Cost of Care and Redirection of Resources

Developing a high quality alternative care system requires adequate funding and resources. In countries that are working to reform their care systems, efforts are needed to redirect financing from residential care options towards new initiatives that support parents, prevent family separation, and provide children with a range of family and community based care alternatives.

Cost-benefit studies of different forms of alternative care demonstrate that it makes good economic sense for governments to invest in family based alternatives rather than residential care. While costs may increase for a temporary period as countries make the shift to family-based care – for example to fund training of social workers, develop social welfare services and establish tracing and foster programmes – in the long run it costs less than keeping children in institutions where funds are required to pay salaries for staff, maintain buildings and provide food and other services. The bottom line is that for the cost of keeping one child in residential care, many more girls and boys can be supported within families.

Funding for care reform involves allocating (or redirecting) resources from institutional care towards a range of family-based care services, investing in the development of a competent social welfare workforce, supporting carers, and providing financial and practical support to children leaving care. It also means investing in programmes that tackle the factors that lead to family separation and children being placed in alternative care – such as poverty, unemployment, disability, health and conflict. This could include promoting access to basic health, education and housing services, developing social protection and financial assistance initiatives, and working to strengthen families through parenting education or counselling.

Governments also need to make a commitment to putting in place licensing and regulation mechanisms to ensure that funding of care is motivated by children’s best interest rather than the financial benefit of the provider – and that resources are directed towards families rather than institutions. Unfortunately in many countries, there are vested interests in admitting or keeping children within formal care (particularly residential facilities) for profit-making, and large numbers of private care facilities operate outside the control of authorities.

The literature in this section focuses on budget and cost analysis pertaining to children’s care, including preventive services to support family based care and the provision of a range of alternative care options.

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Assessing Alternative Care for Children in Uganda

Ismael Ddumba-Nyanzi, Michelle Li, Uganda country core team - MEASURE Evaluation, USAID, 01 Jun 2018

This report presents the findings from an assessment workshop aimed at informing action planning to address high-priority needs identified in alternative care for children in Uganda.

Assessing Alternative Care for Children in Moldova (Volume 2)

Molly Cannon, Camelia Gheorghe, Moldova country core team - MEASURE Evaluation, USAID, 01 Jun 2018

This report presents the findings of an assessment workshop aimed at informing action planning to address priority needs identified in alternative care for children.

“It’s Not a Job!” Foster Care Board Payments and the Logic of the Profiteering Parent

Melissa Hardesty - Social Service Review, 01 Mar 2018

This ethnographic study of a foster care adoption program shows how board payments elicit commodification anxiety at this local site, and in American culture more broadly.

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Maintain, Strengthen, Expand - How the EU Can Support the Transition from Institutional to Family- and Community-Based Care in the Next Multiannual Financial Framework

Opening Doors for Europe's Children, 01 Mar 2018

This publication from Opening Doors for Europe's Children calls upon the EU to maintain, strengthen and expand the use of funds so they make a greater impact and go further to eliminate institutions for children across Europe and beyond.

Strengthening Families, Ending Institutional Care: Recommendations to the European Union on Post-2020 Multi-Annual Financial Framework

Opening Doors for Europe's Children, 01 Feb 2018

This report from Opening Doors for Europe's Children presents recommendations to the EU on how best to include deinstitutionalization and children's care as a part of the next multiannual financial framework.

A Case for Investing in HIV-Sensitive Social Services for Vulnerable Children in Nigeria

Shar Kurtishi, David Akpan, Tapfuma Murove, Kelley Bunkers, & Doreen Magaji - Journal of Poverty, Investment and Development , 2018

A desk review was conducted to examine the current gaps in investment related to care and treatment for children living with or affected by HIV.

Child Abuse Research in South Africa - An assessment of the accomplishments of selected child and youth care centres in providing care and protection of children in Soweto, South Africa

Pius T. Tanga and Leonard M. Agere - South African Society on the Abuse of Children (SAPSAC), 2018

The paper articulates accomplishments of child and youth care centres in providing care and support to children identified to be at risk of significant harm in Soweto, South Africa.

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Childonomics: A Conceptual Framework

Andy Bilson, Maria Herczog, Jean Anne Kennedy, Volodymyr Kuzminskyi and Joanna RogersOxford Policy Management, in association with IFCO and Partnership for EveryChild, 01 Dec 2017

This paper presents the conceptual framework for the Childonomics research project, which has developed the first iteration of a methodology that helps people to reflect on the long-term social and economic return of investing in children and families within a given national or sub-national context.

Improving Child Welfare Outcomes Balancing Investments in Prevention and Treatment

Jeanne S. Ringel, Dana Schultz, Joshua Mendelsohn, Stephanie Brooks Holliday, Katharine Anne Sieck, Ifeanyi Edochie, Lauren Davis - RAND Corporation, 01 Dec 2017

This study is the first attempt to integrate maltreatment risk, detection, pathways through the child welfare system, and consequences in a comprehensive quantitative model that can be used to simulate the impact of policy changes.

Estimating minimum adequate foster care costs for children in the United States

HaksoonAhn, Diane DePanfilis, Kevin Frick, Richard P. Barth - Children and Youth Services Review, 03 Nov 2017

The objectives of this study are to: use the methodology of a 2007 study to establish foster care minimum adequate rates for children (MARC) based on the child's age and geographical location in every state; update the MARC with cost of living adjustments to 2016; examine changes in gaps between the MARC and the current foster care rates; and identify states that have made increases to their reimbursement rates, relative to the MARC over time.

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