Child transitions from residential facilities to other communities: Predictors of Child Wellbeing

Study Title:  Child transitions from residential facilities to other communities: predictors of child wellbeing 

Context: Globally, one hundred and fifty three million children are estimated to have been orphaned as defined by the death of one or both parents due to diseases such as malaria, tuberculosis, and cancers, maternal mortality, unintentional injuries, natural disasters and armed conflict: AIDS accounts for 16.6 million of these children. We can anticipate that numbers of orphaned children will increase with factors such as economic declines, decreased agricultural output due to environmental changes and increased natural disasters. In Ethiopia, an estimated 650,000 children have lost one or both parents to AIDS. The majority of orphaned children and children whose biological parents have left them are cared for by the remaining parent, other family members, or non-relatives in family settings: a small proportion live in residential facilities

Study Aims: The primary goal of this pilot study is to understand the emotional and physical well-being of children transitioning out of residential care to better inform good policy and practice on the protection of children. The intent is to understand factors associated with positive and negative transition outcomes. Care transitions occur for a variety of reasons, such as family placement, aging out (reaching the maximum age allowed in residential facilities), child self-initiated departures, community or family initiated retrievals, residential facility initiated expulsions, and residential facility closures.  This study attempts to assess children’s mental and physical well-being while still living in residential care and then follow them out of residential facility care into other living environments.

Methods: This initial study is designed to determine the feasibility of finding, following and maintaining communication with children as they leave residential facilities, to examine the different living environments they transition into, and to examine if there are trends or associations in how well transitions are made. In particular, pre-transition child characteristics (e.g., age of entry into residential care, years in residential care, age at placement in a community setting), facility characteristics, transition planning characteristics, community placement characteristics, and child wellbeing outcomes will be analyzed and compared to data from matched controls in community-family settings.  Short-term descriptive information such as documenting the range of living environments children transition into is vital.  However, short-term outcomes may not reflect longer-term physical or emotional trends.  If the pilot study methodology proves successful, i.e., children are able to be followed over time and useful measurements obtained, a longer, multi-country longitudinal study will be proposed.

Policy Implications:

• To examine the positive and negative physical and mental health trajectories of children and young adults transitioning out of residential facility care for a variety of reasons, including residential facility closures, aging out and self-other initiated departures.
  • To determine how different types of residential facility-to-community transition experiences (e.g., types of preparation, planning process, availability of resources) affect children and families’ mental and physical wellbeing.
  • To better understand associations between characteristics of the residential facilities and post-residential facility care, and child emotional, physical and social well-being before and after re-location.
  • If the pilot study methodology proves successful and children are able to be followed over time, researchers may propose a larger multi-country study.

Principal Investigator: Sumi Ariely (Duke University)

Investigators: Misganaw Eticha (Stand for the Vulnerable Organization, Ethiopia), Charles Nelson (Harvard University), Jan Ostermann (Duke University), Lorraine Sherr (University College London),  Kathryn Whetten (Duke University), Rachel Whetten (Duke University)

Project Coordinator: Andrew Goodall

Contact Information: duke.ovcstudies@gmail.com