The Impact of Healthcare Reform Plan on the Rate of Vaginal Delivery and Cesarean Section in Shiraz (Iran) in 2015

Authors

  • Parviz Aghaei Borzabad Ph.D., Assistant Professor, Department of Medical Education Management, Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran

Keywords:

Vaginal delivery, Cesarean section, Healthcare reform plan

Abstract

Introduction: The uncontrolled increase in the rate of cesarean section is one of the most controversial issues, and is a primary challenge among health policy makers. This study was conducted to examine the impact of the Iranian health evolution plan on vaginal delivery rate and cesarean section. 

Methods: This cross-sectional study was carried out in 2014. Maternal health data for 2013 and 2014 were used in this study and changes in vaginal delivery and cesarean section were compared before and after the reform, using t-test and Wilkinson test. 

Results: According to the findings of this study, 64.7% of deliveries in 2013 were performed using cesarean section while it was 58.6% in 2014 (p= 0.772), of which no significant changes were observed. In addition, the percentage of vaginal delivery in 2013 and 2014 were 35.3% and 41.4% respectively (p= 0.00), so a significant increase was found for vaginal delivery. 

Conclusion: Healthcare reform has led to an increase in the number of vaginal deliveries in hospitals affiliated to Shiraz University of Medical Sciences (SUMS). Due to the limited number of hospitals adhering to the healthcare reform plan to increase vaginal delivery (using private midwife and implementing painless delivery), the reform for decreasing the cesarean rate was not effective enough.

 

References

Rad EH, Tavakkoli M, Moghadamnia MT, Ghanbari A. Fertility and Minority: A Study in Two Provinces

of Iran Using Matching Estimator Technique. J Immigr Minor Health. 2016; 18(3): 660-5. doi:

1007/s10903-015-0239-4. PMID: 26362670.

Hatam N, Tourani S, Homaie Rad E, Bastani P. Estimating the Relationship between Economic Growth

and Health Expenditures in ECO Countries Using Panel Cointegration Approach. Acta Med Iran. 2016;

(2): 102-6. PMID: 26997596, PMCID: PMC26997596.

Tollånes MC, Moster D, Daltveit AK, Irgens LM. Cesarean section and risk of severe childhood asthma: a

population-based cohort study. J Pediatr. 2008; 153(1): 112-6. doi: 10.1016/j.jpeds.2008.01.029. PMID:

Kadivar MR, Yarmohammadi H, Mirahmadizadeh AR, Vakili M, Karimi M. Prevalence of iron deficiency

anemia in 6 months to 5 years old children in Fars, Southern Iran. Med Sci Monit. 2003; 9(2): 100-4.

PMID: 12601296.

Yazdizadeh B, Nedjat S, Mohammad K, Rashidian A, Changizi N, Majdzadeh R. Cesarean section rate in

Iran, multidimensional approaches for behavioral change of providers: a qualitative study. BMC Health

Serv Res. 2011; 11(1): 159. doi: 10.1186/1472-6963-11-159. PMID: 21729279, PMCID: PMC3146409.

Sefiddashti SE, Rad EH, Mohamad A, Bordbar S. Female Labor Supply and Fertility in Iran: A

Comparison Between Developed, Semi Developed and Less Developed Regions. Iran J Public Health.

; 45(2): 186-93.

Badakhsh MH, Seifoddin M, Khodakarami N, Gholami R, Moghimi S. Rise in cesarean section rate over a

-year period in a public hospital in Tehran, Iran. Arch Iran Med. 2012; 15(1): 4-7. doi: 012151/AIM.004.

PMID: 22208435.

Hosseini L, Iran-Pour E, Safarinejad MR. Sexual function of primiparous women after elective cesarean

section and normal vaginal delivery. Urol J. 2012; 9(2): 498-504. PMID: 22641494.

Shariat M, Majlesi F, Azari S, Mahmoudi M. Cesaren Sestion In Maternity Hospitals Intehran, Iran.

Payesh. 2002; 1(3): 5-10.

Rad EH, Karyani AK, Zandian H. Access and necessity for road emergency sites. Trauma monthly. 2016;

e27577. doi: 10.5812/traumamon.27577.

Larijani B, Majdzadeh R, Delavari AR, Rajabi F, Khatibzadeh S, Esmailzadeh H, et al. Iran’s health

innovation and science development plan by 2025. Iranian J Publ Health. 2009; 38(1): 13-6.

Arsalani G, Sajjadi H, Rafiey H, Habbibpor K. Maternal Health, Quality of Life and Their Relationship in

Iran’s Provinces. Social Welfare Quarterly. 2014; 13(51): 25-41.

Mohamadzadeh DM, Haqaee, DH. Cesarean section or vaginal delivery? Tehran: Tolooe Danesh. 2011.

Askarian M, Memish ZA, Khan AA. Knowledge, practice, and attitude among Iranian nurses, midwives,

and students regarding standard isolation precautions. Infect Control Hosp Epidemiol. 2007; 28(2): 241-4.

doi: 10.1086/510868. PMID: 17265414.

Simbar M, Ghafari F, Zahrani ST, Majd HA. Assessment of quality of midwifery care in labour and

delivery wards of selected Kordestan Medical Science University hospitals. Int J Health Care Qual Assur.

; 22(3): 266-77. doi: 10.1108/09526860910953539. PMID: 19537187.

Farokhi F, Khadivzadeh T. Quality assessment of midwives performance in prenatal cares in urban health

centers in Mashhad, Iran. 2008.

Rad EH, Rezaei S, Fallah R. Physician labor participation and unemployment rate in Iran. Shiraz E- Medical Journal. 2015; 16(4).

Tabrizi J, Maleki A, Yadolahi B, Javadi R. Successfulness of vaginal delivery promotion. The congress of

criticizing the government in health field. Tehran 2014.

Afshari S, Zadeh J, Yadegarfar Q, Soleimani F. The impact of healthcare reform plan on the rate of

secarean section in hospitals affilited to Isfan University of medical Scinces. The international congress on

consistent development. Tehran 2014.

Rezaei S, Bazyar M, Fallah R, Chavehpour Y, Rad EH. Assessment of Need and Access to Physician and

Hospital Beds: A Cross Sectional Province Based Study in Iran. Shiraz E-Medical Journal. 2015; 16(6).

Ivan B, Kiani R, Farmalakuti J. Cesarean section or vaginal delivery? which one is better? Differences, pro

and cones. The international congresss of vaginal delivery Tehran: Tehran; 2007.

Published

2022-03-08