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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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.

Strengthening Child Protection Systems in Sub-Saharan Africa: A Working Paper

Rebecca Davis,Jim McCaffery, and Alessandro Conticini , 01 Aug 2012

This paper is a response to the increasing need for agreement on approaches and documented evidence of good practices consistent with system strengthening work. The purpose of the Inter-Agency Working Paper is to consolidate current thinking, examples and lessons learned about child protection system strengthening in sub-Saharan Africa and suggest a way forward.

Social Security for All: The ILO Social Protection Floors Recommendation (Briefing Note)

International Labor Organization , 01 Jun 2012

This International Labour Organization (ILO) brief introduces a new international standard adopted in June 2012, the Social Protection Floors Recommendation, 2012 (No. 202), that provides guidance to member States in building comprehensive social security systems and extending social security coverage by prioritizing the establishment of national floors of social protection accessible to all in need.

Preventing the separation of children from their families in Bosnia and Herzegovina: Review of Hope and Homes for Children ACTIVE Family Support

Hope and Homes for Children , 01 Apr 2012

Hope and Homes for Children has been implementing ACTIVE Family Support in Sarajevo Canton in BiH since 2003. The program consists of two elements: the prevention of separation of children from their parents as the primary focus, and the reintegration of separated children from institutions back into their biological families. This unique and holistic program is tailored to the individual needs of each child and family and it is built on the following core values: partnership, respect, inclusion, sustainability and the best interest of the child.

The economic burden of child maltreatment in the United States and implications for prevention

Xiangming Fang, Derek S. Brown, Curtis S. Florence, James A. Mercy , 01 Feb 2012

This paper presents new estimates of the average lifetime cost per child maltreatment (CM) victim in the United States and aggregate lifetime costs for all new cases of CM incurred in 2008 using an incidence-based approach. The authors find that the lifetime economic burden of CM is approximately $124 billion. Given this substantial economic burden, the authors argue that the benefits of prevention will likely outweigh the costs for effective programs.

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Child Rights in Central and Eastern Europe and Central Asia: Keeping Families Together: Making social protection more effective for children

Peroline Ainsworth, Elena Gaia, Anna Nordenmark Severinsson, 2012

This edition of Insights produced by UNICEF summarizes the findings and recommendations of studies on the impact and outreach of social protection systems in Albania, Kazakhstan, and Ukraine where high rates of child placement in formal care still persist. The research offers important insight into the weaknesses and challenges faced by social protection systems in the region, but also point to ways in which policy-makers might maximise the impact of social protection systems in order to ‘keep families together’.

Towards Alternative Child Care Services in Armenia: Costing Residential Care Institutions and Community Based Services

UNICEF Armenia, 01 Aug 2011

This recent study by UNICEF in Armenia costed different types of residential care and community based services.

Strengthening Human Resources and Financing for Child Care and Protection Services

Ministry of Gender, Labour and Social Development - Uganda, 01 Aug 2011

This paper highlights human resource and funding gaps that constrain provision of child care and protection services. It advocates for strengthening of social welfare workforce and funding to improve child care and protection services in Uganda.

Too Little, Too Late: Child Protection Funding in Emergencies

Global Protection Cluster , 08 Jul 2011

Report underscoring the need to examine protection in its entirety and ensure that all dimensions of the protection response are adequately supported

Changing Minds, Policies and Lives: Toolkit on Redirecting Resources to Community Based Services

M. Norberg, A. Sahlback; Contributions from L. Fox and R. Gotestam for UNICEF, 17 Feb 2010

This folder contains guidance and planning and assessment tools to implement reform of national social care financing from institutionalized care to a family and community-based framework.

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