Obstetricians' perspective on the Health Section Evolution Plan in Iran: A Quality-Case Study

Background and Objectives: The Increase of unnecessary caesarean sections has become one of the serious concerns in some health systems. One of the seven packages of the health Reform Plan that was sent to all Iranian medical universities in 2014 was the "Promoting Natural Delivery (vaginal births)," It emphasized the need to reduce cesarean delivery and promote more natural delivery. The present study aimed to assess gynecologists’ perspective on the Health Section Evolution Plan in Iran. Methods: This qualitative study was conducted in 2015. Semi-structural interviews were used for data collection. 11 gynecologists of Isfahan University of Medical Sciences through purposive sampling were interviewed. Thematic analysis method was used for data analysis. Results: After analyzing the content of the interviews, four main themes including “making the natural childbirth franchise free”, “reducing C-section rate”, “motivating service providers", and “improving the standards of natural childbirth facilities”, and 5 sub themes including  “not giving attention to  the culture” , “obligatory increase of natural delivery rate”, “not giving attention to some reform laws at the natural childbirth”, “an unacceptable tariff  payment system” and “payment delays on new tariffs” were determined. Conclusion: Promotion of natural childbirth instructions has somewhat realized; however it has serious shortages and limitations. It is possible to solve a lot of problems by increasing the number of vaginal births through developing legal guidelines to respond to the possible problems as well as seeking leg