Background:The high prevalence of cesarean section represents a major public health challenge worldwide. In 2014, the Iranian Health Transformation Plan (HTP) included programs promoting vaginal delivery.
Aim:The aim of this study was to investigate the effect of the HTP on the rate of cesarean section in Iran.
Method: The interrupted time series analysis (ITSA) was used. Cesarean section-and vaginal delivery-related monthly data were collected from eight public hospitals affiliated with the Lorestan University of Medical Sciences, from March 2012 to February 2019. The autocorrelation plots and the Durbin-Watson test were used for evaluating the autocorrelation between data points in the generalized least squares regression model. Results: The ITSA showed that the rate of cesarean section decreased immediately after the HTP, by −0.002 per 1000 persons (95% CI, −0.004 to −0.001; P = .069). After the HTP, a significant decreasing trend of cesarean section per month was computed (−0.003; 95% CI, −0.005 to 0.012; P = .043).
Conclusion:The present study showed that the implementation of the HTP policy was effective in reducing the rate of cesarean section. This policy should continue, involving