The study participants included government officials responsible for maternal health care and NCMS at county level, health managers and providers at township level, as well as health users.
A total of 699 mothers of infants under one year of age were interviewed with structured questionnaires; the county health bureau officials and managers of township hospitals (n = 10) and county level hospitals (n = 2) were interviewed; the process of the maternal care services was observed by the researchers.
Semi-structured individual interviews were conducted with: 1) three key informants who are responsible for maternal health and the NCMS at the county level; 2) twelve health providers (health managers, NCMS managers and obstetric doctors from township hospitals).
The qualitative investigation in RC included focus group discussions with women giving birth before or after 2007, individual interviews with local policy makers and health managers, NCMS managers and obstetric doctors in township hospitals.
According to the township water managers and focus group discussions, the agriculture department built an access road, and the county government invested in a drinking-water project and "five small water" (small water vault, tank, pumping station, pond, and channel)3 projects in Ayoupu.
That is the most important thing.' (Women giving birth after 2007 in FGD) Township NCMS managers and obstetric doctors indicated they perceived that the amount of reimbursement for prenatal care was small.
The managers and midwives of all the study township hospitals were assembled by the County Health Bureau in May 2001 and informed of the provincial government's decision to carry out a province-wide systematic reform of maternal care in May 2001.
This divergence in opinion was also found among the township health managers, NCMS managers and obstetric doctors.
In other townships, village doctors and township maternal or child healthcare workers performed home visits.
The township's FP officers were under the leadership of the County Family Planning Committee and township authorities.
