Perinatal depression policies in China: A three-dimensional analysis with implications for low- and middle-income...

To map China's perinatal depression (PND) policy architecture across three dimensions (policy instruments, policy objectives, and implementers), and to synthesize key themes, thereby identifying structural gaps and implementation-relevant design weaknesses.

National and subnational policy documents issued in China (2009-2025) were systematically retrieved from official government websites using predefined search terms. Policies were mapped using a three-dimensional framework (policy instruments, objectives, and implementers). We conducted content analysis to quantify the distribution and configurations of policy instruments across dimensions, followed by a thematic synthesis of policy texts using a hybrid deductive-inductive coding approach in NVivo 12.0.

Fifty-one policies were included. Supply-oriented instruments predominated; management was the most frequent objective, and maternal and child health (MCH) agencies were the principal implementers. Thematic synthesis indicated that supply-oriented measures prioritized service integration, network development, and workforce capacity-building; demand-oriented measures targeted financial barriers and service uptake; and environment-oriented measures emphasized strategic planning and public education.

China's PND policy mix is supply-oriented, management-centered, and primarily delivered through MCH institutions. To strengthen system performance and equity, policies should diversify demand- and environment-oriented instruments, institutionalize cross-sector coordination, expand service coverage, and standardize early detection and multidisciplinary care pathways. This three-dimensional mapping provides transferable lessons for Low- and Middle-Income Countries aiming to build more integrated and evidence-informed PND policy frameworks.