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Access to health and support services
for families of children with disabilities in China
Karen R Fisher and Xiaoyuan Shang
Symposium on the World Report on Disability: Implications for the Asia and the Pacific, University of Sydney and the World Health Organization
5-6 December 2011
Outline
Chinese disability policy context
Access to health and support services
Methodology
Findings – information, supply, cost, location
Policy implications for support policies
Resources and contact details
Chinese policy context
5 million children with disabilities
Overrepresented in vulnerability and disadvantage measures
China Disabled Persons Federation, Ministry of Civil Affairs
Developing, transition country
Changing values, less informal care
Government support systems only in developed areas
Free public health care is rare
Few additional support resources for schools
Rights to health and support
China signed UN Conventions for children and disability
Rights to service support
Information about child disability and support
Disability support, health and therapy
Children’s services and education
Per cent of children with disabilities who use services
All 37
Disability type
Physical 52
Mental 50
Vision 45
Multiple 40
Speech 31
Intellectual 28
Hearing 27
Location
Urban 49
Rural 34
Source: 2006 Second China National Sample Survey on Disability n=1002 Notes: Significance P<0.001. Gender is not significant
Use of services by disability and location
Per cent of children with disabilities
Need a service Use a service
Medical service and assistance 70 26
Assistance and support for disability poverty 55 23
Rehabilitation training and service 48 23
Educational subsidy reduction/waiver 19 13
Assistive devices 17 11
Living services 13 11
Vocational education and training 8 -
Culture services 6 5
Other 9 7
Source: 2006 Second China National Sample Survey on Disability n=1002
Need and use a service
Research questions
Why do most Chinese children with disabilities not receive the health and support they need?
What prevents families from accessing the services?
What are the policy implications to support their rights?
Methods
2006 National Sample Survey on Disability – 1002 children
National case studies – observation and interviews
8 children, families, school, social networks, organisations
Information about disability support
Poor information for families about
Their child’s disability support needs – identifying, early intervention, expectations of rights
Disability support options – health, therapy, support
Children’s services options – education, activities
Poor quality sources
Informal sharing, commercial interests
Impact on access to support
Delayed, incorrect or no support
Shortage of services
Urban/rural divide in local availability and government/family cost
Health
Disability support and therapy
Education and activities – inclusive/segregated
Impact on inequitable access. Examples of
Rural families not even asking for child to attend school
Urban family income support and free services from birth
Affordability and poverty
Lack of affordable disability support – cost borne by family
Multiple relationships between disability and family poverty
Disability from poverty – access to basic needs
Poverty accentuating disability – cannot afford cost of disability support
Poverty due to cost of disability support and poor information about appropriate support
Policy implications
Local context affects families fulfilling children’s support need
Provincial differences in
Resources and policy implementation
Priority of support for children and families
Requires central government resources and local community implementation to meet the needs of children with disabilities in China
Chinese social policy projects www.sprc.unsw.edu.au/research-areas-and-strengths/?search=&category=20#search-result
Disability policy projectswww.sprc.unsw.edu.au/research-program-/disability-and-mental-health/research-
[email protected]@unsw.edu.au
02 9385 7800
Resources
