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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The Cost of Case Management in Orphans and Vulnerable Children Programs: Findings from South Africa

MEASURE Evaluation, 2019

This brief outlines the findings from the Government Capacity Building and Support project, in South Africa, which Pact implemented with support from three partners and the South African Department of Social Development.

The Cost of Case Management in Orphans and Vulnerable Children Programs: Findings from Uganda

MEASURE Evaluation, 2019

This brief outlines the findings from the Better Outcomes for Children and Youth project, in Uganda

Investing in Adoption: Exploring Child Development Accounts for Children Adopted from Foster Care

Wright, Amy Conley - Journal of Sociology & Social Welfare, 01 Dec 2018

This article suggests that financial supports for adoption could be extended by introducing Child Development Accounts for children adopted from foster care in New South Wales, Australia.

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Maintain, strengthen, expand: How the 2021-2027 EU budget can end the institutionalisation of children in Europe

Opening Doors for Europe’s Children , 01 Dec 2018

These recommendations have been developed by the Opening Doors for Europe’s Children campaign and are based on the work of the campaign since 2016, calling for a stronger commitment to maintain, strengthen and expand the use of EU funds for deinstitutionalisation reforms in Europe.

Child Welfare Financing SFY 2016: A survey of federal, state, and local expenditures

Kristina Rosinsky and Sarah Catherine Williams - Child Trends, 01 Dec 2018

Child Trends conducted this 10th national survey of U.S. child welfare agency expenditures to promote an understanding of the challenges and opportunities agencies face in serving vulnerable children. This report is part of an array of resources compiled from the survey’s findings.

Deliberate investments to protect Ugandan children

National Child Protection Working Group, 01 Nov 2018

This brief from the National Child Protection Working Group examines the key challenges facing financing for child wellbeing in Uganda and how to address funding gaps.

State Variation in Child Welfare Agency Use of Federal Funding Sources

Dana Dean Connelly, Kristina Rosinsky - Child Trends, 25 Jun 2018

This brief highlights variation among states in child welfare agency spending from federal funding sources.

Childonomics: Measuring the long-term social and economic value of investing in children Summary of findings

Eurochild, 11 Jun 2018

This paper summarises the main concepts behind Childonomics and presents the key findings so far.

Assessing Alternative Care for Children in Armenia

Zulfiya Charyeva, Hasmik Ghukasyan, Armenia country core team - MEASURE Evaluation, USAID, 01 Jun 2018

This report presents the findings of an assessment workshop aimed at bringing together key stakeholders—decision makers, policy developers, service providers, civil society representatives, and donors—to assess and identify the main care reform areas in Armenia in which action is needed.

Evaluarea Îngrijirii Alternative a Copilului în Moldova 1

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

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