Objective To analyze the extent of lawmakers' active improvement of maternal health care-related law system in Beijing and Shanghai municipality and to explore the significance of and the feasibility of quantitative evaluation on the active improvement.
Methods We systematically collected all the normative legal documents related to maternal health issued by national administrations and local governmental agencies of the two cities. Then we evaluated the extent of the active improvement of the legal documents based on whether the documents were revised, whether there were local legislations corresponding to national legislations and the time difference in issuing the legislations between national and local administrations; we also analyzed the correlation of the active improvement of the legislations with variations in maternal mortality in the two cities.
Results The grade for active improvement of maternal health care-related legal documents performed by the administrations in both Beijing and Shanghai showed a gradual yearly upward trend. From 1990 to 2017, the overall proportion of the legal documents being improved (revisions of legal documents previously issued, being local documents for some maternal health care services and the specific documents released by local administrations earlier than those by central administrations) increased from 0 to 66.0% and the proportion was inversely associated with the maternal mortality in both the cities significantly (P < 0.05). The ratio of variation in maternal mortality which could be explained by the active improvement of the law system was higher in Shanghai than that in Beijing (71.7% vs. 51.4%).
Conclusion An appropriate maternal health care-related law system should be improved constantly according to specific local circumstances. The active improvement of the law system has been conducted by municipal administration in both Beijing and Shanghai city and the effect of the improvement on maternal health care services is greater in Shanghai than that in Beijing. The study result indicates that the quantitative evaluation method is basically feasible for the assessment on the active improvement of maternal health care-related law system.
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