Effectiveness of presence of physician and midwife in quantity and quality of family planning services in health care centers.
OBJECTIVE
Iran's health sector has been engaging the services of physicians and midwives in healthcare centers since 2005, with the hope of improving the quantity and quality of family planning services. The aim of this study was to assess the effect of serving physicians and midwives on the quantity and quality of family planning services in the healthcare centers of Iran.


METHODS
The present cross-sectional study (Jan 2010 until Sep 2011) was carried out on 600 eligible families who were clients of healthcare centers of Tabriz, Azarshahr and Osku, cities of Northwest Iran from 2006 until 2011, in two groups (before and after). Some of the characteristics of the participants and the data on the quality and quantity of family planning services provided were grouped in a checklist of 16 variables by comparing the patients' past medical histories.


RESULTS
In comparison with 3 years prior to engaging physician and midwife services in health care centers, the Couple Year Protection (CYP) and the quantity of family planning service indexes significantly increased among eligible families. The family size of participants declined significantly after family physicians and midwives became available in the healthcare centers (P < 0.005).


CONCLUSIONS
Our findings showed some improvement in the quantity of services without any noticeable changes in the quality of services provided as a consequence of this huge intervention. Therefore, it is suggested that there should be proper oversight of the duties of the health team in order to keep a close watch on primary healthcare, design of proper mechanisms for collecting and maintaining performance reports and statistics, and continuously monitor and control the quality of services.
Department of Community Medicine, National Public Health Management Center (NPMC), Tabriz, Iran.
Hossein
H
Jabbari
Department of Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Fariba
F
Bakhshian
Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
Atefeh
A
Velayati
Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
Esmat
E
Mehrabi
Department of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
Shirin
S
Allahverdizadeh
Medical Philosophy and History Research Center, Tabriz, Iran.
Hossein
H
Alikhah
Department of Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
Ahdieh
A
Maleki
Liver and Gastrointestinal Disease Research Center, Tabriz, Iran.
Hamid-Reza
HR
Ahadi
Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Maryam
M
Ghorbaniyan
Medical Philosophy and History Research Center, Tabriz, Iran.
Mohammad
M
Naghavi-Behzad
Family planning; fertility; health services; healthcare services; reproductive ages; women of reproductive age