To achieve more efficient and comprehensive maternal and child health (MCH) care services in rural areas through optimizing resource allocation and enhancing service quality.

With the increasing awareness of health among rural residents and the growing demand for MCH care, township health centers, as a crucial component of primary medical services, have emerged as a key factor in ensuring the health of women and children in rural areas.

Using a multi-stage stratified random sampling method, this study conducted on-site investigations on 49 township health centers across six districts and counties of Guilin, Guangxi. Descriptive statistics, entropy weight coefficient method, Data Envelopment Analysis (DEA) Banker–Charnes–Cooper (BCC) Model and Malmquist index were employed for dynamic analysis.

The results indicate an upward trend in the incidence rates of birth defects and low birth weight in MCH services. Disparities in efficiency across regions are observed, which are associated with the economic status and capacity of MCH services in each area. Dynamic results from the Malmquist index show that the total factor productivity of MCH services experienced an upward trend from 2016 to 2021, with efficiency primarily influenced by scale efficiency. Updating management concepts is crucial for effectively addressing the relationship between scaling up and quality improvement.