Background: Out-of-home care entry can have profound effects on families, society, and a child’s development and wellbeing. This review synthesised evidence on the factors contributing to initial entry and re-entry into out-of-home care during childhood (<18 years), as well as those that protect against these outcomes.
Methods: A systematic review of published reviews was conducted. Eligible reviews were peer-reviewed, published in English from 2013 to 2024, focused on childhood out-of-home care placement (<18 years), and were conducted primarily in high-income countries. Framework synthesis approach was used to identify key factors associated with care entry.
Results: Of the 711 records identified, seven reviews were included. Key child-level risks included ethnicity, health, and behavioural challenges; family-level risks encompassed parental socioeconomic adversities and substance use; community-level risks involved poor neighbourhood conditions; and system-level risks included prior child welfare involvement and placement characteristics (e.g., placement instability for re-entry into care). Protective factors included child-level factors such as being elementary school-aged (6–12 years) and ethnicity; family-level factors such as high parental income and education; community-level factors, including access to essential services; and system-level factors, such as increased funding for child welfare.
Conclusions: The evidence highlights that the factors contributing to care entry extend beyond the children’s social care system, encompassing child, family, and community-level influences. There is potential for policymakers and practitioners to move beyond reactive child welfare measures by adopting preventative, holistic solutions across various public services.
