Educational Barriers and Facilitators Related to Iran's Pronatalist Population Policy: A Qualitative Study
Abstract
Background: In recent years, Iran has introduced new policies aimed at enhancing demographic indicators by reducing the replacement fertility rate. These policies present both challenges and opportunities for health education, particularly within midwifery, the frontline provider of reproductive health services. This study aims to explore the experiences of Reproductive Health Service (RHS) providers concerning the educational barriers and facilitators related to Iran's Pronatalist Population Policy. Materials and Methods: This qualitative study was conducted in Yazd, Iran, from May to September 2023. The study involved 32 RHS providers in various roles, including six midwifery instructors, nine midwifery students, 11 midwives, and six health providers in the community health center. Participants were selected via purposive sampling with maximum variation. Data collection employed semi‑structured, in‑depth interviews alongside field note‑taking. Data analysis followed Graneheim and Lundman’s qualitative content analysis method. Results: The barriers were classified under the domain of “multidimensional conflict in driving childbearing policy” and organized into three main categories: sociocultural barriers, economic barriers, and structural issues within reproductive and sexual health services. Moreover, educational facilitators were identified within two main categories: “policy‑making” and “educational infrastructure.” Conclusions: The findings reveal that educational barriers to childbearing programs in Iran arise from intertwined sociocultural, economic, and systemic issues, reflecting complex societal norms, financial constraints, and service accessibility challenges. Moreover, facilitators such as effective policy‑making and strong educational infrastructure are vital in mitigating these obstacles. These results underscore the necessity for culturally sensitive, economically supportive, and systemically integrated interventions to improve educational outcomes in reproductive health services.
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