[Obstetric quality investigation on urban and rural area in China].
OBJECTIVE
A survey on implementing the proclamation in "National plan of action for the survival, protection and development of children in 1990s" in China (NPA), by reducing the maternal mortality rate (MMR) by half and the infant mortality rate (IMR) by 1/3 by the year 2000 as a proof of improved obstetric quality.


METHODS
The maternal and child health (MCH) bureau, ministry of health, have called on a cooperative investigation on obstetric quality in 75 obstetric clinics in 11 provinces, municipalities or autonomous regions, randomly sampled from each of the 6 governmental areas in China. The data were collected and analyzed centrally, together with the yearly reports from the monitored county hospitals.


RESULTS
Senior medical professionals associated to 32.68% in provincial and teaching hospitals while only 2.63% in the country hospitals. The former are provided with all necessary equipment while the latter with inadequate and outdated ones. MMR declined year by year, more marked wherever hospital delivery rate was high and when the numbers of antenatal visit were more. However, when antenatal visit began late in pregnancy, MMR rose Zhejiang province and Shanghai ranked first in obstetric quality because of an efficient systematic management of the pregnancies.


CONCLUSIONS
Having enough leading professionals in this specialty to train adequate medical ground personnel at grass root level; providing sufficient medical installations; enforcing easily and good quality antenatal care and increasing hospital deliveries carried out under authoritative management are important points to raise the quality of obstetrics.
Xiang
X
X
Beijing Municipal Maternal Health Institute.
Wang
L
L
Xu
L
L
D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration; D008428:Maternal Mortality; D011247:Pregnancy; D011295:Prenatal Care; D012423:Rural Health; D011795:Surveys and Questionnaires; D014504:Urban Health