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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Mass Orphanhood in the Era of HIV/AIDS: Bold Support for Alleviation of Poverty and Education May Avert a Social Disaster

Neddy Rita Matshalaga and Greg Powell , 2002

A brief editorial which argues that only by addressing the fundamental causes of the HIV/AIDS epidemic, such as poverty and social exclusion, will a sustainable solution be achieved. Support for extended families and education for children affected by HIV/AIDS are needed to respond the crisis, as well as a larger scale effort to transfer resources, strengthen economies and secure investments throughout Africa.

Costs of Care and Support

Tim Quinlan and Chris Desmond, 31 Dec 2001

Discussion of the cost of care and support for children affected by HIV/AIDS in South Africa, with a recommendation for the combined use of state based interventions and community based solutions.