Objective To compare the disparity in responsibility assignment among various functional institutions of the maternal health care (MHC) system between Beijing and Shanghai and to explore the feasibility of quantitative evaluation on the degree of well-defined responsibility assignment.
Methods We systematically and extensively collected documents and materials on MHC issued by administrative agencies of Beijing and Shanghai municipality published during 2000 – 2017. Then we extracted relevant information from 649 retrieved documents (232 relevant to Beijing and 417 to Shanghai) and analyzed the information quantitatively to assess the responsibility assignment among various functional institutions of MHC system in the two municipalities. Spearman correlation and linear regression analysis were used to analyze the relationship between the degree of well-defined responsibility assignment of MHC system and maternal mortality rate (MMR).
Results The relevant information-derived index for the degree of well-defined responsibility assignment of MHC system increased from 1.8% in 2000 to 23.7% in 2017 in Beijing municipality; while, the index increased from 9.5% to 28.0% in Shanghai, indicating a relatively low level for the MHC system's well-defined responsibility assignment. There was an inverse correlation between the index for well-defined responsibility assignment of MHC system and MMR in the two municipalities.
Conclusion The responsibility assignment among various functional institutions of the maternal health care system was improved and the improvement facilitated maternal health care practice in Beijing and Shanghai during 2000 – 2017; but the responsibility assignment for nonmedical institutions should be well defined. The study verified the feasibility of quantitative assessment on responsibility assignment among various functional institutions of the maternal health care system.
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