Sveikatos, švietimo ir socialinių paslaugų šeimoms, auginančioms vaikus su negalia, ekosistemos spragos Lietuvos savivaldybėse

Abstract

Families raising children with disabilities need a coordinated system of health, education and social services, but its accessibility and consistency of operation at the municipal level in Lithuania remain uneven. To examine how educational, health and social services are organized and accessible to families raising children with disabilities in ten Lithuanian municipalities, based on the perspective of institutional experts. A qualitative research design was applied: 29 experts from the health, education and social service sectors were interviewed through semi-structured interviews. The data were analyzed using the thematic content analysis method, distinguishing aspects of service accessibility, planning and coordination, information and resource environment. It was found that the range of services provided for in legal acts is implemented in municipalities to different extents. In all three areas, there is a recurring shortage of specialists and a “bottleneck” effect, when the lack of one link slows down the entire assistance process. Service planning is more often based on available resources than on a systematic assessment of needs; the initiation of assistance often depends on the initiative of parents. Information dissemination is fragmented and reaches families with greater information capital, increasing the risk of territorial and social inequality. The study, covering several municipalities and three sectors, shows not isolated gaps, but a recurring logic of municipal governance that supports a reactive and fragmented model of assistance, and highlights critical points necessary for the transition to needs-based, inter-institutional coordinated service provision.