RESUMO
Background: in recent decades, the rate of caesarian section [C-section] has increased in the Islamic Republic of Iran. A reform in the Iranian health system - the Health Transformation Plan [HTP] - was launched in 2014 in which one of the objectives of HTP is decreasing the rate of C-section
Aims: this study aimed to assess the effects of the Health Transformation Plan [HTP] on the C-section rate in the Islamic Republic of Iran
Methods: this study was an interrupted time series analysis that used segmented regression analysis to assess the im-mediate and long-term effects of the HTP on C-section rate in two groups of hospitals affiliated and not affiliated to the Ministry of Health and Medical Education [MoHME] in Kurdistan province. Study samples were selected using the data on monthly C-section rate collected over a period of four years
Results: we observed significant decreases in C-section rate immediately after the HTP in both groups of hospitals by 0.0629 and 0.0013, respectively [P < 0.05]. In the long run, we observed no significant decrease in the regression slope of C-section rate in both groups
Conclusions: the implementation of HTP decreased the C-section rate. However, the reduction does not meet expectations