Abstract
Introduction and aim: To improve the individuals' health, reforms should be made in the health systems. As a result, assessing the impacts of reforms is a way to evaluate the effectiveness of the health system. The aim of this study was to study the relationship between the kind of delivery and the five indexes of mother and baby's health before and after implementing the health reform plan in selected hospitals of Azarbaijan Sharghi, Iran.
 Issues and methods: This descriptive-analytical study was conducted in 2017. The study was conducted among eight educational, medical, and private hospitals. Before and after the program, 800 files were selected using simple random sampling method. The researcher made a check list with confirmed validity to extract the data. The data were analyzed using descriptive statistics and T-tests by SPSS-22.
 Results: The average age of mothers in the two intervals was 27 years. Most participants did not deliver before and their education was diploma or lower. The rate of natural delivery from 34.5% (before the plan) reached 44.2% (after the plan)(p<0.05). The rate of mothers and babies' mortality reduced from 0.3 and 0.8 to 0 and 0.5, respectively. Mothers and babies' mortality and stillbirth had no significant difference based on the kind of delivery (p>0.05).
 Conclusion: Findings indicated significant increase of natural delivery after the reform plan in health system. Moreover, the rate of mothers and babies' mortality decreased. These results can guide the policymakers for deciding about the course of plan and its review.
Highlights
The main duty of the health system is improving health and responding to the needs of people in society[1]
The aim of this study was to study the relationship between the kind of delivery and the five indexes of mother and baby's health before and after implementing the health reform plan in selected hospitals of East Azerbaijan, Iran
According to the aforementioned remarks, the aim of this study was investigating the relationship between the kind of delivery and the five indexes () of mother and baby before and after implementing the health reform plan in selected hospitals of East Azerbaijan, Iran
Summary
The main duty of the health system is improving health and responding to the needs of people in society[1]. The latest reforms conducted in the recent decade were the health reform plan, which was implemented in the second half of 2014 This plan has eight axis, one of which is promoting the rate of natural birth to improve the mothers and babies' health indexes by reducing c section and increasing natural birth. According to the statistics by health, treatment, and medical education organization, the frequency of c section was estimated as 40% in Iran, which causes negative effects on health indexes of mothers and babies [16]. From different indexes of health reform plan, reducing c section and promoting natural delivery is provided to improve the mother and baby's health index. These results can guide the policymakers for deciding about the course of plan and its review
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