Iranian Journal of

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Background and Objectives: Responsiveness is a response to the reasonable expectations of people about non-clinical aspects of the health system. The purpose of this paper was to assess the responsiveness of the health system after the first year of the health system reform in Sanandaj in 2015.

Methods: This descriptive-analytic and cross-sectional study was conducted on 646 households in Sanandaj. The World Health Survey (WHS) questionnaire was used to collect the data. The data was analyzed with SPSS 16 as well as descriptive statistics and ANOVA.

Results: All dimensions of responsiveness, except for choice, were 100% important according to the respondents. In inpatient services, social support (100%) and confidentiality (96%) had the best performance while communication had the worst performance (49%). In outpatient services, confidentiality (100%) and autonomy (42%) had the best and worst performance, respectively. In inpatient wards, a significant difference only in “quick attention” dimension was observed among responsiveness dimensions with regards to proprietorship of the health care center (P-value=0.03). On the contrary, this difference was not significant in outpatient wards.

Conclusion: In this study, communication (time to ask questions about health problem/treatment, clarity of providers explanations), autonomy (participation in treatment decision-making, possibility of obtaining information on other types of treatment) and quality of basic amenities (cleanliness inside the health facility, available space in waiting and examination rooms) were identified as priority areas for actions to improve the responsiveness of the health care services.

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Background and Objectives: an important problem challenging cesarean section is its extensive use as a common method of delivery. Due to the growing trend of cesarean section in Iran in recent years, the natural delivery promotion program was implemented as one the programs incorporated in the Health System Reform Plan in 2014. In this study, the trend of changes in the percentage of CS delivery in Qom Province following the implementation of this program was evaluated.
 
Methods: This trend analysis that was performed in all cesarean deliveries in Qom Province from 2005 to 2018 using a joinpoint regression method.
 
Results: These results showed an annual increase of0.4% in the CS percentage 95% CI: -0.5 to  1.2), which was not statistically significant. A significant decrease was observed in the rate of CS in governmental hospitals. Conversely, in non-governmental hospitals, the percentage of CS increased significantly.
 
Conclusion: According to the findings of this study, after more than 3 years of implementation of health sector evolution plan, overall implementation of this plan failed to significantly reduce the overall process of cesarean delivery during this period in Qom province and achieve the predetermined goals.