The right to health of children has been a general concern of the society. The rate of systematic health management for children is a core indicator effectively reflecting the monitoring and management of children's physical growth and psycho-behavioral development. Most of the studies on systematic health management for children use an empirical design, mainly focusing on explorations of management models, while few have made in-depth analysis of the national status from temporal and geographical perspectives.

To analyze the temporal changes and regional differences in terms of the rate of systematic health management of children under three years old from 2010 to 2019, providing valuable evidence for the consolidation and improvement of the health management level in this group, and for promoting health level in children.

In November 2021, data about health management of children under three years old in China during 2011—2020 were extracted from 10 volumes of China Health Statistics Yearbook published annually from 2011 to 2020. A descriptive analysis was used to conduct temporal and geographical analysis of the systematic health management for children.

As a whole, the national health management rate for children under three years old showed a continuous upward trend increased from 81.5% in 2010 to 91.9% in 2019, with a 12.8% increase. The annual rate of systematic health management of the children during the period was greater than 90.0% in Beijing, Inner Mongolia Autonomous Region, Liaoning Province, Shanghai, Jiangsu Province, Zhejiang Province, Shandong Province, Guangdong Province and Shaanxi Province, but was relatively low in the Tibet Autonomous Region (71.9% in 2019) , indicating that there was still a certain gap between the local level and policy goals in this region. The analysis from temporal changes and regional differences as well as regional perspective revealed the following findings: the rate of systematic health management for children under three years during 2010—2019 was higher than the national level in 13 (41.9%) out of 31 regions in China, lower than the national level in 7 regions (22.6%) , and moved around the national level in 11 regions (35.5%) . The systematic health management rate of children under 3 years old varied greatly between regions during 2010—2012, but the inter-regional differences gradually narrowed after 2015. The rate of systematic health management for children under 3 years old was the highest in northeast China, followed by eastern China, western China and central China. In 2019, there was still large differences in the rate of systematic health management for these children among regions in western China.

China has achieved remarkable results in systematic health management for children under 3 years old. More attention should be given to the regions in western China, especially the Tibet Autonomous Region during the improvement of the management for these children. To further improve and consolidate the health management level of children, it is suggested to make efforts to improve the equity and accessibility of essential medical services, narrow the inter-regional differences between health resource allocation and public health services, learn and apply relevant good management methods from advanced regions, make full use of big data and internet techniques, and strengthen the construction of community pediatric health management team.