In 2013 in Iran, almost half of all infants were born by caesarian section (c-section) in public hospitals, even more within the nonpublic sector, a figure which represented one of the highest rates in the world. In 2014, the Ministry of Health commenced major health care reform to break this prevalence. It was designed to alter both the demand and supply side incentives for cesarean surgery in public hospitals and by 2015 was shown to have reduced the rate by six percentage points. Our analysis indicates that changing the financial incentives for doctors had a role in the effectiveness of the programme but that the greater part of the change resulted from a strict cap on the maximum c-section rate for each doctor. We cannot find any effect on infantile health measures in terms of Apgar score, hospitalisation and mortality rate; however, gestation length and birth weight have significantly increased.
![High Rate of C-section and Its Consequences for the Timing of Birth](https://erf.org.eg/app/uploads/2021/05/1620071088_212_84657_nl_hanifapilvar-150x150.png)
Authors
Hanifa Pilvar
PhD student, School of Economics and Finance,...
![High Rate of C-section and Its Consequences for the Timing of Birth](https://erf.org.eg/app/uploads/2021/05/1620073420_129_76310_nl_kowsaryousefi_-150x150.png)
Authors
Kowsar Yousefi
Associate Professor, University of Tehran