Author/Authors :
Hajizadeh, Shayesteh Midwifery and Reproductive Health Department - Faculty of Nursing and Midwifery - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Ramezani Tehrani, Fahimeh Reproductive Endocrinology Research Center - Research Institute for Endocrine Sciences - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Simbar, Masoumeh Midwifery and Reproductive Health Department - Faculty of Nursing and Midwifery - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Farzadfar, Farshad Non-communicable Diseases Research Center - Endocrinology and Metabolism Research Institute - Tehran University of Medical Sciences, Tehran, Iran
Abstract :
Background: LBW is an important factor that can affect infant mortality and represents an index of economic and social development.
It is expected that an increase in the density of midwives attending family physician programs will lead to a decrease in LBW in
health centers. This study aimed to compare the percentage of LBW infants before and after the implementation of the family physician
program in health centers with and without an increase in midwives density.
Methods: This cross-sectional study compared the percentage of LBW infants before and after the implementation of family physician
programs in rural health centers with and without changes in midwives density in Kurdistan. In this study, we included 668 mothers
of 2-month-old children and administered structured interviews in 2005 and 2013. Data were analyzed using the difference-indifferences
and the Matchit statistical models.
Results: The Matchit model showed a significant average percentage increase 0.08 (0.006–0.17) in LBW infants born between 2005
and 2013 in health centers where the density of midwives increased compared with those where it remained unchanged. The difference-
in-differences model showed that the odds ratio of LBW infants is increased by more than twice among participants who had a
history of caesarean section.
Conclusion: The results of this study showed that an increase in the density of midwives in a family physician program did not have
an impact on reducing the percentage of LBW infants born between 2005 and 2013, in health centers where the density of midwives
augmented compared to those where it remained unaltered; it indicated that the increase in the density of midwives alone was not efficient.
On the other hand, the results of our study show an increase in the risk of infants born at a LBW due to caesarean section. It is
recommended that obstetricians and gynecologists must strictly control pregnancies and avoid unnecessary termination of pregnancy.
Keywords :
Iran , Kurdistan , Outcome assessment , Delivery of health care , Low birth weight
