Provision of Alternative Care to Children Affected and Infected with Ebola in Liberia

Government of Liberia

This draft from the Liberian government outlines the protocol and guidelines for responding to children's care issues in the context of Ebola, specifically for the Interim Care Centers for children who have come into contact with Ebola. The draft provides an introduction to the impact of the Ebola epidemic on children’s care in Liberia, stating that UNICEF estimates approximately 2,000 children in Liberia have lost one or both caregivers to the epidemic. Furthermore, there are thousands of other children who are separated from their families because their parents are in treatment or children who have had "contact' with infected relatives and are rejected from  immediate and extended families, according to this paper.

The paper draws on the existing legal and policy framework for alternative care in Liberia - including the recently published “Guidelines for kinship care, foster care, and supported independent living” - to introduce more specific considerations and procedures for dealing with alternative care in light of the Ebola epidemic. The paper identifies the children who are at risk, including children who come into an Ebola Treatment Unit (ETU), children who test positive for Ebola and who survive the illness, children with no kinship carers available or willing to look after them, and children living in households where a member is suspected of being infected with Ebola. The draft then offers a list and description of the alternative care options for these children, which includes kinship care, foster care (both informal and formal), residential care institutions, Kafalah, and “Interim Care Centers” (ICC) where children who have come into contact with Ebola are placed for an observation period of 21 days.

The draft provides specific protocol and guidelines for the use of ICCs, including their purpose, the referral process, the criteria for establishing an ICC, guiding principles, staffing needs and considerations, the structure and standards for ICCs, and the coordination and implementation at the national, county, community levels. Furthermore, the draft includes a step-by-step guide to referral and management of children affected by Ebola by category (children who come into an ETU with a family member who test positive whilst the child tests negative, children who test positive and have undergone treatment, children without an appropriate caregiver, and children living in households with a family member who has been infected). ICCs, says the draft, are meant to provide care, support, and protection to children (ideally over the age of 6) and their families by (a) quarantining “contact” children for a maximum of 21 days, (b) closely monitoring children for symptoms and taking immediate action to refer children to an ETU if necessary, and (c) keep track of families to ensure speedy reunification when possible or to arrange alternative care options if not. The draft concludes with a flow chart that helps to illustrate the protocol and steps to be taken in the case of children affected by Ebola.