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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Alternative Care Provision for Children in Bosnia And Herzegovina

Agency for Statistics of Bosnia and Herzegovina, 24 Sep 2014

This document from the Agency for Statistics of Bosnia and Herzegovina provides an overview and assessment of the alternative care system in the country.

Drumming Together for Change: A Child’s Right to Quality Care in Sub-Saharan Africa

SOS Children’s Villages, Centre for Excellence for Looked After Children in Scotland, University of Malawi, 2014

This report is based on a synthesis of eight assessments of the implementation of the Guidelines for the Alternative Care of Children (“the Guidelines”) in Benin, Gambia, Kenya, Malawi, Tanzania, Togo, Zambia and Zimbabwe.

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Country Care Review: Uzbekistan

Better Care Network, 12 Aug 2013

This Country Care Review includes the care-related concluding observations on the third and fourth periodic reports of Uzbekistan, adopted by the Committee on the Rights of the Child at its sixty-third session (27 May–14 June 2013), as well as other care-related concluding observations, ratification dates, and links to the Universal Periodic Review and Hague Intercountry Adoption Country Profile.

A Goal and targets on child protection for the post-2015 development framework

Family for Every Child and Partners, 01 May 2013

This statement from a group of international and national agencies working towards children's protection include recommendations for the inclusion of a major goal and specific targets on children's care and protection as part of the framework that will replace the current Millennium Development Goals in 2015.

EU Commission Recommendation (2013/112/EU) on Investing in Children

European Union, 20 Feb 2013

This Recommendation by the European Commission on Investing in Children, stresses the importance of early intervention and preventative approaches, and makes quality childcare one of its key policy areas to break the cycle of disadvantage in early years and reduce the risk of child poverty and social exclusion.

Predicting the cost and impact of cash transfer programmes: the power of microsimulation tools

Oxford Policy Management, 01 Feb 2013

Cash transfers to households are becoming an increasingly common policy instrument for reducing poverty in some countries of sub-Saharan Africa. This Briefing Note describes a simple ex-ante ‘microsimulation’ tool to determine whether launching a cash transfer programme will have an affordable impact on poverty.

Unit Costs of Health and Social Care 2013

Lesley Curtis- Personal Social Services Research Unit, University of Kent, 2013

This report is a compilation of health and social care costs in the UK for the year 2013, including an article and corresponding information on the costs of residential care for children.

Preparing and Supporting Foster Parents Who Adopt

Child Welfare Information Gateway - Children’s Bureau, 2013

This document provides an overview of the benefits, costs, and practice implications for adoptions from foster care in the US.

Cost-effectiveness of models of care quality for children affected by HIV and AIDS in Nepal

Pradhan PM, Bhatta G, Bam K , 01 Nov 2012

This research study aimed to identify and assess the cost effectiveness for existing models of care for children affected by HIV and AIDS in Nepal. The study performed a cost effective analysis for three types of care models in order to provide program managers and childcare professionals comparative economic evidence of the cost of caring for these children.

Toolkit on the Use of European Union Funds for the Transition from Institutional to Community-based Care

European Expert Group on the Transition from Institutional to Community-based Care, 01 Nov 2012

The purpose of the toolkit is to assist all public authorities in Europe involved in the programming and implementation of EU Structural Funds (and other relevant funds) to make decisions which will help to improve the lives of more than a million European citizens currently living in institutional care. The toolkit aims to explain how EU funds can support national, regional and local authorities in designing and implementing structural reforms to develop quality family-based and community-based alternatives. The toolkit explicitly deals with the European Social Fund (ESF) and the European Regional Development Fund (ERDF), but it aims to apply also to the programming and implementation of the European Agricultural and Rural Development Fund (EARDF) and the Instrument for Pre-accession Assistance (IPA).