Volume 23, Issue 6 (November - December 2024)
Payesh 2024, 23(6): 885-893 |
Back to browse issues page
Ethics code: IR.TBZMED.REC.1402.039
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Jabbari Beirami H, Yoshari P, Gharekhani D, Ghorbani E, Khodayari-Zarnaq R. The effect of the implementation of the health transformation plan on the health indicators of pregnant mothers in East Azerbaijan province, Iran: a longitudinal study from 2007 to 2016. Payesh 2024; 23 (6) :885-893
URL: http://payeshjournal.ir/article-1-2381-en.html
URL: http://payeshjournal.ir/article-1-2381-en.html
Hossein Jabbari Beirami1 
, Parisa Yoshari2 , Davood Gharekhani3 , Elahe Ghorbani2 , Rahim Khodayari-Zarnaq *4
, Parisa Yoshari2 , Davood Gharekhani3 , Elahe Ghorbani2 , Rahim Khodayari-Zarnaq *4
1- Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
2- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
3- Department of Family Medicine, Faculty of Medical, Tabriz University of Medical Sciences, Tabriz, Iran
4- Department of Health Policy and Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
2- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
3- Department of Family Medicine, Faculty of Medical, Tabriz University of Medical Sciences, Tabriz, Iran
4- Department of Health Policy and Management, Faculty of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract: (798 Views)
Objective(s): Maternal health indicators, especially for pregnant mothers, are among the most important health indicators for any country. Given the implementation of the health transformation plan in the service delivery system in Iran, it was expected that there would be a significant improvement in the quality and quantity of services provided to mothers in recent years. Therefore, the aim of this research was to investigate the effect of implementing healthcare reform on maternal health indicators in East Azerbaijan province, Iran.
Methods: This was a quasi-experimental study. The research population consisted of people living in villages in East Azerbaijan province - Tabriz district, Iran; with active health centers from 2007 to 2016, including a sample size of 200 mothers per year. Villages were randomly selected as clusters. Data collection tool was a questionnaire and all data were analyzed by SPSS version 22 statistical software.
Results: The findings showed that the mean age of mothers during the study period ranged from 25 to 27 years. The number of pregnancies before the reform was 1.39 and after the reform, it was 1.20 which was statistically significant. Examination of the insurance status of pregnant mothers showed that before the reform, 6.4% of rural residents were uninsured, while after the reform, all of them were covered. In terms of laboratory services, 97.7% of mothers underwent routine tests in the first trimester, and 90.5% underwent routine tests in the second trimester. Additionally, over 99% of mothers had undergone at least one ultrasound, with an average of 2.56 ultrasound appointments.
Conclusion: The implementation of the healthcare reform increased the insurance coverage of pregnant mothers and the utilization of services such as ultrasound. This initiative led to a reduction in maternal and neonatal mortality rates and a decrease in the rate of natural childbirth.
Methods: This was a quasi-experimental study. The research population consisted of people living in villages in East Azerbaijan province - Tabriz district, Iran; with active health centers from 2007 to 2016, including a sample size of 200 mothers per year. Villages were randomly selected as clusters. Data collection tool was a questionnaire and all data were analyzed by SPSS version 22 statistical software.
Results: The findings showed that the mean age of mothers during the study period ranged from 25 to 27 years. The number of pregnancies before the reform was 1.39 and after the reform, it was 1.20 which was statistically significant. Examination of the insurance status of pregnant mothers showed that before the reform, 6.4% of rural residents were uninsured, while after the reform, all of them were covered. In terms of laboratory services, 97.7% of mothers underwent routine tests in the first trimester, and 90.5% underwent routine tests in the second trimester. Additionally, over 99% of mothers had undergone at least one ultrasound, with an average of 2.56 ultrasound appointments.
Conclusion: The implementation of the healthcare reform increased the insurance coverage of pregnant mothers and the utilization of services such as ultrasound. This initiative led to a reduction in maternal and neonatal mortality rates and a decrease in the rate of natural childbirth.
type of study: Quazi Experimental |
Subject:
Helath Services Management
Received: 2023/12/20 | Accepted: 2024/10/21 | ePublished ahead of print: 2024/12/8 | Published: 2024/12/14
Received: 2023/12/20 | Accepted: 2024/10/21 | ePublished ahead of print: 2024/12/8 | Published: 2024/12/14
References
1. Khodabakhshi A, Gholamian B. A Comparative Study of the Impact of Governance Sub-Indicators on Health Expenditures in Rich and Poor Countries 2022; 22:353-389 [Persian] [DOI:10.32598/refahj.22.86.2424.2]
2. Mohamadi E, Kiani MM, Olyaeemanesh A, Takian A, Majdzadeh R, Hosseinzadeh Lotfi F, Sharafi H, Sajadi HS, Goodarzi Z, Noori Hekmat S. Two-step estimation of the impact of contextual variables on technical efficiency of hospitals: the case study of public hospitals in Iran. Frontiers in Public Health 2022; 9: 2296-2565 [Persian] [DOI:10.3389/fpubh.2021.785489]
3. Mbau R, Musiega A, Nyawira L, Tsofa B, Mulwa A, Molyneux S, Maina I, Jemutai J, Normand C, Hanson K, Barasa E. Analysing the efficiency of health systems: a systematic review of the literature. Applied Health Economics and Health Policy 2023; 21:205-224 [DOI:10.1007/s40258-022-00785-2]
4. Rudnicka E, Napierała P, Podfigurna A, Męczekalski B, Smolarczyk R, Grymowicz M. The World Health Organization (WHO) Approach to Healthy Ageing. Maturitas 2020; 139:6-11 [DOI:10.1016/j.maturitas.2020.05.018]
5. Peahl AF, Gourevitch RA, Luo EM, Fryer KE, Moniz MH, Dalton VK, Fendrick AM, Shah N. Right-sizing prenatal care to meet patients' needs and improve maternity care value. Obstetrics & Gynecology 2020; 135:1027-1037 [DOI:10.1097/AOG.0000000000003820]
6. Johnson K, Posner SF, Biermann J, Cordero JF, Atrash HK, Parker CS, Boulet S, Curtis MG; CDC/ATSDR Preconception Care Work Group; Select Panel on Preconception Care. Recommendations to improve preconception health and health care--United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR Recomm Rep. 2006 Apr 21;55(RR-6):1-23. PMID: 16617292 [DOI:10.1037/e506902006-001]
7. Kangovi S, Mitra N, Grande D, Long JA, Asch DA. Evidence-Based Community Health Worker Program Addresses Unmet Social Needs and Generates Positive Return on Investment: A return on investment analysis of a randomized controlled trial of a standardized community health worker program that addresses unmet social needs for disadvantaged individuals. Health Affairs 2020; 39:207-213 [DOI:10.1377/hlthaff.2019.00981]
8. Eslami V, Tavakkoli-Sani S, Ghavami V, Peyman N. The relationship of health literacy with preventive behaviors of urinary tract infection in pregnant women. Journal of Health Literacy 2022; 6:22-31 [Persian]
9. Shams Javi S, Raeissi P, Nasiripour AA. The effect of Health System Reform Plan on health indicators in population covered by Ahvaz University of Medical Science 2020; 19:69-77 [Persian]
10. Mosadeghrad AM. Health strengthening plan, a supplement to Iran health transformation plan. Tehran University of Medical Sciences Journal 2019; 77:537-538 [Persian]
11. Raoofi S, Ahadinejad B, Khan Mohammadi S, Arefi S, Shahsawari S. The Effect of health transformation plan on natural childbirth and cesarean section indicators: An Interrupted Time Series Analysis in a Private Hospital of Tehran. . The Iranian Journal of Obstetrics, Gynecology and Infertility 2020; 23: 51-59 [Persian]
12. Alipour A, Khazaei L, Khodakarim S. Cesarean Section Rates before and after the Implementation of Health Sector Evolution Plan in Iran: An Interrupted Time Series Analysis. Current Women's Health Reviews 2022; 18:87-93 [Persian] [DOI:10.2174/1573404817666210604105751]
13. Behzadifar M, Behzadifar M, Saki M, Valipour M, Omidifar R, Iranshahi F, Bragazzi NL. The impact of the "Health Transformation Plan" and related policies on the prevalence rate of cesarean section in Iran: Insights from an interrupted time series analysis. The International Journal of Health Planning and Management 2020; 35:339-345 [Persian] [DOI:10.1002/hpm.2916]
14. Jabari H, Seyedamini B, Navvabi E, Asadi S. The relationship between the kind of delivery and 5 indexes of mother and baby's health before and after implementing health reform plan in selected hospitals of East Azerbaijan (Iran). Evidence Based Health Policy, Management and Economics 2019; 3:105-111 [Persian] [DOI:10.18502/jebhpme.v3i2.1217]
15. Sadeghi M, Rahimi M, Poornoroz N, Jahromi FF. Patient satisfaction with hospital services after the implementation of the health system. Archives of Pharmacy Practice 2021; 12:31-36 [Persian] [DOI:10.51847/tzWsa4CPAf]
16. Khedmati J, Davari M, Aarabi M, Soleymani F, Kebriaeezadeh A. Evaluation of urban and rural family physician program in Iran: a systematic review. Iranian Journal of Public Health 2019; 48:400-409 [Persian] [DOI:10.18502/ijph.v48i3.882]
17. Doshmangir L, Moshiri E, Farzadfar F. Seven decades of primary healthcare during various development plans in Iran: a historical review. Archives of Iranian Medicine 2020; 23:338-352 [Persian] [DOI:10.34172/aim.2020.24]
18. Beirami HJ, Belali-Oskuei S. Prenatal care utilization of pregnant women in East Azarbaijan Province 2018; 9:55-62 [Persian]
19. Beyrami HJ, Asadi S, Doshmangir L. The impact of health reform on maternal and child health indicators in developing countries: A systematic review 2019; 8:9-17 [Persian] [DOI:10.15562/bmj.v8i1.1168]
20. Arab-Zozani M, Pezeshki MZ, Khodayari-Zarnaq R, Janati A. Balancing overuse and underuse in the Iranian healthcare system: a force field theory analysis. Ethiopian Journal of Health Sciences 2019; 29: 231-238 [Persian] [DOI:10.4314/ejhs.v29i2.10]
21. Escuriet Peiró R, White J, Beeckman K, Frith L, Leon-Larios F, Loytved C, Luyben A, Sinclair M, Van Teijlinge E. Assessing the performance of maternity care in Europe: a critical exploration of tools and indicators. BMC Health Services Research 2015; 15:1-3 [DOI:10.1186/s12913-015-1151-2]
22. Abdi Z, Hsu J, Ahmadnezhad E, Majdzadeh R, Harirchi I. An analysis of financial protection before and after the Iranian Health Transformation Plan. Eastern Mediterranean Health Journal 2020; 26:1025-1033 [Persian] [DOI:10.26719/emhj.19.026]
23. Kazemi-Galougahi MH, Dadgar E, Kavosi Z, Majdzadeh R. Increase of catastrophic health expenditure while it does not have socio-economic anymore; finding from a district on Tehran after recent extensive health sector reform. BMC Health Services Research 2019; 19:1-12 [Persian] [DOI:10.1186/s12913-019-4418-1]
24. Farhadi S, Fazaeli AA, Mohammadi Y. The Effect of Health Transformation Plan on Out-of-Pocket Payments of the Hospitalized Patients in Hamedan, Iran. Evidence Based Health Policy, Management and Economics 2021; 5: 253 - 258 [Persian] [DOI:10.18502/jebhpme.v5i4.8160]
25. Ahmadnezhad E, Murphy A, Alvandi R, Abdi Z. The impact of health reform in Iran on catastrophic health expenditures: equity and policy implications. The International Journal of Health Planning and Management 2019; 34: 1833-1845 [Persian] [DOI:10.1002/hpm.2900]
26. Ambarwati ER, Ashar H, Kumorojati R, Yulinda D, Utami NW, Lestari RT. Effect of multiple micronutrient supplementation in pregnant women on infant birth weight. Action: Aceh Nutrition Journal 2023; 8:579-587 [DOI:10.30867/action.v8i4.1210]
27. Arsyad M, Kadir S, Kasim VN. Influence Supplements Multi Micronutrients (MMS) on Nutritional Status Mother Pregnant in City Gorontalo. International Journal of Medical Science and Clinical Research Studies 2024; 4:771-777 [DOI:10.47191/ijmscrs/v4-i04-30]
28. Ghasemyani S, Raoofi S, Hamidi H, Khodayari-Zarnaq R. Iran's health transformation plan; main issues and opportunities for improvement: a systematic review. Iranian Journal of Public Health 2022; 51:1977 -1989 [Persian] [DOI:10.18502/ijph.v51i9.10552]
29. Seifoori B, Hasani Darmian G, Majdi A, Kermani M. Women's Reproductive Behavior with the Family Transformation Process in the Past Three Decades. Quarterly Journal of Woman and Society 2019 23; 10:255-276 [Persian]
30. Jabbari Beirami H, Belali-Oskuei S. Prenatal care utilization of pregnant women in East Azarbaijan Province. Depiction of Health 2018; 9:55-62 [Persian]
31. Zandian H, Tourani S, Moradi F, Moghadam TZ. Effect of health sector evolution plan on the prevalence and costs of caesarean section and natural childbirth. Payesh (Health Monitor) 2017; 16: 411-419 [Persian]
32. Piroozi B, Moradi G, Esmail Nasab N, Ghasri H, Farshadi S, Farhadifar F. Evaluating the effect of health sector evolution plan on cesarean rate and the average costs paid by mothers: A case study in Kurdistan province between 2013-2015 Hayat 2016; 22: 245-254 [Persian]
33. Jamshidi H, Saadat P. The Assessment of Changes in Cesarean Indications Before and After the Implementation of Health Sector Evolution Plan in Valiasr Hospital, Fasa, Fars Province in 2013-2015. Journal of Advanced Biomedical Sciences 2018; 8:778-784 [Persian]
34. Fouladi Z, Shaarbafchi Zadeh N, Shaikhvaisi Y, Alimoradnuri M, Bagheri F. The effect of healthcare reform plan to reduce the rate of cesarean in hospitals affiliated to Qom University of Medical Sciences. Military Caring Sciences Journal 2017; 4:207-212 [Persian] [DOI:10.29252/mcs.4.3.207]
35. Bahmaei J, Maleki A. Evaluation of the effect of health sector evolution plan on the rate of cesarean sections in hospitals affiliated to Abadan school of medical sciences. Journal of Health Research in Community 2019; 5:52-60 [Persian]
36. Yuill C, McCourt C, Cheyne H, Leister N. Women's experiences of decision-making and informed choice about pregnancy and birth care: a systematic review and meta-synthesis of qualitative research. BMC Pregnancy and Childbirth 2020; 20:1-21 [DOI:10.1186/s12884-020-03023-6]
37. Macinko J, Guanais FC, De Souza MD. Evaluation of the impact of the Family Health Program on infant mortality in Brazil, 1990-2002. Journal of Epidemiology & Community Health 2006; 60:13-9 [DOI:10.1136/jech.2005.038323]
38. Victora CG, Aquino EM, do Carmo Leal M, Monteiro CA, Barros FC, Szwarcwald CL. Maternal and child health in Brazil: progress and challenges. The lancet 2011; 377:1863-1876 [DOI:10.1016/S0140-6736(11)60138-4]
39. Jabbari H, Pezeshki MZ, Naghavi-Behzad M, Asghari M, Piri R, Bakhshian F. What is the relationship between family physicians' job satisfaction associated and their educational performance? Journal of Analytical Research in Clinical Medicine 2015;3:30-36 [Persian] [DOI:10.15171/jarcm.2015.005]
40. Ghasemyani S, Raoofi S, Hamidi H, Khodayari-Zarnaq R. Iran's health transformation plan; main issues and opportunities for improvement: a systematic review. Iranian Journal of Public Health 2022; 51:1977-1989 [Persian] [DOI:10.18502/ijph.v51i9.10552]
41. Shams Javi S, Raeissi P, NasiriPour AA. The effect of Health System Reform Plan on health indicators in population covered by Ahvaz University of Medical Science. Journal of Hospital 2020; 19:69-77 [Persian]
Send email to the article author
| Rights and Permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |