Objective To explore the extent of legal status-defined support on maternal health care system and the relationship between the support and maternal mortality in Beijing and Shanghai and to verify appropriate legal status of maternal health care system and its significance.
Methods We systematically collect all normative legal documents related to maternal health issued by governmental agencies of the two cities and assessed extent of support of the legal documents on maternal health care system quantitatively based on the documents′ type and definition for legal status of maternal health care system. We adopted Spearman rank correlation and one-way linear regression to analyze the relationship between the extent of legal support on maternal health care and maternal mortality in the two cities.
Results The appropriateness of the legal status of maternal health care system in Beijing and Shanghai showed an increasing trend year by year. The overall proportion of the maternal health programs with definite legal guarantees increased from 81.5% in 1990 to 96.3% in 2017 for the two cities. There was an inverse correlation between the appropriateness of maternal health care system and maternal mortality in both the cities, with the correlation coefficients of greater than 0.65. The results of fitted regression analysis demonstrated that 46.3% and 68.5% of the variation in the maternal mortality for the women in Beijing and Shanghai could be interpreted by the appropriateness of the legal status of maternal health care system.
Conclusion Appropriate maternal health care system should clearly define the status, purpose, behavioral norms and the rights and responsibilities of all parties in the form of legal provisions. The implementation of maternal health care in Beijing and Shanghai has been guaranteed by relevant law regulations gradually but the responsibilities of various institutions for the implementation needs to be further clarified to strengthen the support of relevant law regulations.
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