Summary: Residential care facilities, including orphanages and children’s homes, are often considered as the primary model of care for millions of orphans and vulnerable children worldwide. As global recognition of the importance of family-based care grows, a variety of effective models of care can be considered to meet the unique needs of children and families.
In a world where millions of children live without adequate parental care, understanding the most effective models of care to support orphans and vulnerable children is vitally important. Whether family separation is due to parental death, poverty, or other challenging circumstances, children need care that prioritizes their well-being, development, and rights.
The global context: Understanding the scale
According to UNICEF, an estimated 140 million children worldwide have lost one or both parents, while millions more are vulnerable due to poverty, disability, or other challenging circumstances. The COVID-19 pandemic and various geopolitical conflicts have furthered the vulnerability of children without adequate care.
Gathering accurate data on the number of vulnerable children facing separation from parental care plays a crucial role in addressing this crisis. Yet many factors make it difficult, if not impossible, to gather official figures on the number of orphaned and vulnerable children in the world.
While children lacking parental care were historically cared for by extended family members or Christians who took them in, residential care in orphanages and children’s homes eventually developed as a primary resource for providing care for millions of vulnerable children.
The prominence of residential care programs
Residential care programs are typically started with the best of intentions, and yet decades of research confirm the Scriptural truth that the family is the ideal setting for raising a child. Residential care often can’t sufficiently meet children’s developmental needs and, in some circumstances, can even cause lasting harm. And yet, millions of children globally grow up in residential care separated from family.
Currently, the child welfare system in most countries relies on this model of care to place children. If we were to shut down these programs overnight, we would create a vacuum of services for children. Further, we would lose the expertise, contacts, contextual knowledge, experience and funding currently present in those programs. In reality, we need the support and participation of individuals and organizations serving children through residential care. They play a critical role in ensuring that children are cared for in families, and families are properly supported.
Encouragingly, many residential programs around the world are recognizing the importance of family and transitioning their programs from orphanages or residential programs to a variety of effective models of care for orphans and vulnerable children.
Family-based care: The ideal place for children to thrive
Children brought up in families tend to do better. They tend to have healthier attachments to their primary caregivers, which lays the foundation for how a child will approach relationships throughout his or her life. Children in families also demonstrate better outcomes related to physical growth, attention, brain development and cognition.
As we embrace God’s design for all children to be in healthy, loving families, an opportunity develops to explore various models of family-based care for children lacking parental care. The continuum of care reflects a variety of ways that children can be cared for in families.
The unique needs of each individual child and family should be the primary consideration in selecting the best care option, as no one care model can meet the needs of every child.
Exploring effective orphan care models
As we embrace God’s design for all children to be in healthy, loving families, an opportunity develops to explore various effective models of family-based care for orphans, which we define here as any child lacking parental care. The continuum of care reflects a variety of ways that children can be cared for in families.
The unique needs of each individual child and family should be the primary consideration in selecting the best care option, as no one care model can meet the needs of every child.
Family strengthening programs
Wherever possible, preventing family separation is preferable to finding alternative care. Families at risk of separation will typically need support to be able to stay together safely, often in the form of family strengthening.
Family strengthening is any effort or intervention aimed at helping families stay together and thrive. This approach is most appropriate for families experiencing challenges that put them at risk of separation, but who maintain the desire and potential capacity to care for their children. This type of care will best serve most children and families.
Best practices in family strengthening address the root causes of separation through support and interventions, including:
- Economic Support: Vocational training, community savings accounts, financial literacy classes, etc.
- Psychosocial Support: Family counseling services, parenting skills training, support groups, etc.
- Physical Support: Material resources, medical care, housing assistance, etc.
- Educational Support: Scholarships, after-school programs, uniforms and school supplies, etc.
- Spiritual Support: Discipleship, connection to a church community, prayer, etc.
Reintegration
Reintegration is the process of returning a child to their birth family after a period of separation. Once a child has been separated from their parents and is in suitable care, the first long-term placement that should be considered is reintegration with their biological family.
Effective family reintegration is a process, rather than an event. It requires time to prepare both the child and the family for success. When implemented thoughtfully, reintegration offers children the opportunity to return to the nurturing embrace of their biological family while fostering long-term stability and emotional well-being.
Best practices for ensuring successful reintegration include:
- Thorough assessments of both the child and the family
- Slow, steady preparation of the child and family
- Quality case management
- Family strengthening
- Ongoing monitoring and support from program staff
Kinship care
Kinship care – placement with relatives or close family friends – represents the most common form of alternative care globally. Although this form of care occurs most naturally in many cultures, it may be overlooked by programs or governments pursuing more formal types of care.
Kinship care allows children to maintain family relationships, preserve cultural and community connections, and develop a sense of belonging. It presents a range of strengths and should be considered wherever possible.
Best practices for supporting kinship care include:
- Careful assessment, preparation and monitoring
- Providing financial support to address the material needs of the expanded family
- Training on child development and trauma-informed caregiving
- Family strengthening services
- Facilitating access to legal services for formalizing arrangements when needed
- Support ongoing contact with birth parents when appropriate
Foster care
When children need temporary care outside their birth family and kinship care isn’t possible, foster care offers children the opportunity to experience family life while maintaining connections with their birth family when possible.
Ideally, foster care is intended to provide safe, nurturing, temporary care while more permanent solutions are being developed.
Best practices for providing effective foster care include:
- Careful assessment, preparation and monitoring
- Good case management to guide care decisions for children and families
- Training on child development and trauma-informed caregiving
- Wise recruitment, screening, and training of foster families
- Family strengthening, where helpful
- Professional support for maintaining birth family connections
Adoption
Through family strengthening, kinship care, and foster care, the needs of many children can be met well. However, a smaller number of children will need a different care option.
Adoption is a legally permanent relationship, bringing with it all of the rights due a biological child. Adoption can be an excellent option for children for whom reintegration and kinship care are not possible.
Best practices in domestic and international adoption include:
- Legal frameworks that prioritize children’s best interests
- Ethical case management and consent procedures
- Comprehensive child and family assessment and preparation
- Post-adoption support services
- Open adoption arrangements whenever possible
Exploring specialized care models to meet complex needs
Specialized care models can be a crucial offering for some vulnerable youth who face challenges in family-based placements. These models of care create structured environments where young people with complex emotional, behavioral or developmental needs can develop life skills while receiving the support and resources necessary for their safety and well-being.
Supported independent living
Supported independent living provides a transitional living arrangement for older youth with limited supervision and support from program staff as they develop independence. This model can be a good fit for older youth moving toward independence who may not be fully providing for themselves yet, but can handle most tasks with a bit of support.
In this model of care, several young people may live together or near each other with support from program staff, which makes it particularly valuable for youth aging out of care systems or transitioning from other care models.
Best practices for supported independent living include:
- Transitional approach to exiting a care program
- Supported growth in mastering skills for independent living
- Good case management
- Living in supported, close community with others
- Building connections in the community for ongoing support
- In most cases, a graduated model of financial support, decreasing over time
Small group homes
Small group homes provide family-like care in a residential setting with consistent caregivers for a small number of children. These homes should be as small and family-like as possible, integrated into local communities.
This type of care is generally not suitable for younger children, but can serve as a specialized care option for children with specific needs that make traditional family placement challenging.
Best practices for small group homes include:
- Low child-to-caregiver ratios care for small numbers of children with unique needs
- Consistent caregivers supported by specialized professional support
- Good case management
- Integration into communities
- Individualized care with trauma-informed care practices
Better together: Collaboration and best practices
Although some organizations may provide a number of effective models of care for orphans and vulnerable children, no single organization can provide all services in all settings.
Healthy partnerships are critical to offering a complete continuum of care for children in a given region. By mapping out the care options available in a given area, a single organization is better able to focus on providing one or two types of placements or supports well while partnering with others who provide other types of care and support services. This leads to a collaborative, robust, and efficient model that benefits entire communities in caring for vulnerable children and families.
Regardless of the specific care model, certain principles are essential for effective care:
- Child-centered approaches: Prioritize each child’s individual needs, preferences, and best interests in all decisions.
- Case management: Develop case management practices that focus on supporting children and families in achieving their goals and guide the delivery of social service support.
- Individualized care planning: Develop comprehensive plans addressing the unique physical, emotional, educational, and social needs of each child.
- Family involvement: Maintain family input and participation whenever safe and appropriate.
- Regular assessment: Continuously evaluate care quality and child wellbeing outcomes.
- Transition planning: Prepare children and families for moves between care settings and provide consistent follow-up support.
- Cultural relevance: Adapt care models to local contexts while maintaining core quality standards.
Embracing change toward effective models of orphan care
As we grow in our understanding of both the importance of family for all children and the essential aspects of effective models of care for orphans and vulnerable children, we are better equipped to provide the kind of care that will best help children to thrive.
Embracing alternative models of care often requires not just a care model transition but the transformation of underlying systems, policies and cultural norms.
By investing in evidence-based approaches to care, we can ensure that all children, regardless of their circumstances, have the opportunity to grow up in safe, loving environments that support their development and well-being.
–The CAFO Research Center is a trusted authority in global orphan care. Through strategic partnerships with leading academic institutions, researchers, governments, and NGOs in over 130 nations, we utilize the latest global research to provide you with resources to improve outcomes for vulnerable children and families. Learn more at cafo.org/research-center.
Christian orphan advocates must accurately understand and communicate orphan-related statistics. Failure to do so undermines the strength of our advocacy and misguides action. Grasping the true nature of the need provides a strong foundation for an effective, well-focused response.
