“Invisible” children: A multiple case study on the experiences and protection of hospital-stranded children

Background: Hospital-stranded children are defined as children who are left by parents in medical settings for over six months. These children, who legally are not classified as orphans, are excluded from existing permanent placement policies in China. Yet, little is known about this vulnerable population of children. 

Objective: This study explores the experiences of hospital-stranded children and the causes for their plight, and examines the strengths and weaknesses of existing child protection practices in medical settings. 

Methods: Using a multiple-case design, 20 hospital-stranded children from three children's hospitals in a first-tier Chinese city were included in this study. Sixteen hospital personnel participated in semi-structured interviews. Interview findings, case records, and field observations were analyzed using a thematic analysis approach. Current child protection practices were analyzed through a child protection system model. 

Results: The children in this study were well cared for by the hospitals, but their rights to provision, participation, and protection were violated due to the lack of a national child protection system. Three key weaknesses of child protection practices were identified: underreporting of suspected cases, delayed action after reporting, and inadequate follow-up services. The ineffectiveness of the national child welfare system and the family-oriented cultural values in China also created barriers to the protection of hospital-stranded children.

Conclusions: The findings suggest an urgent need for a national child protection system. Professional child protection training for healthcare workers and collaboration among departments within and outside hospitals are also necessary to offer a systematic protective network for hospital-stranded children.