Panel regression analysis of the relationship between health resources and infant mortality rate in Chinese mainland provinces, 2010-2020.

BACKGROUND

China has substantially reduced its infant mortality rate (IMR) and targets further declines under the Healthy China 2030 blueprint. Health resources are fundamental to infant health. However, national evidence on the association between multidimensional health inputs and IMR remains limited, particularly for pediatric specific resources.

METHODS

A panel dataset of 31 Chinese mainland provinces (2010-2020) was analyzed. IMR was defined as infant deaths per 1,000 live births. Associations between categorized health resources and IMR were examined using fixed- and random-effects panel regression adjusted for socioeconomic covariates.

RESULTS

Mean provincial IMR was 6.70 per 1,000 live births. Most health resource indicators correlated negatively with IMR. In adjusted panel models, health technical personnel (β = -0.88, 95%CI -1.11, -0.66) and beds (β = -1.26, 95%CI -1.50, -1.02) per 1,000 population were inversely associated with IMR. Health expenditure per capita (β = -1.04, 95%CI -1.40, -0.69) and pediatric beds per 10,000 children (β = -0.39, 95%CI -0.46, -0.31) also showed significant inverse associations. Government health expenditure was not significant (p = 0.15).

CONCLUSION

This study reveals a significant association between increased health workforce and facility capacity and lower infant mortality rates, highlighting the critical role of adequate pediatric-specific resource allocation. Our findings suggest that China should continue to ensure an adequate supply of health resources and potentially direct government health expenditure patterns specifically toward strengthening primary pediatric care and maternal and child health institutions.