It’s Hard To Rely On When You Are Ill: A Study On The Problems And Countermeasures Of The Social Protection System For Rural Stroke Patients

With the significant increase in the incidence of stroke,this disease has become a major public health problem in rural areas of the country.In rural areas of China,a social protection system has now been developed,based on the protection of the family,village society and the state system,to provide important welfare protection for rural residents.However,the reality reflects that the social protection system has revealed many problems in protecting stroke patients after a stroke event among rural residents,and has not followed the expected protection path to protect rural stroke patients,even leaving them in a more marginal situation.The great conflict between the existence of the existing social protection system for rural residents in China and the reality that stroke victims continue to be trapped in a difficult situation provides an entry point for the development of this study.Existing research has paid less attention to the emergence of social protection system issues for stroke patients in rural China.Although researchers have mentioned some of the social protection issues,the types of problems and causes presented are not comprehensive and scattered,and the perspective is limited.There is a lack of historical and contextual examination based on Chinese localities,especially the focus on rural neighbourhood societies,and no deeper analysis of the causes of the emergence of the problems,with a single chain of connection between problems and causes under a predominantly quantitative study.As a result,it is not possible to present a full picture of the problems concerning the overall social protection system for rural stroke patients.In order to present a holistic picture of the social protection system for rural stroke patients,this study uses the ethics of family responsibility and intergenerational relations theory,the cultural exclusion theory of illness and disability and the policy process theory as entry points to explore the crisis in the triple protection system of the family,rural society and the state system.At the same time this paper incorporates the characteristics of the research questions by using a case study approach and data collection methods such as participant observation and semi-structured interviews with 16 rural stroke patients and 27 other relevant people in County H,L.The study found that.A number of problems emerged in the social protection system for rural stroke patients mainly at the levels of family,village society and the state system.Firstly,the problems in the family protection system stem from the contradictions and conflicts between family members in the process of protecting stroke patients.Firstly,the spouse is unable to protect the stroke victim,which is mainly reflected in the "carelessness" under the conflict of life,the "lack of care" under the lack of skills,and the "unsustainable care"under the physical and mental illness."Secondly,intergenerational protection is in a precarious state.Secondly,intergenerational protection is in a precarious state,including inadequate financial provision due to intergenerational evasion of responsibility and the reality of hardship,lack of care due to "inability and unwillingness to provide care" and"passive distance and active alienation".Secondly,the social protection system in the countryside is not as effective as it should be in the case of others.Secondly,the social protection system in rural areas has been "shunned" and "rejected" by others,resulting in the "disintegration" of the rural neighbourhood community and the collapse of the kinship protection network.As a result,rural stroke patients are unable to obtain instrumental help and emotional support from rural society.Finally,the problem of the national system of protection lies in the lack of protection due to the absence of relevant systems at the level of formulation and the lack of protection due to deviations in policy implementation at the level of implementation,which can lead to the "segregation" and "exclusion" of rural stroke patients from the protection system.In particular,excessive administrative burdens can intentionally or unintentionally ’push back’ rural stroke patients from applying for systemic protection.In the rural policy implementation environment,grassroots implementers are prone to policy adaptations,policy substitutions and policy perfunctoryities that result in rural stroke patients being excluded from policy services.This is especially true in the context of the lack of monitoring by the public and administrative oversight,which prevents the policy and rural stroke patients from ’meeting’.The above problems prevent the social protection system from providing comprehensive protection for rural stroke patients,leaving them in a difficult situation when social capital is already scarce.This article proposes more systematic improvement strategies to address the issues in the social protection system for stroke patients in rural areas.Firstly,for the family protection system,it is necessary to change from "family protection" to "family protection" through policy supplementation,family culture education and legal regulation.Secondly,for the rural social protection system,the reconstruction of the rural social solidarity community is realised through the call of rural sentiment and the drive of interests.Thirdly,for the system of institutional protection,the system is optimised through the improvement of the policy system,the reduction of administrative burdens and the correction of deviations in the implementation of grassroots policies.