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Table 1 The main findings of the studies included in the present systematic review

From: The effect of the health transformation plan on cesarean section in Iran: a systematic review of the literature

First author/references Year of publication Location Study design Method of study Main findings
Zarei [16] 2015 Tehran Cross-sectional A public hospital was selected and information from 2013 and 2014 was compared Physicians were able to reduce CS by 3 to 7% compared to last year
Piroozi [17] 2016 Kurdistan Descriptive-analytic Data were collected in 2013 and 1 year after the implementation of the HTP in public hospitals, Social Security Hospitals and 1 private hospital CS decreased by 14.62% compared to the year before the plan was implemented in 9 public state hospitals. In social welfare hospitals, CS rate worsened in 2 hospitals. In the private hospital, a 0.21% increase in CS was observed. Results were statistically significant
Seidali [18] 2016 Khuzestan Descriptive-analytic Data were collected 6 months after the implementation of the plan and compared with the previous year in public hospitals After implementation of the HTP, CS rate decreased from 49.56% to 32.10%. Results were statistically significant
Rooeintan [19] 2016 Fars Cross-sectional Information was collected from private and public hospitals between 2013 and 2014 CS dropped from 64.7% to 58.6%. Findings about the decrease or increase in private hospitals were unclear. The results were not statistically significant
Dehghan [20] 2017 Yazd Descriptive-analytic Information was collected and compared between 2013 and 2014 in 15 public and private hospitals CS decreased from 52.64% to 47.37%. In public hospitals, it decreased from 45.2% to 36.71% and in private hospitals from 56.7% to 54.36%. Results were statistically significant
Fouladi [21] 2017 Qom Descriptive-analytic Two public hospitals were selected and data were compared 2 years before and 2 years after the implementation of the plan The rate of CS in hospital A decreased from 49.43% to 41% and in hospital B from 46.76% to 43.36%. Results were not statistically significant
Zaboli [22] 2017 Kerman Cross-sectional Seven public hospitals were selected and information was reviewed 6 months before the plan and 6 months after CS decreased from 48.02% to 43.43%. Results were not statistically significant
Zandian [23] 2017 Ardabil Cross-sectional Information between 2013 and 2015 was collected from a public hospital CS decreased from 60.5% to 43%. Results were statistically significant
Karami Matin [24] 2018 Kermanshah Time series analysis Information from 15 public hospitals was reviewed between 2012 and 2016 CS dropped by 11% a month after the implementation of the plan, and after the implementation of the plan, the monthly increase was 0.0017%. Results showed that the plan was not effective in reducing CS.
Rezaie [25] 2018 Fars Descriptive-analytic Between 2014 and 2015, information was collected from a public hospital CS was reduced from 47.57% to 38.70%. Results were statistically significant
Yusefi [26] 2018 Fars Descriptive-analytic Information was collected from 10 public hospitals between 2013 and 2015 CS decreased. Results were statistically significant
Jabbari [27] 2018 Isfahan Quasi-experimental Data was collected from 22 public and 6 private hospitals in 6 months before and after the implementation of the HTP CS decreased. Results were statistically significant