Socioeconomic and health system determinants of maternal health inequities across Chinese provinces (2009–2021): a multivariate meta-regression analysis of regional heterogeneity in underlying mechanisms

Household income, education, and insurance coverage are crucial for reducing maternal health disparities, whereas uneven urbanization and workforce allocation exacerbate them. Region-specific governance-focusing on fiscal transfers, education investment, and equitable health workforce distribution in central/western provinces, alongside efficiency improvements in the east-is essential for achieving Healthy China 2030 and SDG 3.1. Future policies must prioritize equity alongside average improvements.