Women’s perceptions of maternity care quality in China: Findings from the Chinese version of the Quality Maternal and Newborn Care Framework index

PROBLEM: Improving maternity care quality is key to reducing adverse outcomes and ensuring maternal and newborn safety in China. BACKGROUND: Evaluating service quality is an important step in promoting quality improvement. The Chinese version of the Quality Maternal and Newborn Care Framework index (C-QMNCFi) is a comprehensive and reliable tool to assess maternity care quality based on women's perceptions. AIM: To conduct a large-scale assessment of maternity care quality in China using the C-QMNCFi and to examine factors associated with women's perceived care quality. METHODS: An online survey using the C-QMNCFi was conducted between March and November 2025 among women between 42 days to 12 months postpartum recruited from nine hospitals across eastern, central, and western China. Descriptive statistics summarized scores, and quantile regression was used to identify factors associated with the global index score. FINDINGS: A total of 1453 women participated. The mean C-QMNCFi global index score was 91.4% (IQR 84.3%-95.2%). Lower scores were observed in the Care providers (continuity of carer) and Information-giving and advice. Quantile regression showed that higher scores were associated with residence in central or eastern China, higher household income, receiving midwife-led care, and receiving pregnancy care or giving birth in public tertiary or private hospitals (all p < 0.05). Lower scores were associated with urban residence, longer travel time to hospitals, and maternal complications (p < 0.05). CONCLUSION: Women generally reported positive maternity care experiences. It is recommended to optimize maternity care provision according to the characteristics of women.