Background & Aim: Cesarean rate has had a rising trend in Iran during the last two decades. Natural childbirth promotion plan has been implemented in the form of health sector evolution plan (HSEP) in order to increase natural childbirth. Present study aimed to evaluate the effect of health sector evolution plan on cesarean rate and the average costs paid by mothers hospitalized in Kurdistan province.

Methods & Materials: This descriptive study was conducted as longitudinal and retrospective study. Cesarean rate in all hospitals of Kurdistan province was assessed in 2013 and one year after the implementation of HSEP. Furthermore, data related to the percentage of out of pocket expenditures by pregnant mothers in one of the hospitals of Kurdistan University of Medical Sciences, which was randomly selected, was also studied. Data were analyzed using SPSS v.20.

Results: There was a 14.02% reduction in the rate of cesarean in Kurdistan province one year after the implementation of HSEP compared to its basal rate in 2013 (P<0.001). The average out of pocket expenditures was 16.05% before the implementation of HSEP. This rate was reduced to 4.30% and 2.5% respectively after the implementation of first and third phases of HSEP.

Conclusion: Natural childbirth promotion plan has reached its predetermined goal, which was a 10% decrease in cesarean rate one year after the implementation of HSEP compared to its rate in 2013. In addition, there was a significant reduction in the percentage of out of pocket expenditures.

Background & Aim: Cesarean rate has had a rising trend in Iran during the last two decades. Natural childbirth promotion plan has been implemented in the form of health sector evolution plan (HSEP) in order to increase natural childbirth. Present study aimed to evaluate the effect of health sector evolution plan on cesarean rate and the average costs paid by mothers hospitalized in Kurdistan province.

Methods & Materials: This descriptive study was conducted as longitudinal and retrospective study. Cesarean rate in all hospitals of Kurdistan province was assessed in 2013 and one year after the implementation of HSEP. Furthermore, data related to the percentage of out of pocket expenditures by pregnant mothers in one of the hospitals of Kurdistan University of Medical Sciences, which was randomly selected, was also studied. Data were analyzed using SPSS v.20.

Results: There was a 14.02% reduction in the rate of cesarean in Kurdistan province one year after the implementation of HSEP compared to its basal rate in 2013 (P<0.001). The average out of pocket expenditures was 16.05% before the implementation of HSEP. This rate was reduced to 4.30% and 2.5% respectively after the implementation of first and third phases of HSEP.

Conclusion: Natural childbirth promotion plan has reached its predetermined goal, which was a 10% decrease in cesarean rate one year after the implementation of HSEP compared to its rate in 2013. In addition, there was a significant reduction in the percentage of out of pocket expenditures by mothers.