Social adaptation of Chinese left-behind children: Systematic review and meta-analysis

Abstract

Background

Existing literature shows several discrepancies between left-behind children (LBC) and non-left-behind children (NLBC) in social adaptation. The role of gender among LBC was widely investigated, reporting different perspectives. Therefore, the aim of this meta-analysis is to examine these inconsistencies and to investigate how these factors affect social adaptation in a Chinese sample.

Methods

Literature search was conducted on PubMed (Medline), OVID, Web of Knowledge, CNKI, Wan fang and Chongqing VIP database without language/date/type of document restrictions until August 11, 2018. The Software Comprehensive Meta-Analysis 3.0 with the Random effects model was used to compare all the selected articles. Moreover, study quality was assessed with a checklist, while sensitivity analysis was performed after having removed graduate thesis, in order to test the robustness of the results.

Results

A total of 13studies met study criteria with 7368LBC and 8894NLBC.LBC scored significantly lower in social adaptation with evidence of true heterogeneity. Sensitivity results and subgroup analysis indicated the robustness of the results. There was no difference between left-behind boys and left-behind girls.

Conclusion

Compared with NLBC, LBC had lower social adaptability. Studies with higher quality are needed to example factors such as scales, region and age of LBC and future research should focus on how to improve social adaptation of LBC.

PROSPERO Registry: Systematic review registration no.: CRD42018106433.

Introduction

A matter of concern is related to left-behind children (LBC), which are supposed to be at higher risk of developing mental health problems compared to their non-left-behind counterparts (Rosa María, Nelly Salgado, Martha, & María Elena, 2004). One of the causes of LBC is parental migration. In fact, many developing countries - or entire regions of these - are witnesses of a parental exodus, since leaving appears to be the only solution to guarantee a better outcome to the next generation. Despite the quality of life appears to improve, this phenomenon may have an impact on children psychological side. If one or both parents move far away, children tend to become more vulnerable to developmental problems, experiencing loneliness, worse academic performance and less psychological well-being. (Battistella, Graziano, & Conaco, 1996; Hugo, 2002). However, the overall impact of parental migration on LBC's development outcomes is not so clear-cut. In fact, while findings demonstrate that LBCs are more likely to feel poor psychological well-being in Thailand and Indonesia, researches conducted in Philippines and Vietnam did not show the same results (Antman, 2011). Reasons partly lied in the fact that the negative impact of parental absence may be overwhelmed by the positive effect of the increased family earning (Gordon Hanson and Christopher Woodruff, 2003; David McKenzie and Hillel Rapoport, 2006) However, more contextualized understandings will be needed. (Graham & Jordan, 2011).

In this framework, grandparents usually become an essential substitute in taking care of children (Senaratna, 2012). However, this arrangement may be potentially fraught, because of the necessary negotiation between the older generation, the migrant parents and LBC (Hoang, Lam, Yeoh, & Graham, 2015).In any case, grandparent-child relationships play a very important role in predicting their school engagement (Song, Ma, Gu, & Zuo, 2018). With regard the health service utilization among caregivers of LBC in poor rural areas an extremely low status was found (Ji et al., 2017). Tan compared the nutrition knowledge, attitudes and behaviors of parent care givers and non-parent caregivers and found that non parent caregivers had relatively poor nutrition (Tan et al., 2010).

In recent years, the problem of migrant children has become one of the most dominant social issues in China, due to the new household registration and the increasing number of LBC. In fact, with the acceleration of the process of modernization and urbanization, the number of internal migrations - from rural to urban areas, to geta better job - has increased significantly in China (J. Zhang, Yan, & Yuan, 2018). Whilst migrant farmer-workers performed the back-breaking work, supporting the urban construction and economic growth, they suffered the social price of the China's economic boom (Ye, 2011). Because of limited access to social services - governed by the provincial or city policy (L. M. Xu, Cheung, Leung, & Xu, 2018) - and noncompulsory-education barriers (S. Y. Xu, Zhu, & Li, 2013), many migrant workers had to leave their children behind in-home village, under the care of grandparents or others.

In China, a left-behind child is a rural child <18 years, who has one or both parents working outside the home village for >6 months. Despite the number of LBC shows a downward trend in rural areas, the rate is supposed to remain rather high thereafter. Indeed, according to a study in 2017, there are 17,262,900 LBC in the Chinese compulsory education stage (Yuan, 2017).