Timothy Powell-Jackson|Yanqiu Gao|Carine Ronsmans|Hong Zhou|Yan Wang|Hai Fang
Health-system determinants of declines in maternal mortality in China between 1996 and 2013: a provincial econometric analysis
London School of Hygiene & Tropical Medicine|National Bureau of Statistics of China|Peking University|Sichuan University|London School of Hygiene & Tropical Medicine|Peking University|Peking University|Peking University
backgroundmaternal mortality china decreased strikingly past 20 years china one countries achieving millennium development goal 5 1996 2013 china substantially strengthened maternalhealth sector large number funds invested maternal health maternal health facilities substantially improved maternalhealth professionals received increased training china also made substantial investments overall healthsystems reform including increases overall health expenditure universal health insurance coverage number health professionals per person healthsystems improvements thought contributed reductions maternal mortality china improvements carried greatest weight known aim study examine healthsystems determinates declines maternal mortality chinamethodswe used panel dataset 31 provinces china 1996 2013 examine effects healthsystems factors maternal mortality data health systems obtained china statistical yearbooks china health statistical yearbooks national provincial publications data maternal mortality obtained annual report maternal child health information ran fixedeffects regressions using logarithm maternal mortality dependent variable healthsystem determinants studied health expenditure number hospital beds human resources length highways controlled income female literacy birth rate local tax revenue capacity data used publicly available aggregate secondary data therefore study exempt ethics approval individual patient data used informed consent patients necessaryfindingsmaternal mortality fell 66 14 deaths per 100 000 livebirths 1996 2013 32 8 deaths per 100 000 livebirths eastern region 52 13 deaths per 100 000 livebirths central region 109 23 deaths per 100 000 western region hospital beds per 1000 population elasticity 078 p0023 length highways 031 p0010 significantly associated maternal mortality health expenditure density health workers effect maternal mortalityinterpretationaccess health care important accounting variation maternal mortality provinces time china hospital infrastructure particular might key driver reduction maternal mortality past two decadesfundingus fund unicef countdown 2015 maternal newborn child survival grant bill melinda gates foundation government canada foreign affairs trade development sichuan university chengdu china