The impact of health reform on maternal and child health indicators in developing countries: A systematic review

Maternal and child health indicators were the focused issues of both programs leading to a substantial improvement in reduction of mortality, providing services, and promoting their health. Health policy makers of the country executed health transformation plan in 2014 to respond to main challenges especially regarding the high cost of treatment, lack of enough coverage, improper facilities, and redundant therapies and procedures. Primary reports showed the success of the results of this plan. Aim: The study aims to investigate the impact of reform program on maternal and child health indicators in developing countries. Method: This study was conducted as a systematic review by searching on SID, Magiran, Pubmed, Science Direct, and Scopus during 2000-2017. The searched keywords in Farsi databases: health reforms, the impact of changes in health, consequences of health reforms, maternal and child health indicators, and their Latin equivalences on English databases. Then data were entered in summary tables and at the next step were investigated and concluded. Result: According to inclusion and exclusion criteria, the result of the searching was 2837 articles refined step by step, and finally 19 items were selected and analyzed. The results of national studies showed that after executing health reform program, the rate of cesarean section decreased about 2.5-4% in the country in the first three-month period of execution of the program and total status of realization of indicators was in a desirable level. Natural childbirth promotion program (free natural childbirth franchise indicator) was 90.8%. Global experiences also show that mortality rate of newborns decreased from 11.1% to 9.1% after reform and promotion of health system in Mozambique. Also, health reforms in Pakistan for developing the health of mothers and newborns showed that beneficiaries should support evidence-based interventions for the sake of the health of mothers and newborns. Finally, health reform in Indonesia, Nepal, Philippines, and India showed that the rate of mortality of mothers, newborns, and stillbirth had been reduced. Conclusion: The reforms have had a positive impact on maternal and child health indicators. The realization status of indicators has reached an acceptable level through execution of reform. The main reasons for improvement within indicators are the extension of the health system, increase in labor force, and more support by government for the health system.