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

Background: Health systems are making reforms to ensure and promote public health. Measuring the effects of reform is one way to determine its effectiveness and consequences.
 Objectives: This study was aimed at investigating the effect of the Iranian Health Sector Evolution Plan (HSEP) implementation with a focus on the type of delivery on maternal and neonatal health indicators in East-Azerbaijan Province.
 Methods: This descriptive-analytical study was conducted in 2017. The data of 800 patients were randomly selected through the dataset of eight hospitals equally in the two time periods of before and after the HSEP implementation. A researcher-made checklist was used for data extraction. Data were analyzed by SPSS version 22 using descriptive statistics, t-test, and chi-square.
 Results: The mean age of the 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). Maternal and neonatal mortality rates decreased from 0.3 and 0.8% to 0.0 and 0.5%, respectively. Maternal and neonatal mortality and stillbirth rates were not significantly different based on the study period and type of delivery (P > 0.05).
 Conclusions: The findings indicated a significant increase in the rate of natural childbirth after the HSEP implementation. Maternal and neonatal mortality rates had also decreased. These results can guide policymakers in deciding whether to continue or review the reform.