GAPS IN THE ECOSYSTEM OF HEALTH, EDUCATION, AND SOCIAL SERVICES FOR FAMILIES RAISING CHILDREN WITH DISABILITIES IN LITHUANIAN MUNICIPALITIE
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Abstract
Families raising children with disabilities require a coordinated system of health, education, and social services; however, at the municipal level in Lithuania, the availability of these services and the consistency of their delivery remain uneven. The study presented in this article, based on the perspectives of institutional experts, aimed to examine how education, health, and social services for families raising children with disabilities are organized and accessed in ten Lithuanian municipalities. A qualitative research approach was applied: semi-structured interviews were conducted with 29 experts from the health, education, and social service sectors. The data were analyzed using thematic content analysis, focusing on aspects of service accessibility, planning and coordination, as well as the informational and resource environment. The findings indicate that the range of services stipulated in legislation is implemented to varying degrees across municipalities. In all three sectors, recurring shortages of specialists and a bottleneck effect were identified, whereby deficiencies at one point in the service chain hinder the entire support process. Service planning is more often based on available resources rather than systematic needs assessment, and the initiation of support frequently depends on parental initiative. Information dissemination is fragmented and tends to reach families with greater informational capital, thereby increasing the risk of territorial and social inequalities. This multi-municipality, cross-sectoral study reveals not isolated gaps but a recurring logic of municipal governance that sustains a reactive and fragmented model of support, and it highlights critical areas that must be addressed in the transition toward needs-based, interinstitutionally coordinated service provision.
Keywords: children with disabilities, municipalities, accessibility of services, inter-institutional collaboration.
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