Evaluation the changes in maternal and child health indicators from 1994 to 2022 and the impact of the covid-19 pandemic on them in rural areas of east azarbayjan

Abstract

Health systems undertake reforms to enhance the provision and promotion of health. Assessing the impact of these reforms serves as a method for gauging their effectiveness, forming the foundation for improvement efforts. Among the crucial areas of focus within this realm is maternal and child health. This study aims to evaluate key indicators of maternal health, encompassing maternal weight during pregnancy, gestational age, abortion rates, stillbirths, and preterm births. Additionally, it addresses fundamental indicators of child health, including birth weight, birth height, and infant mortality. Health indicators represent quantifiable characteristics of a population, utilized by researchers as supportive evidence to characterize population health. Methods: This study examines contextual and process variables (pertaining to the care and services provided to pregnant mothers and their infants up to one year old) using rural household health records. Data were collected at Health Houses in East Tabriz city and subsequently extracted from the electronic file system and entered into questionnaires. The data were then inputted into SPSS software and analyzed across four time periods spanning thirty years to capture significant reforms and changes within the health system. Results: Findings indicate a consistent improvement in literacy rates over the past three decades, alongside an increase in maternal age at pregnancy and a reduction in the number of pregnancies. The trajectory of maternal and child care processes demonstrated an overall positive trend, although the decline in natural childbirth persisted and accelerated. Routine healthcare provision for children in Iran has seen continuous improvement over the same period. While certain aspects of child care have shown enhancements, anthropometric indicators of height and weight exhibited no significant improvements. The onset of the coronavirus pandemic coincided with a reduction in care burden, delayed initiation of care, and ultimately a decrease in pregnancy weight, height, and birth weight. However, the rate of cesarean deliveries continued to rise significantly.