Investigating the Effectiveness of the Health System Transformation Plan on the Type of Delivery in Khorramabad Hospitals

Changaee, Farahnaz

doi:10.22087/ijac.2022.492125.1032

Investigating the Effectiveness of the Health System Transformation Plan on the Type of Delivery in Khorramabad Hospitals

Document Type : Research

Author

Farahnaz Changaee

Social Determinants of Health Research Centre, Shahid Rahimi Hospital, School of Nursing & Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran

10.22087/ijac.2022.492125.1032

Abstract

Cesarean section rates are commonly regarded as a key indicator for assessing the effectiveness of maternal health programs across countries. A rising trend in elective or unnecessary cesarean section reflects inefficiencies within the healthcare system's performance. The health reform plan has been implemented since 2014 in Iran to reduce the cesarean section rate to 25–30%. The present study aimed to evaluate the prevalence of cesarean section and vaginal delivery before and after the implementation of the health reform plan in Lorestan province. This descriptive-analytical study was conducted in 2020 on all women giving birth between 2011- 2016 in one of the public hospitals in Khorramabad, implementing the health reform plan. The data were collected through a census sampling method using statistics provided by the Vice President of Treatment of the Lorestan University of Medical Sciences and analyzed using descriptive and analytical statistics, including the chi-square test. The cesarean section rate increased in the public hospitals in Khorramabad after implementing the health reform plan compared to the pre-implementation period, and the difference was statistically significant. Consequently, the percentage of vaginal delivery decreased. The discrepancy between the results of the present study and the objectives of the health reform plan cannot be attributed to the plan itself and various factors, such as the rising age of marriage in recent years, leading to an increase in the age of pregnant women and the likelihood of cesarean section are effective in this regard. Moreover, the rising age of primiparous mothers, coupled with the increase in the number of ultrasounds, have enhanced the detection of maternal and fetal complications, contributing to an increased rate of cesarean section.

Keywords

Vaginal delivery

Cesarean section

Health system transformation plan

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