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There are so many studies which evaluated the maternal quality of life based on their delivery type with different results. The purpose of this paper is to evaluate the effect of type of delivery on the maternal QOL systematically.

In this systematic review, which was conducted for 15 years (2000-2016), the international databases including PubMed, Scopes and ISI and the Persian databases were searched using the following words: quality of life or health-related quality of life, vaginal delivery, cesarean delivery or cesarean section. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was adopted for this study. The quality of articles was assessed by a checklist that has been used in previous studies. All of the data analysis was performed using STATA ver.12.

In total, 13 articles were included in the present systematic review and meta-analysis. The overall sample included 8,136 women (3,990 cesareans vs 4,146 vaginal). The results of the random effect model for eight QOL dimensions based on SF-36 questionnaire showed that there was no significant difference between two groups in terms of QOL. But this model for four QOL dimensions of WHOQOL showed that the maternal in two groups had a significant difference in two dimensions of QOL (mental health and total health) and insignificant difference in other dimensions.

The results of the study may have been affected by the selection of few databases. Therefore, researchers are encouraged to test the proposed propositions in further databases.

The study results could be helpful to design appropriate policies for maternal based on their type of delivery.

This systematic review showed that despite the insignificant difference between women with vaginal delivery vs women with cesarean delivery in some aspects of QOL, it can be concluded that health status of women with vaginal delivery is better than women with cesarean delivery, so it should be considered in the setting of appropriate policies and implementation framework to encourage women for choosing the appropriate delivery type.

Health Sector Evolution Plan (HSEP) is known as the biggest and most comprehensive reform in Iran’s health system. One of the goals of HSEP is to reduce inequity in the healthcare financing. The purpose of this paper is to demonstrate HSEP agenda setting from the perspective of equity in healthcare financing (EHCF) using the multiple streams model.

This qualitative study was conducted by 26 documents review and analysis, and 30 semi-structured interview with Iranian key informants in the field of HSEP that were selected based on purposeful and snowball sampling method. Data were collected using a researcher-made checklist based on the goals. All audio-taped interviews were transcribed and analyzed thematically. Data management and analysis were performed using the framework analysis in MAXQDA software.

The framework analysis identified 12 complementary sub-themes totally. Problem stream included four sub-themes (high share of Out Of Pocket, high index of catastrophic health expenditures, low EHCF index, and inappropriate economic state and sanctions). Focus on EHCF in general policies of the Iran World Health Organization’s report in 2000, the Targeted Subsidies Law and emphasis on equalizing healthcare financing in the Fourth and Fifth Development Plan were considered as policy stream sub-themes. Finally, political stream showed four sub-themes including strong support from the Minister of Health for HSEP, mass media, the pressure of WHO and people’s request to reduce health costs.

The limitations of the present study included paying attention to one package (evolution in the treatment sector) of three health packages to assess EHCF, as well as the lack of similar national and international evidence in implementation framework.

The results of this study can be used to analyze other health sector reforms around the word and can help the formulation and implementation of most practical reforms, especially in field of health system financing.

This study gives a holistic view about health system policy setting that can be used for understanding policy-making streams to population.

This is the first study that has examined HSEP (the biggest health sector reform in Iran) from the perspective of agenda setting. In addition, using the popular and well-known Kingdon’s model to explain HSEP agenda setting is one of the strengths of this study. Furthermore, taking advantage of a wide range of related views by including highly informed people increased the strength of the results of the study. In addition, the short interval between the interview and reviewing the results on reforms reduced the recall bias of the participants in the study.

Health-promoting schools have been associated with improvements in the health status of students globally. This study is a secondary analysis study assessing Iranian HPSs.

This was a cross-sectional study on routinely collected data using an external audit 63-item checklist, which was utilized to evaluate 440 HPSs between 2014 and 2017. The mean score for each of the checklists' components was calculated. Nonparametric tests were conducted to investigate the association between the presence of a school caregiver, students' educational level and the school's score.

While the number of five- and four-star schools increased significantly, one- to three-star schools declined. Providing clinical and counseling services had negative growth. Despite the steady growth of the staff's health, this category still had the lowest score among; on the contrary, physical activity had the highest score in 2017. The presence of a full-time school caregiver and middle schools were both significantly correlated with achieving higher scores (p < 0.005).

It seems that in addition to developing school facilities to promote physical activities, measures should be taken to promote access to counseling services, considering health issues of students and staff and finally increasing the number of full-time school caregiver