Effect of the Iranian Health Sector Evolution Plan Implementation Focused on the Type of Delivery on Maternal and Neonatal Health Indicators in Selected Hospitals of East Azerbaijan Province

Abstract

Introduction: Health systems are making reforms to ensure and promote public health. Measuring the effects of reform is one way to determine its effectiveness and can lead to improved consequences. This study was aimed to investigate the effect of the Iranian Health Sector Evolution Plan (HSEP) implementation with the focus on the type of delivery on maternal and neonatal health indicators in East-Azerbaijan Province. Material and Methods: This descriptive-analytical study was conducted in 2017. The data on a total of 800 patients were randomly selected through the dataset of 8 hospitals equally in the two time periods of before and after the HSEP implementation. A researcher-made checklist was used to data extraction. Data were analyzed by SPSS-22 software using descriptive statistics, t-test, and chi-square. Findings: The mean age of mothers in both periods was 27 years. Most of the participants did not have a previous delivery and had a diploma or a lower level of education. The rate of natural childbirth increased from 34.5% (before the HSEP) to 44.2% (after the HSEP) (p 0.05). Conclusion: The findings indicate a significant increase in the rate of natural childbirth after the HSEP implementation. Maternal and neonatal mortality rates have also decreased. These results can guide policy-makers in deciding whether to continue and review the reform.

Keywords

• Health system evolution plan, maternal and neonatal health, Iran