Objective To investigate the current status of construction and monitoring of healthcare-associated infection (HAI) system in maternal and child health care institutions in Guangxi Zhuang Autonomous Region, and provide reference for improving the quality of HAI management. Methods After discussed by members of expert group of HAI Prevention and Control Professional Committee of Guangxi Maternal and Child Health Care Association, the "Questionnaire on the construction and monitoring of HAI system in maternal and child health care institutions in Guangxi Zhuang Autonomous Region" was designed. The questionnaires were distributed to all maternal and child health care institutions in the region via "Questionnaire Star", and a WeChat group was established to address any questions in questionnaires. Results A total of 104 maternal and child health care institutions were included in the study, including 6 primary, 74 secondary, and 24 tertiary level institutions. All maternal and child health care institutions have established HAI management departments, 95.19% (n=99) of institutions held HAI management committee meeting at least once every six months. Among 201 HAI management professionals, most were female (90.55%), with nursing specialty (72.64%), with a bachelor’s degree (66.17%), and aged 31-50 years old (73.13%). Only 30.77% of the maternal and child health care institutions had HAI monitoring system. Seventy institutions (67.30%) have carried out the special action of improving the pathogen detection rate before antimicrobial therapy for hospitalized patients, out of which 55 (78.57%) were led by the HAI management department. Ninety-seven (92.27%) maternal and child health care institutions conducted surgery-related monitoring, with 50.96% of institutions relying on manual monitoring; only 30.77% of institutions have carried out the special action of "Strengthening perioperative infection prevention and control to ensure surgical quality and safety". Conclusion HAI management system in maternal and child health care institutions in Guangxi has been basically established and can carry out monitoring work, but personnel compostion is limited and talent reserve is insufficient. The information construction of HAI monitoring is underdeveloped, with a lagged implement of special action. Administrative support is needed to enhance infection prevention and control at the grassroots level. All levels of maternal and child health care institutions should communicate and exchange work experience. Hospitals should increase their support for the construction of HAI information technology, improve level of HAI monitoring as well as prevention and control capabilities.