Trends in maternal and child health in China and its urban and rural areas from 1991 to 2020: a joinpoint regression model.

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  • Additional Information
    • Source:
      Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : Nature Publishing Group, copyright 2011-
    • Subject Terms:
      Child Health*/trends ; Rural Population* ; Urban Population* ; Maternal Health*/trends ; Infant Mortality*/trends ; Child Mortality*/trends ; Maternal Mortality*/trends; Humans ; China/epidemiology ; Female ; Infant ; Child, Preschool ; Child ; Infant, Newborn ; Male
    • Abstract:
      The long-term trends in maternal and child health (MCH) in China and the national-level factors that may be associated with these changes have been poorly explored. This study aimed to assess trends in MCH indicators nationally and separately in urban and rural areas and the impact of public policies over a 30‒year period. An ecological study was conducted using data on neonatal mortality rate (NMR), infant mortality rate (IMR), under-five mortality rate (U5MR), and maternal mortality ratio (MMR) nationally and separately in urban and rural areas in China from 1991 to 2020. Joinpoint regression models were used to estimate the annual percentage changes (APC), average annual percentage changes (AAPC) with 95% confidence intervals (CIs), and mortality differences between urban and rural areas. From 1991 to 2020, maternal and child mortalities in China gradually declined (national AAPC [95% CI]: NMRs - 7.7% [- 8.6%, - 6.8%], IMRs - 7.5% [- 8.4%, - 6.6%], U5MRs - 7.5% [- 8.5%, - 6.5%], MMRs - 5.0% [- 5.7%, - 4.4%]). However, the rate of decline nationally in child mortality slowed after 2005, and in maternal mortality after 2013. For all indicators, the decline in mortality was greater in rural areas than in urban areas. The AAPCs in rate differences between rural and urban areas were - 8.5% for NMRs, - 8.6% for IMRs, - 7.7% for U5MRs, and - 9.6% for MMRs. The AAPCs in rate ratios (rural vs. urban) were - 1.2 for NMRs, - 2.1 for IMRs, - 1.7 for U5MRs, and - 1.9 for MMRs. After 2010, urban‒rural disparity in MMR did not diminish and in NMR, IMR, and U5MR, it gradually narrowed but persisted. MCH indicators have declined at the national level as well as separately in urban and rural areas but may have reached a plateau. Urban‒rural disparities in MCH indicators have narrowed but still exist. Regular analyses of temporal trends in MCH are necessary to assess the effectiveness of measures for timely adjustments.
      (© 2024. The Author(s).)
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    • Grant Information:
      2022-147 The Innovation and Entrepreneurship Training Program for University Student in Southwest Medical University; 2021LZ31 The National Statistical Science Research Projection of China; 2021ZKMS002 The Scientific Research Project of Southwest Medical University
    • Contributed Indexing:
      Keywords: Infant mortality rate; Joinpoint regression model; Maternal and child health; Maternal mortality ratio; Neonatal mortality rate; Under-five mortality rate
    • Publication Date:
      Date Created: 20240612 Date Completed: 20240612 Latest Revision: 20240615
    • Publication Date:
      20240615
    • Accession Number:
      PMC11169526
    • Accession Number:
      10.1038/s41598-024-63689-2
    • Accession Number:
      38866837