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Abstract

Researchers have sought perspectives from students, parents, teachers, and school administrators to investigate the educational status of migrant children. This study sheds new light on the same topic by adopting the perspectives of local government officials. Specifically, it investigates the practices advocated by local governments to improve the educational equity of migrant children and the barriers they may encounter. Face-to-face, semi-structured interviews were conducted with government officials working in a provincial education department in East China. The findings indicated that the practices advocated by the local government showed the following five characteristics: (1) the key practices implemented by the local government were almost exclusively related to migrant children’s access to education, (2) the local government paid greater attention to the primary and lower secondary stages of migrant children’s education, (3) there was no task force dedicated to migrant children’s education, (4) although several government agencies worked on migrant children’s education, the provincial education department played a leading role, and (5) the local government did not work closely with private schools on migrant children’s education because of a lack of trust. Evidence from this study also suggests three key barriers to promoting educational equity: lack of educational resources, uneven distribution of good teachers, and lack of reform of the household registration system. These findings have important implications for re-evaluating policies and practices promoting educational equity for Chinese migrant children at the state and regional levels.

Keywords

migrant children educational equity household registration system rural-urban disparity social justice

Introduction

China’s state-planned economic system has gradually transformed into a socialist market economy since the launch of the economic reform in 1978. State-owned companies and private businesses are impressive generators of employment opportunities; therefore, many workers flock to metropolitan cities (S. Yang & Wang, 2023). Migrant workers who originally came from less-developed areas to seek better jobs in urban areas must decide whether to take their children with them or leave them behind in rural households. Children who were brought by their parents to urban areas are referred to as “children of migrant workers” (suiqian zinv) or “migrant children” (liudong ertong) (hereafter referred to as migrant children). This special group of children temporarily migrates from their place of household registration (huji zhucedi) to urban areas and lives with their parents. Likewise, children left by their parents in rural households are referred to as “left-behind children” (liushou ertong) (Jin et al., 2020). Migration with parents is often associated with improved psychological well-being and fewer behavioral problems (F. Wang et al., 2017).

The dual classification of the household registration system (hukou dengji zhidu) in China was established in 1951. The purpose of the system is to consolidate the socialist structure and monitor and control migration from rural to urban areas (Y. Zhou et al., 2020). Under this system, all Chinese citizens were classified according to two related parts: (a) place and (b) registration status. The former classification divides citizens’ places of registration into two categories: urban centers and rural settlements. The latter classification divides residential status into agricultural and non-agricultural registered permanent residences. The system has been a key determinant of individuals’ access to food, housing, education, and other social welfare and has had a significant impact on individuals’ life changes (Jipeng Zhang, Wang, & Lu, 2019).

Formal rural-to-urban migration is a complex process. Individuals who wish to obtain full urban residence status must change both the place and the status of their registration. The former requires the applicant to obtain a migrant permit from a public security authority. The latter conversion requires the applicant to meet the conditions (e.g., qualification and work experience) stipulated by the government and obtain a place under quota control (Shi, 2021). Only a limited number of individuals meet these requirements to obtain a place.

In recent years, there have been continuous reforms to the household registration system (Jipeng Zhang, Wang, & Lu, 2019) and the development of new enrolment policies for migrant children in megacities such as Beijing (Yu & Crowley, 2020). However, migrant workers still face many obstacles when enrolling their children in urban public schools, such as presenting all the required enrolment documents (Liang et al., 2020). Most migrant workers in host cities do not have local residential status. They work temporarily and have limited access to general urban benefits. Correspondingly, their children have limited access to public education in host cities (L. Guo et al., 2019). Migrant workers who are unable to transfer their household registration to host cities must adopt alternative strategies to augment urban educational resources for their children, such as exploring social connections (guanxi) and repeatedly visiting urban public schools to try their luck (Peng, 2019).

Most empirical research pertinent to migrant children’s education has sought the perspectives of students (X. Chen et al., 2021), migrant workers (Gu & Yeung, 2019), teachers (Brandmiller et al., 2020), and school administrators (Mahfouz et al., 2020). Local governments are primarily responsible for migrant children’s education; they allocate resources, supervise and inspect education activities, implement national policies, and establish policies at the local level. However, few studies have investigated local government practices and barriers to promoting educational equity among migrant children. This study aims to fill this knowledge gap. Thus, the purpose of this study was to reveal the practices and barriers of the local government in promoting educational equity among migrant children in China.

Following this introduction, this article provides an overview of changes in central government policies and key issues concerning migrant children’s education. Subsequently, educational equity is conceptualized, knowledge gaps are outlined, and the research questions are presented. The research methods section justifies the choice of research design and explains the steps taken to collect and analyze the qualitative data. The results are discussed in conjunction with educational equity and broader education literature. The implications for policy and practice are also discussed. The significance of this study is that it provides a governmental perspective that reveals the current key practices and barriers to promoting educational equity among migrant children in China. The findings of this study could be useful to scholars and policymakers in relevant fields.

Literature Review

Education for Migrant Children: A Policy Perspective

A chronological review of the social and educational policies for migrant children stipulated by the central government over the last 20 years reveals the following four trends: First, the control of migrant children’s movements gradually eased. Before 2000, the central government stipulated that migrant children should receive education in which their residence status was registered (State Education Commission, 1996; State Education Commission & Ministry of Public Security, 1998). More recently, the central government required local governments to incorporate migrant children’s education into the plan for economic and social development (State Council of China, 2003) and the local education plan (State Council of China, 2006). Therefore, fewer hurdles exist for migrant children to receive education in host cities.

Second, public schools are the first choice for migrant children to study in host cities. The central government encouraged migrant children to study in qualified privately run schools (State Council of China, 2001; State Education Commission, 1996). Later, the central government advised that the standards for teaching staff, safety, and hygiene in privately run schools for migrant children should be comparable to those of local public schools (State Council of China, 2003). Recently, policies have placed a great emphasis on migrant children’s access to public schools (State Council of China, 2008). Local governments are responsible for making rational decisions based on the number and distribution of migrant children in the host cities.

Third, the fiscal responsibilities of the central and local governments have become shared. Before 2003, the central government stressed the role of local governments in migrant children’s education, but did not stipulate any fiscal responsibility (State Council of China, 2001; State Education Commission, 1996; State Education Commission & Ministry of Public Security, 1998). Later, the central government stipulated local governments’ fiscal responsibility, but did not assume any fiscal responsibility (State Council of China, 2003). From 2006 onwards, the law indicated that the central and local governments shared fiscal responsibility for migrant children’s education (The NPC Standing Committee, 2006). However, the fiscal responsibilities of the central and local governments are blurred. Local governments are the primary source of funding (The CPC Central Committee & The State Council, 2014).

Fourth, financial assistance for migrant children has become available. Before 2000, the government did not explicitly stipulate financial assistance for migrant children. More recently, the government developed various need- and merit-based schemes and provided reduction and exemption of fees to support migrant children in need (State Council of China, 2003, 2004, 2008). Local governments are the primary sources of financial assistance.

These changes have had profound effects on local urban governments. Local governments in host cities must unconditionally receive a growing number of qualified migrant children and bear primary responsibility for the provision of educational resources. However, providing adequate public education to migrant children of equal quality to that of resident children is often beyond the capacity of local governments (Callahan et al., 2022). Simultaneously, funding for migrant children’s education granted by the central government is limited, considering that a decentralized fiscal system has been adopted in China. Consequently, the policies advocated by the central government cannot be implemented by local governments, and several issues pertaining to migrant children’s education have emerged (Gabrielli & Impicciatore, 2022). These issues are discussed in detail in the following subsections.

Key Issues in Education for Migrant Children

Access to Education

For decades, equal access has been recognized as a key issue in migrant children’s education. A large-scale survey in 1995 indicated that migrant children were 17% less likely than left-behind children to enroll in school (Liang & Chen, 2007). Simultaneously, the enrolment rate of migrant children was estimated to be 60% lower than that of local resident children (Horizon Market Research, 1997; Solinger, 1999). The school attendance of migrant children increased to 90% in 2003, which was still lower than the national average of 99% (He & Li, 2007).

The reasons why migrant children did not attend school were compounded. As previously discussed, host cities have limited educational resources for migrant children. Public policies regarding equal admissions are sometimes not implemented by local governments as intended (B. Hu & West, 2015). In addition, most migrant workers have unstable jobs and limited financial resources for sending their children to school. Excessive schooling fees are often perceived as the primary factor discouraging migrant children from enrolling in school (Hung, 2022). Research suggested that migrant children within a year of residence in host cities were the most disadvantaged group (Liang & Chen, 2007). The higher the financial capacity of migrant workers and the longer they resided in cities, the more likely they were to enroll in schools (G. Yang & Bansak, 2020). Other factors such as mothers’ education and whether both parents were in the same city also influenced the school attendance rate (Y. Cui et al., 2019).

Resources

A small number of migrant children’s schools may be credited with outstanding facilities and helpful services such as picking up children (Liang et al., 2020). Schools set up for migrant children generally have lower standards and less favorable conditions than public schools. Underground or illegally operated private-run schools attract migrant children by charging low tuition fees (L. Wang & Holland, 2011). These schools aim to maximize profits, and the quality of their schooling is of little concern. These schools have rather poor infrastructure and teaching facilities (Yuan et al., 2017), which not only severely affects children’s studies but also their physical and mental health (Han, 2004).

The quality of the teaching and administrative staff is also a major concern. The school operators and teachers did not have any teaching qualifications or experience. In a study of 114 school operators, 30 had not been formally trained as teachers (Lu & Zhang, 2004). In small migrant children’s schools, some teachers were school operators’ relatives or acquaintances, and some teachers themselves were temporary rural–urban migrants (Rotter & Timpe, 2016). Teachers’ mobility in migrant children’s schools is high. Those qualified to teach tend to stay temporarily and seek better jobs (Sorkos & Hajisoteriou, 2021). Low wages, poor living conditions, and heavy workloads are key factors in the high turnover of teachers (H. Zhang et al., 2023).

Educational Performance

The academic performance of migrant children attending migrant children’s schools is generally lower than that of those attending public schools. Studies have suggested that such a difference does not normally exist at the primary level (Y. Chen & Feng, 2019). However, the difference can become significant at the lower secondary level, particularly in the Chinese language and literature, mathematics, and English (Curtis et al., 2021).

Migrant children may have poor academic performance in school for various reasons. Many scholars have attributed the difference in academic output to the huge discrepancy between public and migrant children’s schools, such as in teachers’ qualifications, quality of teaching, and school infrastructure (Lv et al., 2022). Other studies have revealed that the lack of consistency in children’s knowledge levels is a major factor. Evidence indicates that only one-fourth of the migrant children’s schools investigated in Beijing required students to take an entrance exam, whereas the remaining schools accepted parents’ accounts of their children’s knowledge levels (Han, 2004). Consequently, some children skipped one or more grades, while others repeated what they had learned previously (Han, 2004). This finding is consistent with Schwartz et al. (2017), who found that an increase in the frequency of school transfers had a significantly negative impact on migrant children’s academic performance.

Notably, although migrant children who attend public schools enjoy the same schooling and facilities as resident children, their academic performance is generally lower than that of resident children. Empirical evidence indicates that such a disparity is attributable to differences at the individual level (e.g., sex and motivation) and the family level (e.g., parental socioeconomic status and family income) rather than differences at the school level (H. Zhou & Wu, 2008). Studies further suggest that a variety of factors can lead to low academic performance, such as a lack of good study habits at the individual level, a lack of parental guidance, a supportive learning environment, harmonious parent–child relationships, and cultural capital at the family level (Ma & Wu, 2020; Xiong, 2015).

Level of Educational Attainment

Parental mobility and high school fees are critical factors affecting the progress of migrant children in schools. The high mobility of migrant workers implies that their children occasionally discontinue their studies. It is common for migrant children to transfer from one school to another in response to the movement of their parents. In Cheng’s (2010) study, six out of 15,000 migrant children remained in grades 1 to 6. Another study suggested that the number of school transfers was negatively associated with migrant children’s academic performance, particularly for female children, children studying at lower secondary levels, and children studying at public schools (H. Zhang et al., 2011). Simultaneously, excessive schooling fees force migrant children to move from public schools to migrant children’s schools. In a study of 365 children, 64% claimed that high fees and hidden expenses such as those for extracurricular activities, private tutoring, and school uniforms were the major reasons for transfer (Han, 2004).

Educational Equity

Educational equity is related to justice in the provision of education (Mavrogordato & White, 2020). Field et al. (2007) defined two dimensions of educational equity: fairness and inclusion. Fairness means that personal and social circumstances, such as ethnicity and socioeconomic status, should not obstruct educational success, and inclusion implies that a basic minimal standard education should be guaranteed to everyone. This is consistent with Strike’s (1985, p. 414) assertion that “[educational] resources will need to be distributed not on a criterion of ability but on a criterion of need … to ensure that as many as possible achieve at a minimum level.”

Equity differs from equality in that the former emphasizes the quality of being equal or fair, whereas the latter focuses on being equal in quantity (Minow, 2021). Equity denotes fairness, and equality denotes sameness (Herrera, 2007; Larkin & Staton, 2001). Additionally, greater equity implies greater inequality (Meuret, 2001; Rawls, 1971). Achieving equity may require a special configuration of inequalities because “those who [were] disadvantaged in the past … may require … special encouragement and support” (Samoff, 1996, p. 266). In this sense, disadvantaged social groups may require different interventions to satisfy their needs or improve their conditions.

In the past, scholars have provided an analysis of migrant children’s educational inequalities considering the aspects of access, resources, educational performance, and level of educational attainment (Triventi et al., 2022; L. Wang & Holland, 2011). They also provide recommendations to practitioners and policymakers based on the empirical evidence from their research. However, there is a general lack of understanding of the role of local governments in addressing educational inequalities among migrant children. Few attempts have been made to investigate the characteristics of the practices advocated by local governments and their constraints. To fill these knowledge gaps, this study addresses the following key research questions:

Research Question 1: What are the characteristics of the practices implemented by local governments in the last 5 years to improve educational equity for migrant children?

Research Question 2: What are the key barriers local governments face in improving the educational equity of migrant children?

Methods

Case Study Approach

A case study approach was chosen for this study. Case studies are “often not a methodological choice… but rather a choice regarding what is to be studied” (O’Reilly et al., 2012, p. 4). In this instance, the focus was on government officials from a provincial department of education in East China who have knowledge of and responsibility for one or more aspects of migrant children’s education. The specific location in which this case study was conducted was kept confidential because it involves some of society’s controversial issues (Sieber & Stanley, 1988) and may therefore impinge on the “vested interests of powerful persons … or the exercise of … domination” (Lee & Renzetti, 1990, p. 512). According to the fifth national census, the number of migrant children in this province is close to the national average of 450,000, and the proportion of school-aged migrant children among all school-aged children in the province is close to the national average of 3.23%. The researcher envisaged that the selected case represents the relevance of the phenomenon and appropriately addresses the research questions.

Semi-Structured Interviews

Data were collected through semi-structured interviews. Interviews emphasize depth, detail, vividness, and nuance (Rubin & Rubin, 2011). The interviews provided “an undiluted focus on the individual” (Ritchie, 2003, p. 36) and allowed the researcher to obtain in-depth information beneath the surface appearance (Seidman, 2019). This method treated government officials as individuals capable of reflecting on their social world while helping the researcher to empathetically understand “social reality” through their lenses by “putting self aside” (Miller & Crabtree, 2004, p. 196) and “tak[ing] the role of the other” (Lofland et al., 2006, p. 222). In addition, the interviews helped the researcher generate considerable descriptive details regarding the social contexts in which the officials provided their answers. The rich detail provided “a contextual understanding of social behaviour” (Bryman & Bell, 2018, p. 8). It also provided readers with a database to determine the transferability of the results to other research settings (Lincoln & Guba, 1985).

In this study, data collection ceased when thematic saturation was reached and no new information was discovered in the data analysis. Data were collected through face-to-face semi-structured interviews with six government officials working in four different subsections of a provincial department of education (personnel, planning and development, compulsory education, public policies, and law). The average work experience in the department was 5.8 years. The interview questions were divided into four sections: addressing the official’s background information, the local government’s practices to improve educational equity, the barriers encountered by the local government in enhancing educational equity, and additional comments (Appendix A). It should be noted that these were standard interview questions. The use of probing questions was subject to the situation in each interview and was, therefore, not included.

Ethics Considerations

Before data collection, ethical approval was obtained from the university’s research ethics committee. To protect the privacy of the officials, the researcher did not use any covert methods to collect data or obligate any officials to answer any questions. The researcher recorded the interviews after obtaining permission from officials. Specifically, the researcher stressed the need to guarantee anonymity and confidentiality. Anonymity or anonymization is a method to ensure confidentiality (Leavy, 2014), whereas confidentiality also implies not disclosing information collected from an interviewee accidentally or deliberately in ways that may identify that individual (Wiles et al., 2008). To ensure anonymity, the researcher assigned fictitious names to the officials and ensured that their identities would not be revealed during the dissemination of the research results. The researcher also protected the identities of the interviewees by clearly explaining in the written consent form how this would be done (Seidman, 2019). To prevent accidental breaks in confidentiality, the researcher did not discuss the details of the interviews with individuals outside the research team. Further, the research data and related materials were stored on an encrypted computer and all audio recordings were destroyed after the transcription was completed. The researcher did not deliberately break confidentiality because the information disclosed by the interviewees was not related to crime or illegal activities (Wiles et al., 2008).

Data Collection Procedures

Gaining access is not only a practical matter but also “a political process” (Bryman & Bell, 2018, p. 20), which is often mediated by gatekeepers. Gatekeepers control access and re-access and seek to influence the method of investigation, types of interview, questions asked, duration, and dissimilation of research results (Billups, 2019). To receive permission from the gatekeepers, the researcher first contacted the General Office of the Department of Education and provided a clear explanation of the researcher’s status, research aims, and value of the study. After receiving permission from the gatekeeper, the researcher made phone calls to each potential interviewee and explained the research purpose, procedures, duration, risks, benefits, and issues pertaining to confidentiality. If the official agreed to participate in the study, the researcher would schedule an interview with them.

Before the interview started, the researcher emphasized the importance of this study and greatly appreciated the official’s contributions. The researcher explained that the interviews lasted 45 to 60 min. An information sheet was provided to each participant to obtain informed consent. It outlined the purpose and nature of the study, research procedures, duration, anticipated risks and benefits, confidentiality, voluntary participation, and the researcher’s contact details. The researcher then asked for permission to audio-record the interviews. The researcher explained that the recording would greatly assist in the data analysis; no one except the researcher would have access to the audio, and the audio would be deleted following transcription. Subsequently, the researcher answered general questions raised by the officials. All officials voluntarily agreed to participate.

During the interviews, the researcher listened to the officials attentively and maintained a friendly and well-mannered attitude. Furthermore, the researcher avoided conveying an imprint of thoughts on the face and disrupting the officials’ speaking. At the end of each interview, the researcher reiterated the significance of their answers and expressed heartfelt gratitude for their participation. Each interview lasted approximately 50 min.

Data Analysis Procedures

Data analysis was guided by grounded theory to investigate the practices and barriers to promoting educational equity among migrant children. The researcher read the transcripts and field notes several times to obtain a general understanding of the data and kept reflective research notes while reading them. The researcher then paused his data analysis and revisited the data every 2 days to obtain a fresher perspective. The researcher then imported the transcripts, field notes, and research notes into the qualitative data analysis software MAXQDA.

The software was helpful in managing raw data. However, the software did not perform the analysis. When the researcher refined the data into themes, he paid extra attention to similarities and differences, repetitions, indigenous typologies, transitions, and linguistic connectors in the data (Ryan & Bernard, 2016). Another researcher participated in this process to ensure the coding reliability. All disagreements were resolved by consultation and re-inspection of the raw data. After classifying the data into exhaustive and mutually exclusive themes, the researcher kept the objectives in mind and began to look for connections and comparisons between themes. Finally, the researcher presented a clear, coherent, and fair account of the data. The data analysis was finalized in December 2021. To preserve “the multivocality and complexity of lived experiences” (Miller & Crabtree, 2004, p. 201), the researcher interwoven verbatim quotations with comments when reporting the results.

Research Objectivity

Complete objectivity cannot be achieved in qualitative research because researcher bias is inevitable (Chowdhury & Shil, 2021). However, researchers can establish relative confirmability by acknowledging predispositions, exposing inner thoughts and emotions, and examining personal values and beliefs underpinning decisions made (Halkias et al., 2022). To enhance confirmability, the researcher recorded decisions, questions, and thoughts in research notes and referred to them when auditing interpretations and inferences.

Results

This section presents the results to answer the two questions proposed in this study.

Research Question 1: What are the characteristics of the practices implemented by local governments in the last 5 years to improve educational equity for migrant children?

Research Question 2: What are the key barriers local governments face in improving the educational equity of migrant children?

Key Practices

Improving Access to Education Is the Task of Top Priority

All the officials reckoned that the local government paid close attention to migrant children’s access to education, even though some of the officials chose to use synonyms for access, such as “placement” (anzhi), “enrolment” (zhuce), and “admission” (ruxue). Cheng succinctly summarized the focus of the last 5 years:

From the state level to the district or county level, we are paying much more attention to … the placement of migrant children. (Cheng, 7 years)

Officials held similar views as to why local governments should focus on migrant children’s access to education. There was a general sentiment that access was a prerequisite for everything else.

To a certain extent, we are still facing some difficulties when tackling the issue of admission, for there is a lack of educational resources… . We will pay more attention to other aspects after the problem of admission is tackled. (Wei, 5 years)

I feel that we are nearing the solution to the problem of access … . Afterwards, we should think about equity in the process of education. Streaming children (fenban) is an example… . Even though we ask schools not to stream children by their resident status, the schools are likely to put migrant children into a class… . There is a big difference between a class in which the majority of students are resident children and a class that consists of migrant children, especially in terms of the experience and qualification of teachers… . However, there is little point in discussing the equity of teaching resources if not every child has access to schools. (Liang, 7 years)

Primary and Lower-Secondary Stages of Education Receive Greater Attention

Officials were unanimous that the local government placed great importance on the primary and lower secondary stages of education. Wei summarized the main stages of focus in the last 5 years:

We are trying to ensure every child in our city receives a complete primary and lower-secondary education. (Wei, 5 years)

According to officials’ speculation, the reasons local governments focus on the primary and lower-secondary stages of education are twofold. In one respect, officials reckoned that migrant children in the primary and lower-secondary stages of education were more vulnerable:

Most higher-secondary students are studying in boarding schools and have cultivated self-managing ability … . Primary and lower-secondary students are younger. Usually, their parents are busy earning a living and have little time or the ability to help with children’s study. (Cheng, 7 years)

In another respect, and perhaps more importantly, primary and lower-secondary education are stipulated by the central government and enforced by the Compulsory Education Law, as Li and Zhu expressed:

Compulsory education is legally compelling… . The central government clearly specified that local governments should ensure every school-aged child receives compulsory education, including migrant children (Li, 3 years).

We will strive to guarantee migrant children’s primary and lower-secondary education unless the central government re-stipulates the scope of compulsory education. (Zhu, 7 years)

In line with Li and Zhu, Wei believed that political systems play a crucial role.

Our tradition is that subordinate departments will follow the regulations set by their superiors. Once the central government makes an adjustment, we will follow their steps. (Wei, 5 years)

Liang commented on the credibility of policies ratified by the central government.

The central government policies are carefully drafted and worked on by experts… . As a local authority, we will try to grasp the essence of the policies and adapt them according to our local conditions. (Liang, 7 years)

Key Practices Are Primarily Related to Access to Education

Officials seemed to have different opinions on key practices for improving educational equity. This is understandable considering that the interviewees were selected from different departmental subsections. However, officials’ views have a common ground: key practices are closely related to children’s access to education. Ling maintained that the admission process became less complicated and entering a higher-level school in the host city became easier.

We simplified admission procedures so that migrant children can be accepted by local schools at a faster speed… . In addition, the process of entering a higher-level school has been eased. Since 2008, migrant children are allowed to take the high school entrance exam (zhongkao) in our province. Since 2012, migrant children who complete 3-year high school study in our province are allowed to take the university entrance exam (gaokao) here. I would say these changes are significant. (Ling, 6 years)

Zhu indicated two practices that he considered important: exemption from fees and reform of the Mechanism of Compulsory Educational Funds (yiwu jiaoyu jingfei baozhang jizhi):

We implemented at least two important practices… . The first one is that we waived migrant children’s tuition and miscellaneous fees from 2008… . The second practice is that we reformed the Mechanism of Compulsory Educational Funds. The mechanism stipulated that migrant and resident children should be treated equally, such as the provision of a bursary. For migrant children, these practices reduced the threshold of attending schools in our province. (Zhu, 7 years)

Similarly, Wei believed that allowing migrant children to study in nearby schools is a key initiative.

I would say the most important practice is to allow migrant children to be admitted by the nearest primary and lower-secondary schools which have available places… . We require that all such schools should receive school-aged migrant children unconditionally without asking them to take any form of entrance exam. (Wei, 5 years)

The Provincial Education Department and Public Schools Play a Crucial Role in Migrant Children’s Education

Officials seemed to have different opinions about collaboration in migrant children’s education. Their answers revealed the following three characteristics: First, no task force was dedicated to the education of migrant children. Cheng’s answers are highlighted below.

We do not have a particular team or office to look at this issue. The issue of migrant children’s education requires the cooperation of many government agencies. (Cheng, 7 years)

Second, the Provincial Department of Education collaborated with several government agencies, but still played a leading role. Collaboration depends on the nature of matter, as explained by Wei, Liang, and Cheng:

The Department of Education is the dominant agency… . In particular, we need to take counsel with the Development and Reform Commission (fazhan he gaige weiyuanhui) when we are adjusting the planning of schools, such as the level, type, number, and location of schools. (Wei, 5 years)

We work with the Provincial Commission Office for Public Sector Reform (sheng gonggong bumen gaige weiyuanhui bangongshi). Recently, the office authorised the increase of approximate 2,000 teaching posts. The increase in the number of teaching posts means an increase in financial investment. That is to say, we also closely work with the Department of Finance… . In addition, we work with the Women’s Federation (fulian) and the Working Committee on Children and Women (funv ertong gongzuo weiyuanhui) and introduced initiatives such as free family hotlines and charitable libraries… . We are still the leading force in migrant children’s education. (Liang, 7 years)

We work with several government agencies, such as the Department of Public Security and Department of Public Health… . For example, the Department of Public Health establishes the health archives for migrant children, and monitors their physical and immunisation conditions (Cheng, 7 years)

Third, local governments did not work closely with private schools.

We also work with schools running by non-government sectors. But these schools do not play a key role. (Ling, 6 years)

Zhu ascribed the lack of cooperation to the mismanagement of these private schools.

According to the written policy, the local government ought to subsidise private schools which offer compulsory education programmes, for they act on behalf of the local government and alleviate the pressure of public schools… . However, practically speaking, many private schools do not use the government subsidy on students… . Now we have stopped subsidising some private schools… . Further refinements of practices and policies have to be made to tackle this issue before we further explore partnerships… . At present, private schools are definitely not the dominant part of migrant children’s education. (Zhu, 7 years)

Key Barriers

General Lack of Educational Resources

All officials agreed that the general lack of resources was a major barrier. This study has revealed three main characteristics. First, there is a lack of resources to provide high-quality education at the local level.

In our province, investment in education just reach 4% of the local GDP… . Considering our economic condition, 4% of the local GDP is not a huge amount of money… . Our total investment in education is low. (Liang, 7 years)

Cheng commented that the consistency between the ratio of educational expenditure to GDP at the local and state levels did not mean that investment in education was sufficient.

The total investment in education accounted for 4% of the country’s GDP. This figure was generated by local authorities in each province. Considering there is a huge economic difference between each province, 4% could mean 10 million Yuan in a metropolitan city, but it could also mean a 100,000 Yuan in a small town… . We need to pay attention not only to the amount and percentage of investment but also to the structure and quality of investment. (Cheng, 7 years)

Officials ascribed the underinvestment in education to low short-term returns on investment, as expressed by Ling and Li:

The local government is likely to increase financial input in the matters that can significantly contribute to the social and economic development… . Education is a long-term investment. The benefit from investing in education is cumulative. (Ling, 6 years)

For each level of government, it is more effective to spend their revenue on projects and businesses that will directly boost the local economy, such as constructing a new train station or widening the existing roads. (Li, 3 years).

Second, local governments did not prioritize educational equity. It seemed to Wei that there were more important targets in education that were yet to be achieved.

Making all citizens satisfied is the fundamental principle of education in our country… . We need to monitor many indicators other than educational equity. For example, an important indicator could be the effectiveness of allocation of educational resources to promote social and economic development. We prefer to spend more resources on professional and tertiary education because we think they can promote economic development at a faster speed. (Wei, 5 years)

In line with Wei’s comment, Cheng reckoned that some educational expenditures should take precedence over the expenses of addressing educational equity.

We will give priority to the payment of teachers’ and principals’ salaries, construction and maintenance of schools, and teacher training. (Cheng, 7 years)

In contrast, the two officials maintained that the local government should increase its educational equity input. Ling’s sentiments are as follows:

We should increase investment in migrant children’s education… . Even though migrant workers’ salary is relatively low, they are still a part of local taxpayers… . We need to formulate long-term plans if we really want to improve educational equity. (Ling, 6 years)

Third, the financial assistance received from higher levels of government is insufficient. Officials reflected on two important methods of financial assistance from the higher levels of government: the school voucher system (jiaoyu quan) and direct transfer payments (zhuanyi zhifu). It seemed to the officials that neither initiative had compensated for the deficiency of educational funding at the local level.

In the past, compulsory educational fund granted by the state went to the place where migrant children originally came from. Later we introduced the school voucher system so that host cities would receive this fund… . The amount of fund is 725 Yuan per person for lower-secondary school students, and 525 Yuan per person for primary school students… . This amount of money is little more than a drop in the ocean for improving the condition of local education. (Zhu, 7 years)

The central government does make direct transfer payment to improve the condition of local education. This payment was increased to 100 million Yuan in the last year and is likely to continue to rise. However, the payment is far from enough to cover the shortfall in the local educational expenditure. (Liang, 7 years)

Uneven Distribution of Good Teachers

Officials also believe that the uneven distribution of good teachers is a major obstacle. Liang acknowledges the importance of teachers.

Migrant workers earn their living by manual work, and they have limited time and capacity for their child’s study. It is expected that teachers will spend more time with migrant children and know every child very well… . It is critical that teachers have good knowledge and flexibility to help migrant children to catch up with their studies. (Liang, 7 years)

However, the competence of migrant children’s teachers is often subpar.

We have set the minimal design and construction standard for schools. Also, we have a basic requirement of the maintenance of school facilities… . However, teachers’ knowledge and ability vary significantly… . A lack of qualified teachers is the main obstacle. (Li, 3 years)

Officials seemed to have similar opinions on the reasons for the huge diversity in teacher competence. The opinions of many officials were well-expressed by Zhu and Liang:

Teachers from schools primarily hosting local children are reluctant to work at schools primarily hosting migrant children… . This is because children studying at the former usually have an above-average family background, and their parents are likely to be well-educated… . Naturally, it is easier to teach these children than to teach migrant children… . In addition, these schools are likely located in downtown areas, which also brings convenience to teachers. (Zhu, 7 years)

Working for a school primarily hosting resident children benefits teachers’ professional development. It helps to present a better personal image when evaluating the conferring of a senior teaching post and attending teachers’ conferences. (Liang, 7 years)

To optimize the allocation of teaching resources, the local government introduced several practices to facilitate the exchange of teachers between schools.

In our city, teachers who have 6 years of teaching experience in the same school are required to do a temporary job rotation in nearby public schools. In addition, teachers who want to be on the shortlist of “municipal top-tier teachers” are required to have at least 1-year work experience in low-performing schools… . These initiatives are all aimed at improving educational equity… . However, the implementation of these initiatives has not been very successful. (Li, 3 years)

From Li’s perspective, the implementation of these practices was not successful because it infringed on the legitimate interests of key stakeholders.

Some teachers feel it is unfair to ask them to leave the workplace they know well… . Principals believe it is a waste of resource because every teacher exchange from other schools needs to be retrained to meet new requirements… . Parents who sent their children to distinguished schools cannot accept teachers exchanged from lower-performing schools. (Li, 3 years).

Lack of Reform to the Household Registration System

Officials believed that the high mobility of migrant children was a key issue, as expressed by Wei and Liang.

The number of migrant children is unpredictable… . It is challenging for us to plan for the construction of schools, recruitment of teaching staff, and so on… . We cannot just idle infrastructures and resources. (Wei, 5 years)

When migrant children’s mobility is fairly high, it is a heavy task for us to control the dropout rate… . Besides, it is hard to manage migrant children’s academic archives and school transfers. (Liang, 7 years)

Superficially, the high mobility of migrant children poses a major difficulty. However, one should not forget that the underlying reason for their high mobility is the implementation of the household registration system. Ling acknowledged the importance of system reform:

The phenomenon of migrant children is primarily induced by the household registration system… . It would be hard to imagine that we can fully achieve educational equity if the system and its related policies remain unchanged… . It is critical that the central government will tinker with and reform the system. (Ling, 6 years)

In line with Ling’s opinions, Li commented that the issue of educational equity should not only be treated as an educational problem but also as a social task.

Migrant children’s education involves more than just the problem of education. It certainly concerns many other rights of migrant children and their parents, such as health insurance, housing, and social benefit… . It is important for the government to deepen reforms. (Li, 3 years)

Some officials did not explicitly comment on the system’s reform. However, they also agreed that the system could have negative consequences for equity in education.

We implement a school district system. The quota of best schools in our city is allocated to local students residing in nearby communities… . Although migrant children hope to have access to good educational resources, we have to admit that our capacity is limited. We must give the highest priority to local students. (Cheng, 7 years)

Zhu further explained the effect of the system on migrant children and their education.

Primary and lower-secondary schools will give priority consideration to children from nearby school districts and those who hold local permanent residency. After that, schools will accept applications from migrant children. In most cases, places in good schools would have been taken by resident children by the time application is open for migrant children. Therefore, migrant children are almost always studying at less selective and low-performing schools… . At present, migrant children do not have to pay tuition, miscellaneous, or temporary schooling fees. However, it is not uncommon to see top-tier schools charge migrant children with education endorsement fees… . In our provincial capital, schools are allowed to recruit 5% of students who do not belong to their school district. If migrant workers want to send their children to better schools, they have to pay education endorsement fees. This fee ranges from 10,000 to 20,000 Yuan per head for the 6-year primary study. This is a lot of money for migrant workers. The majority of migrant workers are either reluctant or unable to pay. (Zhu, 7 years)

Discussion

The evidence from this study suggests several major characteristics of the practices advocated by local governments. These were almost exclusively related to migrant children’s access to education because access was perceived to be the premise of achieving other aspects of educational equity. Local governments have paid greater attention to the primary and lower secondary stages of migrant children’s education. This is because primary and secondary education was compulsory and enforced by the law, coupled with the fact that migrant children at the primary and lower-secondary stages of education were less independent. In addition, there was no dedicated task force. Although several government agencies worked on migrant children’s education, the provincial education department played a dominant role. The local government does not work closely with private schools for migrant children’s education because of a lack of trust in them.

These findings support the idea that migrant children experience inequalities at various educational stages (Xiang et al., 2020). Targeting earlier stages of education could potentially prevent the rise of bottlenecks; that is, too many would-be university students fail to complete compulsory education because they do not possess permanent residency in host cities (C. Wang et al., 2020). The findings also confirm the change in central government policies, such as relaxing restrictions on the rural–urban movement of migrant children and recognizing public schools as the primary choice for migrant children’s education in host cities, reflecting the everyday practices of local governments.

These practices appear to reflect the two dimensions of educational equity identified by Field et al. (2007): fairness and inclusion. On one hand, the local government made efforts to ensure that personal and social circumstances, such as a lack of permanent local residency, did not obstruct migrant children’s access to education. On the other hand, the local government strived to guarantee basic primary and lower secondary education for all children. It appears that local governments have attempted to provide fair and inclusive education for all children.

However, it should not be forgotten that achieving educational equity requires a special configuration of inequalities (Karlsson et al., 2020). Therefore, different strategies and courses of action should be applied to different groups of children. Evidence from this study suggests that there are at least two different strategies. The first is the provision of special assistance to migrant children, such as the establishment of family hotlines and charitable libraries. The second is to encourage the exchange of teachers between schools, aiming to improve teaching standards in lower-performing schools. However, the impacts of these practices require further exploration. The first strategy seemed to be more of a social care initiative than an educational treatment. The second strategy proved to be unsuccessful. Whether these actions will bring real changes to educational equity is questionable.

The findings revealed that other practices aimed at improving migrant children’s education were exemptions from fees and simplified admission procedures. However, these practices seemed to support the idea that “everyone shall have the same [resources]” (Herrera, 2007, p. 323) rather than “resources will need to be distributed ……on a criterion of need” (Espinoza, 2007, p. 348). For example, the local government provides all public schools with the same level of subsidies based on the number of students, whereas schools receiving more migrant children demand higher subsidies from the local government than those receiving more resident children. In other words, the evidence seemed to suggest that the local government provided resources to both resident and migrant children, but such a provision did not consider the special needs of disadvantaged groups. This finding resonates with ethnographic fieldwork showing that urban schools tend not to offer private tutoring or remedial programs to help migrant children catch up with their studies while adopting innovative pedagogical practices and urban-oriented teaching content with which they are unfamiliar (D. Zhang & Luo, 2016). Extant literature has shown that several indicators of migrant children, such as self-esteem (B. Zhou & Zhong, 2022), parent–child attachment (Shuang et al., 2022), and life satisfaction (J. Zhang, 2018), are substantially lower compared to those for resident children, and migrant children have a higher likelihood of displaying behavioral and psychological problems, such as aggressiveness (H. Hu et al., 2018), bullying (K. Cui & To, 2019), and self-accusation (Junhua Zhang, Yan, & Yuan, 2019). To truly promote educational equity, local governments are advised to implement evidence-based interventions such as mindfulness sessions (Lu et al., 2018), summer reading programs (Q. Guo et al., 2021), and resilience-based social work practices (Huang et al., 2022), just for migrant children.

This study identifies three key barriers. The first is the general lack of educational resources, which is reflected in the following three aspects: First, total expenditure on education is low. This is because local governments prefer to spend their revenues on sectors that can directly promote economic growth. Education is perceived as a long-term investment, and the effects of such investments may not be conspicuous in the short term. Second, local governments did not prioritize educational equity. Other educational expenditures, such as teachers’ salaries and school construction, were perceived as more salient. Third, the financial assistance received from higher levels of government for migrant children’s education is insufficient. Although the local government was chiefly responsible for raising the education budget, it seemed that more funding was expected from higher levels of government. These findings confirm the results of a recent study showing that educational resources are constrained and disproportionally distributed in developed Chinese cities, and migrant children will be marginalized in host cities’ school systems as long as competition for quality educational resources exists (Xu & Wu, 2022), particularly when educational equity is not prioritized by the government (S. Liu et al., 2017). School quality factors such as expenditure and student-to-teacher ratio can effectively explain the variance in migrant children’s academic performance (Y. Li et al., 2020). Increased investment narrows the achievement gap between students in migrant children’s schools and their peers in public schools (Y. Chen & Feng, 2017). It is, therefore, paramount that different levels of government provide additional financial assistance to this disadvantaged and marginalized group.

The second barrier is the uneven distribution of good teachers. Teachers from schools that mainly host resident children are more qualified than those from schools that primarily host migrant children. This is because teaching in schools that host mainly resident children is more convenient for teachers (e.g., reduced workload and accessible transportation) and enhances teachers’ professional identity. The local government has formulated policies to encourage the exchange of teachers among schools. However, this proved unsuccessful because such policies infringed on the vested interests of teachers, school administrators, urban students, and their parents. Teachers who are reluctant to rotate may simply perform their jobs perfunctorily and high-performing schools may not care about spending resources on training less experienced or less competent teachers who will eventually not stay (Wu, 2020). The parents of resident children also demand that the quality of education should not decrease because of the influx of migrant children (S. Liu et al., 2017), even though a higher proportion of migrant children in class demonstrates an overall positive effect on local students’ academic performance (H. Wang et al., 2018). A well-intended teacher rotation policy may not be the best option for improving the educational equity of migrant children. The implication is that local governments should seek alternative strategies to narrow the gap between the quality of teachers in schools that mainly host resident children and those that primarily admit migrant children. For example, Owens and Candipan (2019) and Turetsky et al. (2021) found that income inequality is an essential factor in the uneven distribution of teacher quality among schools, and suggested the need for policymakers to mitigate income inequality. García and Weiss (2019) highlighted the need to distribute the best teachers fairly among schools serving children of all backgrounds, and suggested that incentives should be provided to attract and retain teachers. Goldhaber et al. (2019) proposed the following strategies to close the teacher quality gap: (1) using financial incentives such as retention bonuses for educators who serve in disadvantaged schools, (2) improving working conditions at low-performing schools, (3) improving hiring practices at disadvantaged schools to identify and eliminate less effective candidates, and (4) training more student teachers at low-performing schools.

The evidence from this study also revealed that improving educational equity for migrant children was a social mission in addition to being an educational task. There were several government agencies working on migrant children’s education. This is likely because the issue of migrant children’s education not only concerns migrant children or education itself but also other stakeholders and social benefits. Officials seemed to suggest that inequality in residency status was one cause of inequality in education. The household registration system not only hindered migrant children from enjoying better schooling but also led to their high mobility, which further resulted in difficulties in school planning and management. The evidence confirms that enhancing educational equity should be considered in the larger context of social justice (Lu & Zhang, 2004; Xiong, 2015) and that barriers related to the household registration system should always be considered in studies on migrant children’s education (Ma & Wu, 2019).

Studies have suggested that both will and capacity are essential to improving educational equity (Bishop & Noguera, 2019). Will implies the willingness of individuals or groups to take action to improve equity, while capacity refers to the knowledge and abilities of those individuals or groups (Levin, 2003). The evidence from this study suggests that the local government lacked the will to address the issue of migrant children, as it prioritized the development of undertakings that could directly boost the local economy. Similarly, the Department of Education was reluctant to spend public funds on equity because it considered other educational expenses and performance indicators more salient. Evidence also shows that local governments lack the capacity to improve equity. Officials acknowledged that the uneven distribution of teachers was a major barrier; however, there was a lack of effective measures to address this issue. It seemed that the only attempt was to encourage the exchange of teachers between schools, hoping to improve the standards of teaching in low-performing schools. However, there is still a lack of effective remedies, even after this attempt has been unsuccessful. These observations are consistent with past research showing that local governments have low motivation and insufficient capacity to implement policies designed by the central government owing to the financial burden on local governments and the limited number of teachers and student spaces in public schools (S. Liu & Zhao, 2018). These observations also confirm that pursuing rapid economic development and maintaining social stability are priority agendas of local governments (S. Liu et al., 2017).

Implications

The findings from this study have implications for policy and practice. The central government is encouraged to conduct in-depth, systematic, and longitudinal research to monitor educational equity. These results suggest that local governments may lack persistent political interest in promoting educational equity for migrant children. This is partly because education for migrant children is not a significant factor when evaluating a local government’s performance, and the effect of such investments is inconspicuous. An improvement plan for migrant children’s education should be incorporated into the local development scheme, and its outcomes should be measured when evaluating the effectiveness of local governments. Such a plan is likely to ensure continuous improvements in educational equity (Montgomery, 2012). In addition, this study reaffirms that inequality in education is partially attributable to the implementation of the household registration system (X. Li et al., 2010; Xiong, 2015), and that local governments’ practices were hindered by this system (Wei & Hou, 2011; J. Yang et al., 2014). Therefore, the central government is advised to continue reforming the household registration system and re-examine practices aimed at migrant workers and their children.

Local governments are also advised to pay more attention to equity in education through initiatives, such as assessing the implementation of inclusive education policies and allocating more funding to support teachers in migrant children’s schools (T. Liu et al., 2020). The effect of such an investment may not be evident in the short run, whereas the long-term benefits can be tremendous. Apart from being denied admission to urban public schools, migrant children face many other challenges, such as adapting to new school environments and living in adequate housing (Z. Zhou et al., 2019). Those attending migrant schools receive the least educational support from their families (Jin et al., 2017) and require additional attention and support from local governments (Sun et al., 2020). Promoting educational equity is not only closely associated with improved employment, quality of life, health, and parenting (Assari, 2019), but also with higher levels of social cohesion (Green & Preston, 2001) and better utilization of talent within society (Levin, 2003; Spruyt, 2015). Additionally, the financial cost of educational failure is high (Fitzpatrick et al., 2020). It is for such reasons that the local government is obliged to address educational inequalities by developing long-term strategic plans and spending more resources on education for migrant children. Closing the gap in educational inequality has long-term political and economic implications, as providing equal educational opportunities for migrant children could alleviate social tensions in cities, lessen income inequality, and facilitate a country’s transition to a service-based economy (Montgomery, 2012). Disregarding educational inequality is detrimental to society. As Jiang (2022) noted, migrants who lack access to equal educational resources may struggle to escape poverty and integrate into the local society.

Limitations

A limitation of this study is that it uses a single case study. Although the case and interviewees were carefully selected to represent the relevance of the phenomenon, the results may not be generalizable to other contexts. Future research using a multiple case study approach will contribute to an improved understanding of the education of migrant children in China. Alternatively, future research could be conducted in larger metropolitan cities where the number of migrant children is much higher than the national average. Cities that host substantially more migrant children may present different practices and barriers compared to cities that host fewer migrant children. It is important to compare the similarities and differences between these characteristics to generate a more comprehensive view of migrant children’s education and provide informed policy recommendations for improving educational equity.

Conclusions

The educational success of migrant children is not only critical for individual upward mobility, but also fundamentally impacts society’s economic well-being and social stability. Most empirical research pertinent to migrant children’s education has sought the perspectives of students, migrant workers, teachers, and school administrators. Local governments take the primary responsibility for migrant children’s education, and they allocate resources, supervise and inspect education activities, implement national policies, and establish policies at the local level. However, few studies have examined local government practices and barriers to promoting educational equity among migrant children. This study fills this knowledge gap by investigating the practices advocated by local governments in East China to improve the educational equity of migrant children and the barriers they may encounter.

Through interviews, the researcher found that the practices advocated by the local government had five characteristics: (1) they were almost exclusively related to migrant children’s access to education; (2) the local government paid greater attention to the primary and lower-secondary stages of migrant children’s education; (3) there was no task force dedicated to migrant children’s education; (4) although several government agencies worked on migrant children’s education, the provincial education department played a leading role; and (5) the local government did not work closely with private schools on migrant children’s education because of a lack of trust. The findings also suggest three key barriers to promoting educational equity: (1) lack of educational resources, (2) uneven distribution of good teachers, and (3) lack of household registration system reform.

Currently, improving educational equity is often shadowed by developing economies and other social undertakings. However, one cannot afford to sacrifice migrant children’s futures for economic gain. Strengthening social support not only contributes to the development of migrant children’s resilience (Song et al., 2019) and educational aspirations (Fang, 2016), but also reduces their involvement in delinquent activities (S. D. Li & Xia, 2018). Equity in education should not be merely regarded as a tactic to enhance short-term social stability but as a genuine will and action to achieve greater equity. Inequality leads to a higher incidence of crime (Fajnzylber et al., 2002). An increase in educational attainment substantially reduces crime and generates sizable social benefits (Lochner, 2020). It is critical that different government levels acknowledge the non-production benefits of educational equity, monitor the state of educational equity, formulate short- and long-term strategies to combat educational inequalities, and continuously refine these strategies. Based on this study’s findings, several recommendations are provided. The central government should conduct systematic and longitudinal research to monitor educational equity. Local governments should develop continuous improvement plans for educational equity. When evaluating the performance of a local government, the outcomes of the improvement plans should be considered. Finally, pilot reforms in the household registration system should be continued by the local government with a focus on measuring their effectiveness.

Footnotes

Appendix A: Interview Questions

Acknowledgements

The authors would like to thank the anonymous reviewers for their constructive feedback.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the National Natural Science Foundation of China [Grant number 72204072].

Ethical Approval

This study follows the ethical review guidelines and was approved by the Departmental Research Ethics Committee.

ORCID iDs

Ruiqi Deng

Yifan Gao

Data Availability Statement

As per the ethics approval agreement, the data used in this paper cannot be made publicly available for participant privacy reasons.

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Practices and Barriers to Promoting Educational Equity for Migrant Children in China from the Perspective of a Local Government

Abstract

Keywords

Introduction

Literature Review

Education for Migrant Children: A Policy Perspective

Key Issues in Education for Migrant Children

Access to Education

Resources

Educational Performance

Level of Educational Attainment

Educational Equity

Methods

Case Study Approach

Semi-Structured Interviews

Ethics Considerations

Data Collection Procedures

Data Analysis Procedures

Research Objectivity

Results

Key Practices

Improving Access to Education Is the Task of Top Priority

Primary and Lower-Secondary Stages of Education Receive Greater Attention

Key Practices Are Primarily Related to Access to Education

The Provincial Education Department and Public Schools Play a Crucial Role in Migrant Children’s Education

Key Barriers

General Lack of Educational Resources

Uneven Distribution of Good Teachers

Lack of Reform to the Household Registration System

Discussion

Implications

Limitations

Conclusions

Footnotes

Appendix A: Interview Questions

Acknowledgements

Declaration of Conflicting Interests

Funding

Ethical Approval

ORCID iDs

Data Availability Statement

References