Effects of Recruiting Midwives into a Family Physician Program on the Indices of Maternal Health Program in the Rural Areas of Kurdistan

A family physician program has been implemented in rural areas of the country since the early 2005.Therefore, due to the increase in the density of midwives in this project, it is expected that more services would be provided to pregnant women. This cross-sectional study used the difference-in-differences model and Matchit statistical model to compare the indices of maternal health program before and after the implementation of a family physician program. It compared health centres that had increase in their density of midwives in the course of the study with those that did not. The study sample consisted of 668 mothers of 2-month-old children in 2013. Data were collected using a questionnaire that was administered in structured interviews. In this study, in 2013, 38.8% of the women received preconception care, 66.5% received prenatal care and 41.6% received postpartum care, as defined by the standards. Based on the results of statistical models of difference-in-differences analyses and Matchit, there was no significant change in indices of maternal health program between 2005 and 2013. The results of this study showed that an increase in the density of midwives in a family physician program did not have an impact on the indices of maternal health program; it indicated that the increase in the density of midwives alone was not efficient. In other words, the quality of primary health care is strongly dependent on the use of trained health workers. In addition, manpower planning and management can have an important role in improvement of prenatal care.