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Foster care (Part 1)

Foster care video by Rebecca Nhep
What is foster care? So foster care is basically one type of family-based care that falls within the continuum of alternative care. And it’s one of the types of care that we can assess under the suitability principle. So basically once alternative care has been deemed as necessary for a given child, then we’re looking at what type of care is best for that child, taking into consideration their broader rights, taking into consideration their specific needs and also the available resources and services within their country and within their context. So foster care is one of those types of care options that we may assess as being suitable for a given child. And it’s basically a type of family-based care.
And if we look to the guidelines on the alternative care of children, it’s actually defined within those guidelines. And I’ll read it out to you. It’s defined as situations where children are placed by a competent authority for the purpose of alternative care in the domestic environment of a family other than the child’s own family that has been selected, qualified, approved, and supervised for providing such care. So within those guidelines, we can see that particular definition really refers to formal foster care.
But it’s also worth noting that in many countries and in many contexts there also exists informal foster care, which is where two families will enter into a private agreement and arrangement for the care of one child or a sibling group whereby they’ll place a child within a family. But there’s no state involvement. So that’s also a type of foster care that is quite common as well. What are the different types of foster care? There are several different types of foster care. It’s an umbrella term for family-based care arrangements. But we have one type which is called emergency foster care. And that’s really unplanned foster care whereby a child is going to come into care in very short notice.
And they may stay for just one night or they may stay for up to a maximum period of time. And countries may define that maximum differently. It can range from 28 days up to a 90-day period whereby they’re looking for those more long-term options. We’ve also got short-term foster care which is care provided for usually under a six-month period of time. And that’s more generalised foster care. We’ve got long-term foster care which is whereby care is provided for in over a six-month period of time. And in some countries, it can actually be considered a permanent option. We’ve also got specialist foster care. So this can be care provided, intensive care provided, for children with special needs.
Often, care for babies is also included in the specialised foster care category. And then, lastly, we have respite foster care. And that’s giving a break to families or to other foster families who are providing that long-term care for children. So all of these different types of family-based care placements that come under that category of foster care are still considered temporary care options. And as a result, we do need to make sure that we are continuing to monitor and to support and supervise those placements for the full duration of the placement. What are the key benefits of foster care?
Foster care is a really positive alternative, particularly to residential care, because it can provide children with that very personalised care in a normal family and community environment that residential care can’t. And as a result of that, it really reduces or removes the risk of children becoming institutionalised. And therefore it’s considered widely considered in the care sector as being more conducive to children’s long-term well-being and also their cognitive development and their socialisation. So that ability to provide that personalised care is one of the key benefits. It’s also a really positive alternative for young children, particularly for children under three, to be cared for in that family environment.
And the guideline actually makes a recommendation that young children’s’ care always takes place in a family environment. So where that needs to be alternative care not within the biological family or extended family, foster care is a really good option for them where it’s suitable for that individual child. And obviously it removes that risk in the very early years where the risk of developmental delays or detriment to their brain formation is highest by providing that care for them within the family. We also say that there’s a benefit to children’s’ self-esteem and their social standing in the community.
In many countries and contexts, there’s a much higher stigma, social stigma, attached to growing up in residential care in comparison with growing up in foster care. And so we say that it has a benefit to a child’s standing in the community, their connection and identity to a community and a culture and as such to their self-esteem and their self-image. And all of those things are really critical, particularly for young people and kids, for their transition into independent adulthood. Those things are all very, very critical component. So it definitely has that benefit. We also say that there’s a cost benefit.
In most countries, the comparative studies are showing us that foster care is anywhere between three and ten times cheaper than providing care for children in residential care centres. So although they can pay a high cost to investing in the establishment of foster care initially, particularly where we need to make a significant investment in the development of the social work force, that can be quite expensive. So in the outlying set up, there can be high cost. But as that is developed ongoing, we generally say that foster care is a much more cost effective option than residential care. So there’s some of the key benefits. What is required to make foster care safe and effective for children?
To ensure that foster care is safe, that it’s effective, and that it actually is and remains in children’s best interests, it’s really important that we develop and implement really robust processes covering all the different components of a foster care programme. So that includes starting right from the selection and screening and training of families to the matching of children to specific families based on the individual dynamics of both the child and the family through to the monitoring of those placements to the support that we provide to the child and also to the caregivers and the family, and also looking at when the child is preparing to exit the care system and the preparation that goes around that as well.
So we need to make sure we’ve got procedures, we’ve got processes that cover all those different components to make sure that it is safe and effective for children. And while there are very generic, universal good practise principles and knowledge that can be applied to all of those different components, it’s also really important that we take into account the very specific cultural and contextual dynamics in the country or the communities where we’re running these foster care programmes into consideration. And I’ll give you a couple of examples. In Cambodia, where we’ve developed a foster care programme there, we recognised early on that the country has a very strong orientation towards collectivism.
And so we were able to understand how that affects the way children are cared for, how it affects the way communities rally around children and families. And we are able to adapt some of their procedures and processes in light of that. So some of those adaptations for us included looking at more of a collective model of foster care whereby we firstly looked at when we’re starting a foster care cluster in a new community, not starting them with individuals but rather starting them where there was a network of families that were willing, screened, approved, and accredited to provide care for children.
And that really increased the peer support for these children and also for their caregivers and was really quite pivotal in making sure that these placements didn’t break down. Because it created that support framework that aligned with their culture. And so that became embedded in our procedural framework for how we establish the foster care clusters in new communities. We also found that this increased the level of acceptance for a child into the community when there were other children in the community being cared for in foster families as well. So again, that is why we changed some of our recommendations on that basis.
It’s also really important that we have these mechanisms in place, not just so that we get children into foster families and that initial matching and placement process is successful, but so that care remains appropriate and remains safe for children on an ongoing basis for however long that they’re in care. So when we don’t have those solid and robust procedures in place, that’s where we put children at risk of being abused in those care placements, of been neglected. That’s where we put children and families at risk of those placements breaking down.
And so it’s really, really critical that our procedures are solid, that they’re grounded in both these universal notions of good practise, but they’re also grounded in the contextual dynamics in the country and the community. So is foster care the answer for deinstitutionalisation? There’s no doubt that, in many countries in the world, foster care systems are underdeveloped. And many, many children are going to benefit from a significant investment into establishing and also scaling up the foster care system in those countries. But it’s really important to understand that it’s not the sole answer to a country’s deinstitutionalisation process.
And it’s really critical that in whichever country and context we’re working in, we are working towards developing, supporting, scaling, and sustaining a whole system of care and also a whole system of social protection for children and families. And not every child that currently lives in residential care– even for those children who don’t need to be there, where it’s an unnecessary placement and we need to look towards reintegrating that child back into the community, either into their family or into a family-based care setting, foster care is still not going to be the sole answer for every one of those children. It’s not going to be appropriate for every child. And so it’s always important that, yes, we develop these systems.
But then we also are very much looking at the individual needs of every child. We have to look at it at a case-by-case basis and only place children in care when that is the most suitable placement for that particular child. So it’s not the sole answer. But it is an important component of a whole system that needs to be developed and strengthened. And it’s when we have that system in place that we really can say that our decisions around individual children is really legitimately based upon both the necessity and the suitability principal.

In this video Dr Ian Milligan, International Project Advisor at CELCIS in the University of Strathclyde, asks care specialist, Rebecca Nhep, about her experience working on a foster care programme in Cambodia.

Rebecca holds a Master’s Degree in International Development, and a Graduate Certificate in Missiology and Anthropology. She is the Senior Technical Advisor for Better Care Network. Previous to this role she was joint Chief Executive Officer and Head of International Programs at ACC International, and ran the ACCI Kinnected program which focuses on upholding children’s right to a family through deinstitutionalisation, family based care and family preservation.

Foster care is described in the UN Guidelines for the Alternative Care of Children as:

‘situations where children are placed by a competent authority for the purpose of alternative care in the domestic environment of a family other than the children’s own family that has been selected, qualified, approved and supervised for providing such care’.

We should note, however, in reality, in many different country settings, the term “foster care” does not always match this definition but is being used to denote many different forms of family-based and community-based care including informal care with relatives and care in small group homes.

Rebecca tells us about the steps that must be taken if foster care is to work effectively and safely including a rigorous process of selection and training of foster carers, thoughtful preparation and support of children who are to be fostered and, very careful matching of children and prospective carers. She reflects on how a foster care service also requires on-going review, support and guidance for foster carers and foster children once the placement has been arranged. We will also understand how important it is to have effective legislative and a policy framework with standards and regulations for foster care.

Whilst we reflect on Rebecca’s experience we should be mindful of any cultural setting and how this can affect whether and, how, foster care is developed. In addition, we should consider messages from research alerting us to the possible poor consequences for children when there is insufficient investment in foster care. This lack of investment might not only lead to the breakdown of unsuitable placements but, most concerning, is the possibility of endangering children if placed in unsafe and unmonitored care.

Rebecca also reminds us of the need to create different forms of foster care i.e. carers able to take care of babies, react to an emergency placement or, care for older children.

Please see pages 19 and 20 of the publication ‘Fostering better care: improving foster care provision around the world’ prepared by the NGO EveryChild for further ideas about different forms of foster care.

This article is from the free online

Getting Care Right for All Children: Implementing the UN Guidelines for the Alternative Care of Children

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