title: The utilization rate of antenatal care after health sector reform implementation in rural areas of Islamic Republic of Iran.
abstract: BACKGROUND
  Improving the utilization rate of antenatal care is a critical strategy for achieving the reproductive health goals in Iran. The aim of this study was to assess the utilization rate of antenatal care (ANC) by women after health sector reform (HSR) interventions in rural areas of Islamic Republic of Iran (IR Iran).
  
  
  METHODS
  This is a retrospective cross-sectional study. The data were gathered by cluster sampling from 400 motherhood records of mothers whose last pregnancies had been terminated in the first 3 months of 2013. Data were collected from 21 rural health centers of Isfahan district during the year 2013. The utilization rate of ANC by mothers was assessed by the number of visits they had, the time of the first ANC visit, the occurrence of pregnancy- or delivery-related complications, and the number of postpartum visits.
  
  
  RESULTS
  The mean time of the first ANC was 9 ± 5.23(th) week of gestational age. For 69.3% of pregnant women, the first ANC was before the 12(th) week. Overall, the frequency of ANC visits ranged from 2 to 21, with the average of 10.6 ± 3.23 visits. 93.8% of the utilized ANC visits were adequate. 99.8% of the deliveries took place in the hospital. 99% of mothers had at least one visit in the postpartum period. 4% of the mothers had suffered from pregnancy-related complications.
  
  
  CONCLUSIONS
  It seems that IR Iran has achieved to one of the important objectives by its reform in health care access, that is, more ANC for pregnant women.
authors.affiliation: Department of Community Medicine, Medical School, Hazarjarib St. Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Alikhasi
authors.affiliation: Department of Community Medicine, Social Determinants of Health Research Center, Hazarjarib St.Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Khadivi
authors.affiliation: Department of Community Medicine, Medical School, Hazarjarib St. Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Kheyri
keywords: Antenatal care; Iran; Isfahan; developing country; family physician; high-risk pregnancy