Objective To evaluate the completeness of maternal health care-related legal regulations and its relationship with maternal mortality in Beijing and Shanghai and to verify appropriate completeness of maternal health care-related legal regulations 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 the completeness of the legal regulations based on the documents' type and main releaser. Spearman rank correlation and one-way linear regression were used to analyze the relationship between the completeness of the legal regulations and maternal mortality in the two cities.
Results The completeness of maternal health care-related legal regulations released by the administrations in Beijing and Shanghai showed a gradual yearly upward trend. From 1990 to 2017, the proportion of the legal regulations with complete feature (in accordance with national legal provisions, involving a variety of maternal healthcare aspects) increased from 35.7% to 72.0% in Beijing and from 53.2% to 74.9% in Shanghai and the proportion was inversely associated with the maternal mortality in both the cities, with the correlation coefficients of greater than 0.70. The results of fitted regression analysis demonstrated that 46.2% and 79.1% of the variation in the maternal mortality for the women in Beijing and Shanghai could be interpreted by the completeness of maternal health care-related legal regulations.
Conclusion Complete legal regulations related to maternal health care should have a systemic framework and various aspects and relevant departments, professional institutions and other organizations. At present, there are relatively complete legal regulations related to maternal health care in Beijing and Shanghai, but there is no a universal law for public health and the legal regulations are not brought into a full play in numerous aspects of maternal healthcare.
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