Objective To explore the status quo and disparity of support of social environment on maternal health care system in Beijing and Shanghai and to evaluate the relationship between the support and maternal mortality and to verify the feasibility of quantitative evaluation on the support.
Methods We systematically collected all the normative legal documents related to maternal health issued by governmental agencies of the two cities during 2000 – 2017 and quantitatively assessed the support of social environment on maternal health care system in four aspects: policy context, legal guarantee, financial sustaining, and culture guidance. Spearman rank correlation was used to analyze the relationship between the extent of social environment support on maternal health care system and maternal mortality in the two cities.
Results Social environmental support on maternal health care system showed an annual upward trend in both Beijing and Shanghai during the period, especially after the release of health strategy in 2017, with the increased support indexes from 22.8% and 21.1% in 2000 to 52.6% and 46.1% in 2017 in Beijing and Shanghai. Inverse correlation between social environmental support degree and maternal mortality was observed in the two cities, with the the correlation coefficients of greater than 0.50. The results of fitted regression analysis indicated that 9.7% and 22.2% of the variation in maternal mortality in Beijing and Shanghai could be explained by the extent of social environment support on maternal health care system.
Conclusion Social environment plays a significant role in the performance of maternal health care system in Beijing and Shanghai city. Although somewhat stronger in Beijing than in Shanghai, the social environment support on maternal health care system has not been utilized effectively in resources allocation and management. The study results demonstrate that the quantitative evaluation method is basically feasible.
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