.966, 95% CI -0.987 to -0.949; Kuwait: -0.939, 95% CI -0.979 to -0.909; and Qatar: -0.941, 95% CI -0.976 to -0.910). On the other hand, ENV factors and SDOH only influenced the IMR indirectly and negatively. Their beta coefficients ranged from -0.745 to -0.805 for ENV factors and -0.815 to -0.876 for SDOH. This study emphasizes the importance of adopting multi-faceted public health strategies that focus on improving socioeconomic conditions, expanding healthcare resources, and reducing environmental degradation. By adopting these multi-dimensional approaches, Bahrain, Qatar, and Kuwait can continue to progress in reducing IMRs and improving overall public health outcomes.