Jundishapur Journal of Health Sciences

Published by: Kowsar

Challenges of Iranian Maternal Health Program from Midwives’ Perspectives: A Qualitative Study

Rozita Firouznia 1 , * , Hossein Dargahi 2 , Tohid Jafari Koshki 3 and Zeinab Khaledian 4
Authors Information
1 Department of Health Services Management, Semnan Branch, Islamic Azad University, Semnan, Iran
2 Department of Management and Health Economics, Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Statistics and Epidemiology, Road Traffic Injury Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
4 Department of Midwifery, Semnan Branch, Islamic Azad University, Semnan, Iran
Article information
  • Jundishapur Journal of Health Sciences: 11 (3); e92354
  • Published Online: July 3, 2019
  • Article Type: Research Article
  • Received: April 16, 2019
  • Revised: May 29, 2019
  • Accepted: June 16, 2019
  • DOI: 10.5812/jjhs.92354

To Cite: Firouznia R, Dargahi H, Jafari Koshki T, Khaledian Z. Challenges of Iranian Maternal Health Program from Midwives’ Perspectives: A Qualitative Study, Jundishapur J Health Sci. Online ahead of Print ; 11(3):e92354. doi: 10.5812/jjhs.92354.

Copyright © 2019, Jundishapur Journal of Health Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Goberna-Tricas J, Banus-Gimenez MR, Palacio-Tauste A, Linares-Sancho S. Satisfaction with pregnancy and birth services: the quality of maternity care services as experienced by women. Midwifery. 2011;27(6):e231-7. doi: 10.1016/j.midw.2010.10.004. [PubMed: 21145632].
  • 2. World Health Organization. Trends in maternal mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. Geneva: WHO Press; 2014.
  • 3. Lawn JE, Cousens S, Zupan J, Lancet Neonatal Survival Steering T. 4 million neonatal deaths: When? Where? Why? Lancet. 2005;365(9462):891-900. doi: 10.1016/S0140-6736(05)71048-5. [PubMed: 15752534].
  • 4. Sandall J, Devane D, Soltani H, Hatem M, Gates S. Improving quality and safety in maternity care: The contribution of midwife-led care. J Midwifery Womens Health. 2010;55(3):255-61. doi: 10.1016/j.jmwh.2010.02.002. [PubMed: 20434086].
  • 5. Aboagye E, Agyemang OS. Maternal health-seeking behavior: The role of financing and organization of health services in Ghana. Glob J Health Sci. 2013;5(5):67-79. doi: 10.5539/gjhs.v5n5p67. [PubMed: 23985108]. [PubMed Central: PMC4776872].
  • 6. Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587-603. doi: 10.1016/S0140-6736(15)00837-5. [PubMed: 26794078].
  • 7. Jolly SP, Rahman M, Afsana K, Yunus FM, Chowdhury AM. Evaluation of maternal health service indicators in urban slum of Bangladesh. PLoS One. 2016;11(10). e0162825. doi: 10.1371/journal.pone.0162825. [PubMed: 27732596]. [PubMed Central: PMC5061363].
  • 8. Warren C, Njuki R, Abuya T, Ndwiga C, Maingi G, Serwanga J, et al. Study protocol for promoting respectful maternity care initiative to assess, measure and design interventions to reduce disrespect and abuse during childbirth in Kenya. BMC Pregnancy Childbirth. 2013;13:21. doi: 10.1186/1471-2393-13-21. [PubMed: 23347548]. [PubMed Central: PMC3559298].
  • 9. Chowdhury ME, Botlero R, Koblinsky M, Saha SK, Dieltiens G, Ronsmans C. Determinants of reduction in maternal mortality in Matlab, Bangladesh: A 30-year cohort study. Lancet. 2007;370(9595):1320-8. doi: 10.1016/S0140-6736(07)61573-6. [PubMed: 17933646].
  • 10. Paxton A, Bailey P, Lobis S, Fry D. Global patterns in availability of emergency obstetric care. Int J Gynaecol Obstet. 2006;93(3):300-7. doi: 10.1016/j.ijgo.2006.01.030. [PubMed: 16682039].
  • 11. Luck M. Safe motherhood intervention studies in Africa: A review. East Afr Med J. 2000;77(11):599-607. doi: 10.4314/eamj.v77i11.46732. [PubMed: 12862106].
  • 12. Vintzileos AM, Ananth CV, Smulian JC, Scorza WE, Knuppel RA. Prenatal care and black–white fetal death disparity in the United States. Obstet Gynecol. 2002;99(3):483-9. doi: 10.1097/00006250-200203000-00019.
  • 13. Stephansson O, Dickman PW, Johansson AL, Cnattingius S. The influence of socioeconomic status on stillbirth risk in Sweden. Int J Epidemiol. 2001;30(6):1296-301. doi: 10.1093/ije/30.6.1296. [PubMed: 11821332].
  • 14. Lowery C, Bronstein J, McGhee J, Ott R, Reece EA, Mays GP. ANGELS and University of Arkansas for Medical Sciences paradigm for distant obstetrical care delivery. Am J Obstet Gynecol. 2007;196(6):534 e1-9. doi: 10.1016/j.ajog.2007.01.027. [PubMed: 17547884].
  • 15. Reece EA, Leguizamon G, Silva J, Whiteman V, Smith D. Intensive interventional maternity care reduces infant morbidity and hospital costs. J Matern Fetal Neonatal Med. 2002;11(3):204-10. doi: 10.1080/jmf. [PubMed: 12380679].
  • 16. de Bernis L, Kinney MV, Stones W, Ten Hoope-Bender P, Vivio D, Leisher SH, et al. Stillbirths: Ending preventable deaths by 2030. Lancet. 2016;387(10019):703-16. doi: 10.1016/S0140-6736(15)00954-X. [PubMed: 26794079].
  • 17. Heazell AEP, Siassakos D, Blencowe H, Burden C, Bhutta ZA, Cacciatore J, et al. Stillbirths: Economic and psychosocial consequences. Lancet. 2016;387(10018):604-16. doi: 10.1016/S0140-6736(15)00836-3. [PubMed: 26794073].
  • 18. The Irananian Ministry of Health and Medical Education (MOHME). The state of the world's children United Nations Children's Fund. 1999. Available from: http://behdasht.gov.ir/?siteid=1&pageid=1508&newsview=184825.
  • 19. Tabrizi JS, Gholipoor K, Asghari Jafarabadi M, Farahbakhsh M, Mohammadzedeh M. Customer quality and maternity care in Tabriz urban health centers and health posts. J Clin Res Gov. 2012;1(1). doi: 10.13183/jcrg.v1i1.15.
  • 20. Parsa P. Effect of prenatal health care on pregnancy outcomes in Hamadan, Iran. J Commun Med Health Educ. 2012;2(1). doi: 10.4172/2161-0711.1000114.
  • 21. Ebrahimi Tavani M. Strengthening reproductive health and safe motherhood programs in Iran. 25thcongress medical women’s International association. Tehran, Iran; 2001.
  • 22. Aghlmand S, Akbari F, Lameei A, Mohammad K, Small R, Arab M. Developing evidence-based maternity care in Iran: A quality improvement study. BMC Pregnancy Childbirth. 2008;8:20. doi: 10.1186/1471-2393-8-20. [PubMed: 18554384]. [PubMed Central: PMC2443790].
  • 23. Tabrizi JS, Askari S, Fardiazar Z, Koshavar H, Gholipour K. Service quality of delivered care from the perception of women with caesarean section and normal delivery. Health Promot Perspect. 2014;4(2):137-43. doi: 10.5681/hpp.2014.018. [PubMed: 25650105]. [PubMed Central: PMC4300438].
  • 24. Eden AR, Peterson LE. Impact of potential accreditation and certification in family medicine maternity care. Fam Med. 2017;49(1):14-21. [PubMed: 28166575].
  • 25. Azarabadie S, Aghlmand S. The real quality of maternity care in Iran hospitals: A quality assessment study. IIOABJ Inst Integr Omics Appl Biotechnol J. 2016;7(sup2):611-7.
  • 26. Medicine IO. Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press; 2001.
  • 27. den Breejen EM, Nelen WL, Schol SF, Kremer JA, Hermens RP. Development of guideline-based indicators for patient-centredness in fertility care: what patients add. Hum Reprod. 2013;28(4):987-96. doi: 10.1093/humrep/det010. [PubMed: 23411619].
  • 28. Biza A, Jille-Traas I, Colomar M, Belizan M, Requejo Harris J, Crahay B, et al. Challenges and opportunities for implementing evidence-based antenatal care in Mozambique: A qualitative study. BMC Pregnancy Childbirth. 2015;15:200. doi: 10.1186/s12884-015-0625-x. [PubMed: 26330022]. [PubMed Central: PMC4557743].
  • 29. Ganle JK, Otupiri E, Obeng B, Edusie AK, Ankomah A, Adanu R. Challenges women with disability face in accessing and using maternal healthcare services in Ghana: A qualitative study. PLoS One. 2016;11(6). e0158361. doi: 10.1371/journal.pone.0158361. [PubMed: 27347880]. [PubMed Central: PMC4922658].
  • 30. Hoang H, Le Q, Ogden K. Women's maternity care needs and related service models in rural areas: A comprehensive systematic review of qualitative evidence. Women Birth. 2014;27(4):233-41. doi: 10.1016/j.wombi.2014.06.005. [PubMed: 25028188].
  • 31. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. doi: 10.1016/j.nedt.2003.10.001. [PubMed: 14769454].
  • 32. Vallely LM, Homiehombo P, Kelly AM, Vallely A, Homer CS, Whittaker A. Exploring women's perspectives of access to care during pregnancy and childbirth: A qualitative study from rural Papua New Guinea. Midwifery. 2013;29(10):1222-9. doi: 10.1016/j.midw.2013.03.011. [PubMed: 23684099].
  • 33. Lacey A, Luff D. Qualitative data analysis nottingham: National institute for health research. orkshire and the Humber: The NIHR RDS for the East Midlands:; 2009.
  • 34. Zamanzadeh V, Valizadeh L, Lotfi M, Salehi F. Burn Survivors' Experience of Core Outcomes during Return to Life: a Qualitative Study. J Caring Sci. 2014;3(4):227-37. doi: 10.5681/jcs.2014.025. [PubMed: 25717453]. [PubMed Central: PMC4334175].
  • 35. Kellaghan T, Stufflebeam DL. The international handbook of educational evaluation. Boston: Kluwer Academic Publishers; 2003. doi: 10.1007/978-94-010-0309-4.
  • 36. Zhang G, Zeller N, Griffith R, Metcalf D, Williams J, Shea C, et al. Using the context, input, process, and product evaluation model (CIPP) as a comprehensive framework to guide the planning, implementation, and assessment of service-learning programs. J High Educ Outreach Engagem. 2011;15(4):57-84.
  • 37. Ahmady S, Yazdi L. Exploring the midwifery training challenges in Iran from the viewpoint of faculty members and graduates of this field: Content analysis. J Med Educ. 2016;15(2):82-9.
  • 38. Moghasemi S, Vedadhir A, Simbar M. Models for presentation of midwifery care and its challenges in Iran: A review study. J Holist Nurs Midwifery. 2018;28(1):64-74.
  • 39. Makvandi S, Mirzaiinajmabadi K, Tehranian N. [The challenges of the physiologic childbirth program from the perspective of service providers: A qualitative approach]. J Hayat. 2018;24(3):244-60. Persian.
  • 40. Joulaei H, Maharlouei N, Lankarani KB, Razzaghi A, Akbari M. Narrative review of women's health in Iran: Challenges and successes. Int J Equity Health. 2016;15:25. doi: 10.1186/s12939-016-0316-x. [PubMed: 26880036]. [PubMed Central: PMC4754925].
  • 41. Mohammadi Y, Parsaeian M, Mehdipour P, Khosravi A, Larijani B, Sheidaei A, et al. Measuring Iran's success in achieving Millennium Development Goal 4: A systematic analysis of under-5 mortality at national and subnational levels from 1990 to 2015. Lancet Glob Health. 2017;5(5):e537-44. doi: 10.1016/S2214-109X(17)30105-5. [PubMed: 28363513].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments