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Effect of Health Transformation Plan on Natural Childbirth and Cesarean Section Indicators: An Interrupted Time Series Analysis in a Private Hospital of Tehran Publisher



Raoofi S1 ; Khosravizadeh O2 ; Ahadinezhad B3 ; Mohammadi SK4 ; Arefi S5 ; Shahsavari S6, 7
Authors
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Authors Affiliations
  1. 1. Health Management and Economics Research Center, School of Health Management & Information Sciences, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Health Service Management, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
  3. 3. Department of Health Economic, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran
  4. 4. School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. School of Medical Science, Tarbiat Modares University, Tehran, Iran
  6. 6. Department of Biostatistics, Health Products Safety Research Center, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran
  7. 7. Department of Epidemiology and Biostatistics

Source: Iranian Journal of Obstetrics# Gynecology and Infertility Published:2020


Abstract

Introduction: Increasing natural childbirth and decreasing cesarean section is one of the strategies for improving maternal and neonatal health to achieve the millennium development goals. In order to achieve this goal, health transformation plan and program for promotion of natural childbirth have been developed and implemented in Iran. Therefore, this study was performed with aim to analyze the trend of natural childbirth and cesarean section indicators in order to realize the goals of the health transformation plan in Madaen Hospital, Tehran. Methods: In this cross-sectional study, the data of delivery and cesarean section were collected from 2013 to 2017. Changes in the level and trend of natural childbirth and cesarean sections before and after transformation plan were evaluated by independent t-test and regression model of cut-off in STATA software (version 15). Results: The trend of natural childbirth after implementation of the plan increased by 0.685% per month (p=0.020) and the trend of cesarean section decreased by 0.749% per month (p=0.011). In the 3-year period after the health transformation plan, the percentage of natural childbirth increased by 0.680 per month (p<0.001) and the percentage of cesarean section decreased by 0.744 per month (p<0.001). Conclusion: According to the results of the study, implementation of adoption policies was effective in reducing the rate of cesarean section in the private hospital. Therefore, the promotion of natural childbirth in order to implement the transformation plan leads to achieve the goals of improving maternal and neonatal health. © 2020, Mashhad University of Medical Sciences. All rights reserved.
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