III. Health and Rehabilitation
China attaches great importance to ensuring the right to health for persons with disabilities. It makes comprehensive efforts in preventing disability, and works hard to improve rehabilitation services, in pursuit of the goal that "everyone in need has access to rehabilitation services."
Policies for ensuring health services for people with disabilities are pragmatic and comprehensive. The "Outline of Healthy China 2030", the "Plan for Health in the 13th Five-year Plan Period", and the "Plan for Deepening Medical and Healthcare Reform in the 13th Five-year Plan Period" have raised explicit requirements for ensuring healthcare for persons with disabilities, and improving the ability of community-level institutions to deliver medical and rehabilitation services. The Regulations on Disability Prevention and Rehabilitation of Persons with Disabilities have been enacted and implemented. A subsidy system for nursing persons with severe disabilities has been established. Persons with disabilities are provided with special medical services, and they are also priority targets in family doctors' contracting services. Local governments are encouraged to incorporate basic rehabilitation services into personalized contracts with family doctors. Exercise therapy and 28 other medical rehabilitation items are covered by basic medical insurance. Since the 1990s, the Chinese government and various sectors of the society have funded surgeries for cataract patients, and more than 10 million people have recovered eyesight through this campaign.
Special attention has been paid to medical and healthcare services for impoverished people with disabilities in rural areas. The government has issued the "Guiding Opinions on Programs of Poverty Alleviation Through Healthcare", "Action Plan for Three Groups of People in Programs of Poverty Alleviation Through Healthcare", "Implementation Plan for Addressing the Difficulties of Poor Households Caused by Disabilities", and the "Three-year Action Plan for Poverty Alleviation Through Medical Security (2018-2020)". In rural areas, poor people with disabilities are now covered by basic medical insurance, serious disease insurance, and medical assistance, all of which play an effective role in securing comprehensive healthcare for them. Medical insurance benefits for registered poor people with disabilities have been improved. More efforts have been made to build county-level rehabilitation service centers for persons with disabilities, with the goal of improving the capabilities of community-level institutions in providing rehabilitation services. A working mechanism has been established to coordinate medical institutions and professional rehabilitation institutions for persons with disabilities.
Positive results have been achieved in preventing disability. The "National Disability Prevention Action Plan (2016-2020)" has been promulgated, by which effective measures are being taken to reduce and control the occurrence of disabilities. Pilot work on comprehensive disability prevention has been carried out around China to improve the integrated mechanism for disability screening, assessment, report and intervention. The national immunization program has been implemented, and pre-marriage and pre-pregnancy health checks, maternal prenatal screening and tests, and screening for newborns and children with disabilities have been strengthened. The Specifications for Disability Screening for Children Aged 0-6 Years (Trial) has been formulated to realize early screening and treatment of children with five types of disability. More efforts have been made in the prevention and treatment of infectious diseases, endemic diseases, and chronic diseases, with a focus on key prevention projects such as salt iodization and folic acid supplementation. These have basically eliminated poliomyelitis and iodine deficiency disorders, and other causes for disabilities. Safety measures have been strengthened to reduce accidental injuries that cause disabilities.
The Ministry of Science and Technology (MOST) actively pursues breakthroughs in disability prevention technologies. Through two key programs – "reproductive health and prevention and control of major birth defects" and "prevention and control of major non-communicable chronic diseases" – the MOST has planned and conducted prevention and control of birth defects and technical research on the prevention and control of major chronic diseases that will lead to disabilities, effectively reducing the occurrence of disabilities caused by illnesses. In 2017, the State Council officially designated August 25 as the Disability Prevention Day. Promotional activities to raise public awareness of disability prevention have been carried out on Disability Prevention Day, Ear Care Day (March 3), Global Iodine Deficiency Disorders Prevention Day (October 21), National Eye Care Day (June 6), World Birth Defects Day (March 3), and World Mental Health Day (October 10). As of 2016, the Chinese government had provided free folic acid to 81 million rural perinatal women, free thalassemia screening for 978,000 couples, and free congenital disease screening for 4.69 million newborns.
Rehabilitation services for persons with disabilities have gradually improved. Starting from scratch, rehabilitation institutions for persons with disabilities have developed a team of professionals, established a work system, business structure and operational mechanism, and improved their service capabilities. By 2018, 914 rehabilitation facilities at provincial, municipal and county levels had been completed, with a total floor area of 3.4 million sq m. There were 9,036 rehabilitation institutions for persons with disabilities, which employed 250,000 people, and 2,750 counties (cities or districts) offered community rehabilitation services. Rehabilitation institutions, which used to provide services only for cataract patients, post-polio patients, and hearing-impaired children, have evolved into to a multi-disciplinary service system with equal emphasis on prevention and rehabilitation that meets the needs of a wide range of people with disabilities.
In 2018, 621 secondary and higher vocational technical schools and regular colleges and universities began to offer degree programs on rehabilitation services, with 29,334 graduates. To train more rehabilitation professionals, preparatory work has officially started for China Rehabilitation University, which is included in the 13th Five-year Plan for National Economic and Social Development and the "Outline for Accelerating the Process Toward Prosperity for Persons with Disabilities in the 13th Five-year Plan Period".
Vigorous efforts are being made to offer community rehabilitation services and enhance the service capacity. By 2018, 1,001 municipal districts and 1,749 counties (cities) were offering community rehabilitation services, employing 478,000 community rehabilitation coordinators. A rehabilitation and assistance system for children with disabilities has been established, providing institutional guarantee for these children to receive basic rehabilitation assistance. A system subsidizing assistive devices for persons with disabilities has been established in nine provinces, autonomous regions and municipalities directly under the central government, reducing the financial burden on families with disabled members. A campaign has been launched to offer targeted rehabilitation services, such as rehabilitation therapy, rehabilitation training, support services, and assistive devices, to disabled children and those with certified disabilities. The MOST encourages the R&D of products that help and benefit persons with disabilities. It has carried out R&D programs on rehabilitation aids and repair materials for artificial tissues and organs, with a focus on two key projects – "active health and technological response to aging" and "R&D of biomedical materials and repair and replacement of tissues and organs". The rehabilitation system for work-related injuries has been improved, and pensions for injuries and disabilities have been enhanced.
From 2006 to 2016, 21.8 million persons with disabilities made progress in rehabilitation. In 2018, 10.7 million disabled children and persons with certified disabilities received basic rehabilitation services, and the coverage of rehabilitation services for persons with disabilities reached 79.8 percent.
Special attention has been paid to the health of children with disabilities. Following the principle of maximizing the interests of children, the Chinese government pays close attention to the health of children with disabilities. According to the results of the second national sample survey on disability published in 2006, children aged 0-14 years accounted for 4.69 percent of the total population with disabilities, 11.21 percentage points lower than data from the first survey published in 1987. Priority has been given to the rescue therapy and rehabilitation of children with disabilities aged 0-6, with targeted rehabilitation services. In 2018, 157,000 children with disabilities aged 0-6 years were provided with basic rehabilitation services.
To protect the basic rehabilitation rights of children with disabilities in a more comprehensive and sustainable way, the State Council issued the "Directives on Establishing a Rehabilitation and Assistance System for Children with Disabilities" in June 2018, marking the formal establishment of the system. Efforts have been made to promote rehabilitation and assistance services for children with major diseases such as cerebral palsy, amblyopia, and hearing impairments. A basic living allowance system has been established for orphans, including those with disabilities. China has carried out the Blue Sky Plan on Developing Child Welfare Institutions and the Tomorrow Plan on Surgical Rehabilitation for Orphans with Disabilities. In the framework of the latter, by June 2018, 125,000 disabled orphans and abandoned infants with surgical indications had received surgical correction and rehabilitation training.