title: Provincial maternal mortality surveillance systems in China.
abstract: BACKGROUND
  Provincial maternal mortality surveillance systems (PMMSS) have been set up in nearly all the provinces in China to monitor local maternal mortality and provide the evidence for maternal health interventions suited to local conditions. However, till now little is known outside of China about the characteristics of PMMSS.
  
  
  METHODS
  A systematic review of the literature contained in PubMed and China Academic Journal Network Publishing database was carried out. The current situation on PMMSS was described. Provincial disparities on PMMR in six provinces were analyzed by Poisson regression analysis.
  
  
  RESULTS
  A total of 35 studies met the inclusion criteria, of which 31 were published in Chinese. PMMSS were set up and adjusted by the provincial government based on their own financial resources and demand. Provinces from remote region had the highest risk of maternal mortality, followed by provinces from inland region and coast region.
  
  
  CONCLUSIONS
  PMMSS may be the most reliable data source for measuring provincial level MMR in each province. Great provincial disparities on PMMSS and PMMR do exist within the country; more emphasis should be placed on improving PMMSS and reducing PMMR particularly in the provinces with high maternal death burden.
authors.affiliation: Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China ; School of Public Health, Epidemiology, Biostatistics and Clinical Research Centre, Université Libre de Bruxelles (ULB), Brussels 1070, Belgium.
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Gan
authors.affiliation: Hematology Department, The Affiliated Hospital of Chengde Medical College, Chengde 067000, China.
authors.forename: Chang-Lai
authors.initials: CL
authors.lastname: Hao
authors.affiliation: Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Dong
authors.affiliation: School of Public Health, Epidemiology, Biostatistics and Clinical Research Centre, Université Libre de Bruxelles (ULB), Brussels 1070, Belgium.
authors.forename: Sophie
authors.initials: S
authors.lastname: Alexander
authors.affiliation: School of Public Health, Epidemiology, Biostatistics and Clinical Research Centre, Université Libre de Bruxelles (ULB), Brussels 1070, Belgium.
authors.forename: Michèle Wilmet
authors.initials: MW
authors.lastname: Dramaix
authors.affiliation: Obstetrics and Gynecology Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Hu
authors.affiliation: School of Public Health, Epidemiology, Biostatistics and Clinical Research Centre, Université Libre de Bruxelles (ULB), Brussels 1070, Belgium.
authors.forename: Wei-Hong
authors.initials: WH
authors.lastname: Zhang
mesh_terms: D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*