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Background and Objectives: Health system reform plan is a plan for improvement of health systems in Iran, which started on May 15, 2014 in hospitals of Ministry of Health of Iran. In this study, changes in neonatal outcomes following the implementation of the health system reform plan, were investigated. Methods: This cross-sectional study (before and after exposure) was conducted in a public educational hospital. The study population was all deliveries (normal and cesarean section) performed at Izadi educational treatment hospital (2011-2016), which were selected using Stratified random sampling. Information was collected using a checklist based on hospital records. The data were analyzed by t-test and Chi square test. Results: According to the results of this study, after implementation of health system reform plan, the ratio of normal delivery significantly increased (p