Objective To evaluate the guarantee of legal regulations on maternal health care system and its correlation with maternal mortality of Beijing and Shanghai city and to verify appropriate legal guarantee on maternal health care system and its significance.
Methods We systematically collected all normative legal documents related to maternal health issued by governmental agencies of the two cities and quantitatively assessed guarantee degree of the legal regulations by weighting the completeness, the legal status-defined support, rigid constraints, and the self-improvement of the legal regulations. Spearman rank correlation and one-way linear regression were used to analyze the relationship between the extent of legal regulations′ guarantee on maternal health care and maternal mortality in the two cities.
Results The extent of legal regulations′ guarantee on maternal health care in Beijing and Shanghai showed a gradual yearly upward trend. From 1990 to 2017, the proportion of the maternal health programs guaranteed by legal regulations increased from 30.2% to 69.8% in Beijing and from 43.5% to 70.6% in Shanghai and the proportion was inversely associated with the maternal mortality in both the cities, with the correlation coefficients of greater than 0.75. The results of fitted regression analysis demonstrated that 57.5% and 82.8% of the variation in the maternal mortality for the women in Beijing and Shanghai could be interpreted by the extent of legal regulations′ guarantee on maternal health care.
Conclusion A perfect legal system is irreplaceable in guiding and regulating the operation and development of a maternal health care system. A relatively complete legal system related to maternal healthcare has been established in Beijing and Shanghai but the system needs to be further strengthened in its rigid binding force of the legal regulations.
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