An exploration of voluntarily abandoned free health services among children with disabilities in China: An ideological conflict perspective

In terms of protecting children with disabilities, healthcare rights are a crucial issue that cannot be ignored. In China, although the government provides generous health services, children with disabilities abandoning those services is a common phenomenon. Few scholars have directly and systematically studied this important issue. Using a qualitative method, we investigated the experiences and feelings of six service providers and twelve primary caregivers. From an ideological conflict perspective, we have found that China is a social context in which the state-led ideology of egalitarianism and the ideology of developmentalism co-exist but clash at the level of local governments and organizations. We produced two themes: (a) Governance methods arising from developmentalism produce invisible institutional exclusion in the form of non-client-centered tasks, constraints surrounding service costs, competitive welfare development models, and "good" performance chasing; (b) parents operating under developmentalism treat children with disabilities as abnormal, unprofitable, burdensome, and tragic, which encourages the voluntarily abandonment of healthcare services. The interaction of these two themes strengthens the ideological split occurring between them, leading to the widespread deprivation of health rights among children with disabilities. The results of this study call for critical reflections on disability policy implementation under this current conflicting ideology.