Inequality in maternal and child health seriously hinders the overall improvement of health, which is a concern in both the United Nations Sustainable Development Goals (SDGs) and Healthy China 2030. However, research on the equality of maternal and child health is scarce. This study longitudinally assessed the equality trends in China’s maternal and child health outcomes from 2000 to 2013 based on place of residence and gender to improve the fairness of domestic maternal and child health. Data on China’s maternal and child health monitoring reports were collected from 2000 to 2013. Horizontal and vertical monitoring were performed on the following maternal and child health outcome indicators: incidence of birth defects (IBD), maternal mortality rate (MMR), under 5 mortality rate (U5MR) and neonatal mortality rate (NMR). The newly developed HD*Calc software by the World Health Organization (WHO) was employed as a tool for the health inequality assessment. The between group variance (BGV) and the Theil index (T) were used to measure disparity between different population groups, and the Slope index was used to analyse the BGV and T trends. The disparity in the MMR, U5MR and NMR for the different places of residence (urban and rural) improved over time. The BGV (Slope BGV = -32.24) and T (Slope T = -7.87) of MMR declined the fastest. The gender differences in the U5MR (Slope BGV = -0.06, Slope T = -0.21) and the NMR (Slope BGV = -0.01, Slope T = 0.23) were relatively stable, but the IBD disparity still showed an upward trend in both the place of residence and gender strata. A decline in urban-rural differences in the cause of maternal death was found for obstetric bleeding (Slope BGV = -14.61, Slope T = -20.84). Improvements were seen in the urban-rural disparity in premature birth and being underweight (PBU) in children under 5 years of age. Although diarrhoea and pneumonia decreased in the U5MR, no obvious gender-based trend in the causes of death was observed. We found improvement in the disparity of maternal and child health outcomes in China. However, the improvements still do not meet the requirements proposed by the Healthy China 2030 strategy, particularly regarding the rise in the IBD levels and the decline in equality. This study suggests starting with maternal and child health services and focusing on the disparity in the causes of death in both the place of residence and gender strata. Placing an emphasis on health services may encourage the recovery of the premarital check and measures such as prenatal and postnatal examinations to improve equality.

To explore the application of plan-do-check-action (PDCA) cycle management model in the management outpatient appointment, and improve the efficiency of outpatient appointment services. The data of outpatients from January 2019 to December 2020 were collected from a tertiary class B general hospital affiliated to a university in Shanghai. Through the investigation and analysis of the current situation, the reasons were found for the low rate of outpatient appointment. PDCA management was carried out, and measures were formulated for continuous improvement and the effective measures were standardized. The appointment rate, recognition rate and the utilization rate of self-service appointment (handheld hospital and self-service machine) were analysed after the intervention of PDCA. Through PDCA cycle management model, the appointment rate of outpatients increased from 9.93% before improvement to 82.50% after improvement, and the recognition rate of patients increased from 51.39% to 92.76%. The utilization rate of self-service appointment increased from 1.03% to 56.38%. Through the construction of multi-channel, wide coverage and convenient operation of the appointment service system, the PDCA cycle management model effectively improves the efficiency of the outpatient appointment services.

This study aimed to explore relationships between job stress and psychological adaptation and how they related to interpersonal needs through mood states among female migrant manufacturing workers. A cross-sectional survey was conducted in 16 factories in Shenzhen, China. Sociodemographic, job stress, psychological adaptation and other psychological information of was collected. Structural equation modeling was performed to delineate the internal relationship between variables. The hypothetical structural equation model exhibited acceptable model fit among female migrant manufacturing workers (χ² = 11.635, df = 2, χ²/df = 5.82, p = 0.003, RMSEA = 0.090, CFI = 0.972, SRMR = 0.020). Job stress was directly associated with mood states and interpersonal needs; Psychological adaptation was directly associated with mood states and indirectly associated with interpersonal needs; Bootstrapping tests demonstrated mediation effect of mood states in the way from psychological adaptation to interpersonal needs. Female migrant manufacturing workers who suffered stress from job and the process of psychological adaptation may have worse mood states and workers with worse mood states are more likely to develop unmet interpersonal needs, a proximal factor of suicidal ideation.

Building highly qualified General Practitioners (GPs) is key to the development of primary health care. It’s therefore urgent to ensure the GPs’ quality service under the background of the new round of health care system reforms in China. A new model of GP qualification examination was originally implemented in Pudong New Area of Shanghai, China, which aimed to empirically evaluate the GPs’ capability in terms of clinical performance and social recognition. In the current study, an analysis was made of the first two years (2014–2015) of such theoretical and practical examinations on the GPs there with a view to getting a deep insight into the GP community so as to identify the barriers to such a form of GP qualification examination. The agency survey method was applied to the two-year database of the GP examinees, the formative research conducted to explore the key elements for developing the examination model. The data analysis was performed with SPSS for Windows (Version 19.0) to describe the GPs’ overall characteristics, and to make comparisons between different groups. In 2015, the total number of GPs was 1264 in the area, in different districts of which, statistically significant differences were found in sex, age, professional title and employment span (P < 0.05). Such results were found to be similar to those in 2014. The examinees’ theoretical scores were statistically different (F = 7.76; P < 0.05), showing a sloping trend from the urban district to the suburban, to the rural and then to the farther rural, as indicated by LSD-t test (P < 0.05). From the theoretical examinations the scores were higher on the western medicine than on the traditional Chinese medicine (F = 22.11; P < 0.05). As suggested by the current study on the GPs’ qualification examination, which was pioneered in Pudong New Area of Shanghai, the construction of GP community was far from sufficient. It was a preliminary study and further studies are merited along the construction and development in terms of continuing medical education, performance appraisal and incentive mechanism.

Internal migrant workers have been experiencing increasing psychological problems recently. This study investigated the interplay between depressive and anxiety symptoms and their association with suicidal ideation among migrant industrial workers, using a network analysis approach. Cross-sectional data from 1792 participants were collected using self-reported scales for depressive and anxiety symptoms in Shenzhen, China. Network analysis was adopted to reveal key symptoms and their connections within the network. The detected rates of depressive and anxiety symptoms were 40.3% (95%CI: 38.1%~42.6%) and 29.0% (95% CI: 27%~31.2%), respectively. The reported rate of suicidal ideation was 7.9% (95% CI: 6.7%~9.2%). The top ten strongest edges in the model were observed within depression and anxiety domains. “Being so restless that it is hard to sit still”, “Feeling blue” and “Trouble relaxing” were central to the network, while “Feeling nervous, anxious or on edge” and “Sleep disturbance” acted as bridge symptoms in the network. The strongest direct relation to suicidal ideation was anxiety symptom A2 “Unable to stop or control worrying”. Findings highlight the interconnected nature of depressive and anxiety symptoms and how these symptoms related to suicidal ideation, thus providing insights for targeted interventions to improve mental well-being among migrant industrial workers in Shenzhen. Intervention strategies focusing on the most influential symptoms such as “restlessness” and “feeling blue” may yield better effectiveness.