Provincial Maternal and Child Information System in Inner Mongolia, China: Descriptive Implementation Study

Abstract

Background: After the implementation of two-child and three-child policies, the rising proportion of high-age and high-risk pregnancies put enormous pressure on maternal and child health (MCH) services for China. This populous nation with increasing population flow imperatively required the supports of large-scale information systems for management. Municipal MCH information systems were commonly applied in developed cities of eastern provinces in China. However, experiences of provincial MCH information systems in relatively underdeveloped areas are lacking. In 2020, the implementation of Regional Maternal and Child Information System (RMCIS) in Inner Mongolia filled this gap. Objective: This paper aims to demonstrate the construction process and evaluate the implementation effect of RMCIS in improving regional MCH of Inner Mongolia, which could be an available reference for other areas. Methods: This study performed descriptive implementation study for the implementation of RMCIS in Inner Mongolia. Based on the role analysis and information reporting process, the system architecture was designed as ten modules, supporting basic healthcare services, special case management, health supports and administration & supervision. Five-Color Management was applied for pregnancy risk stratification. This study collected data including construction cost, key characteristics of patients and use count of main services between January 1, 2020 and October 31, 2022 in Inner Mongolia. Descriptive analysis was used to demonstrate the implementation effects of RMCIS. Results: The construction and implementation of RMCIS cost 8 million CNY, with the duration of 13 months. Between 2020 and 2022, the system recorded 221,772 registered pregnant women with 44.75% early pregnancy registry rate and 147,264 newborns, covering 278 hospitals and 225 community healthcare centers in 12 cities. Five-Color Management of high-risk pregnancies included 76,975 (45.45%) for "Yellow"(general risk), 36,627 (21.63%) for "Orange"(relativelyhigh risk), 156 (0.09%) for "Red"(high risk) and 3,888 (2.30%) for "Purple"(infectious diseases). Scarred uterus (n=28,159, 36.58%), BMI≥28 (n=14,164, 38.67%), aggressive placenta praevia (n=32, 20.51%) and viral hepatitis (n=1,787, 45.96%) were the top factors of high-risk pregnancies for "Yellow"and above. 132,079 pregnancies with 65,018 high-risk pregnancies were registered in 2022, compared to 32,466 pregnancy with 21,849 high-risk pregnancies in 2020. Conclusions: The implementation of RMCIS in Inner Mongolia has achieved the provincial MCH data interconnection for basic services and obtained both social and economic benefits, which could provide valuable experiences to medical administration departments, practitioners and medical informatic constructors across the world.