The June edition of the WHO Bulletin features an articles that explores inequality in hospital births in China and finds significant increases in access to facilities. With the exception of the poorest region of the country, nearly all mothers gave birth in facilities in 2008. In fact, the socioeconomic discrepancies were nearly non-existent between the highest income groups and the lowest income groups. Among the poorest quintile, approximately 15% of births occurred in facilities in 1988, but 20 years later, nearly 90% of births occurred in facilities. According to the UN maternal mortality ratio (MMR) estimates, China’s MMR decreased by two-thirds between 1990 and 2008 from 110 deaths per 100,000 live births to 38.
Regarding these successes, the authors conclude:
“The gap in institutional birth rates between urban and rural regions is narrowing, which suggests that China’s safe motherhood strategy, with its regional focus, is working…Our analysis suggests that inequalities between socioeconomic regions are more pronounced than between individual households. It did not show household income to be an important determinant of hospital delivery.”
Given the uniqueness of China, with its huge population and landmass and booming economic growth, what works there may not be replicable in other countries, but it has seen some of the most progress on Millennium Development Goal 5. The UN data puts China ninth in terms of percentage reductions in maternal mortality between 1990 and 2008.
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