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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A Case for Investing in HIV-Sensitive Social Services for Vulnerable Children in Nigeria

Shar Kurtishi, David Akpan, Tapfuma Murove, Kelley Bunkers, & Doreen Magaji - Journal of Poverty, Investment and Development , 2018

A desk review was conducted to examine the current gaps in investment related to care and treatment for children living with or affected by HIV.

Childonomics: A Conceptual Framework

Andy Bilson, Maria Herczog, Jean Anne Kennedy, Volodymyr Kuzminskyi and Joanna RogersOxford Policy Management, in association with IFCO and Partnership for EveryChild, 01 Dec 2017

This paper presents the conceptual framework for the Childonomics research project, which has developed the first iteration of a methodology that helps people to reflect on the long-term social and economic return of investing in children and families within a given national or sub-national context.

Improving Child Welfare Outcomes Balancing Investments in Prevention and Treatment

Jeanne S. Ringel, Dana Schultz, Joshua Mendelsohn, Stephanie Brooks Holliday, Katharine Anne Sieck, Ifeanyi Edochie, Lauren Davis - RAND Corporation, 01 Dec 2017

This study is the first attempt to integrate maltreatment risk, detection, pathways through the child welfare system, and consequences in a comprehensive quantitative model that can be used to simulate the impact of policy changes.

Estimating minimum adequate foster care costs for children in the United States

Haksoon Ahn, Diane DePanfilis, Kevin Frick, Richard P. Barth - Children and Youth Services Review, 03 Nov 2017

The objectives of this study are to: use the methodology of a 2007 study to establish foster care minimum adequate rates for children (MARC) based on the child's age and geographical location in every state; update the MARC with cost of living adjustments to 2016; examine changes in gaps between the MARC and the current foster care rates; and identify states that have made increases to their reimbursement rates, relative to the MARC over time.

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Estimating minimum adequate foster care costs for children in the United States

HaksoonAhn, Diane DePanfilis, Kevin Frick, Richard P. Barth - Children and Youth Services Review, 03 Nov 2017

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How wealthy are orphans and vulnerable children households in a metropolitan community, South-West Nigeria?

Oyindamola B Yusuf, Temitayo Odusote, Olusanmi Iyabode, Joanna Nwosu, Tessie Phillips–Ononye, Ayo S Adebowale, Elijah A Bamgboye - African Population Studies, 01 Nov 2017

This study determined the socio-economic status of Orphans and Vulnerable Children (OVC) in relation to service areas in Lagos Nigeria.

Opening up communities, closing down institutions: Harnessing the European Structural and Investment Funds

Neil Crowther, Gerard Quinn & Alexandra Hillen-Moore - Community Living for Europe: Structural Funds Watch, 01 Nov 2017

This report from Community Living for Europe: Structural Funds Watch reviews findings of an examination of the EU financial framework as it relates to the promotion of community-based care of children and adults and offers key recommendations for the EU and Member States to facilitate the transition from institutional to community-based care.

Predictive Analytics in Child Welfare An Assessment of Current Efforts, Challenges and Opportunities

Christopher Teixeira and Matthew Boyas - MITRE Corporation, 01 Oct 2017

This document explores the state of the use of predictive analytics in child welfare by conducting an environmental scan of child welfare agencies, academia, nonprofit organizations, and for-profit vendors in the United States.

The State of Play: How have global children and youth issues fared in the U.S. government’s Fiscal Year 2018 appropriations process?

Gillian Huebner Consultant, Elevate Children Funders Group, 29 Sep 2017

This document sheds some light on where funding discussions currently stand with regard to U.S. government programs for global children and youth issues.

Care Reform in Moldova: Timeline of System Achievements

MEASURE Evaluation & USAID, 15 Sep 2017

This infographic provides a historical timeline of the alternative care reform process in Moldova, marking key achievements in the establishment of policies, guidelines, procedures, and programs to improve the quality of care and protection for children without adequate family care.