A large number of children are currently living in alternative care. The relationship they establish with their caregivers can play a significant role in their development. However, not much literature examines the caregivers’ relationship with children, other staff and the organisation. The aim of this review is to analyse the existing published studies regarding these caregivers’ relationships, with a focus on programs in South Asia. The review analysis is also based on first-hand experiences shared by the caregivers working with children in alternative care in India. These findings are based on focused group discussions with caregivers working with children in child care institutions, group foster care and aftercare settings, along with available literature reviews on the same. This research will help in guiding the policies for better child care, with a focus on developing the child-caregiver relationship, while also addressing and resolving concerns in the relationship dynamics of caregivers with other staff and the organisation.