Inclusive, Enabling Communities

Inclusive, Enabling Communities
Learning Brief

Epworth Children's Village

Mitigating institutionalisation of children in care

Category: Inclusive, Enabling Communities | Caring and protection of particularly vulnerable groups | 30 October, 2012 - 21:29



There are an estimated 3.7 million orphans in South Africa, about half of whom have lost one or both parents to AIDS. Although some remain in extended family care, many are separated from their families and many of these end up in children’s homes.

Although statistics on children in institutional care are not complete, it is known that there are 345 registered children’s homes in South Africa, looking after some 21,000 children. These facilities qualify as ‘child and youth care centres’, a provision of the new Children’s Act which establishes a system of specialised alternative childcare programmes with proper standards and governance structures.

In terms of the South African child care policy, institutionalisation (in a children’s home) should be a last resort under exceptional circumstances when all home and community options are considered inappropriate. Government makes provision for securing stability for the child by placing the child in alternative care for a limited period, to allow for the reunification of the child with the parent or caregiver, with assistance of the designated social worker.

Research in the UK and elsewhere has shown that long-term institutionalisation of children impinges on their linguistic, intellectual and educational performance. Young children who remain in institutions tend to crave affection, to cling to visitors and later on to make indiscriminate friendships and to have difficulties in forming lasting relationships. Early and prolonged institutional care has also been shown to work against successful fostering later on.

However, within the South African context institutionalization of children is inevitable. Most children come into care because of abandonment, abuse or neglect because families cannot cope with challenges of daily living and for some, they remain there until 18, as it becomes the only place they can call ‘home’,

Improving family reunification programmes

Through major changes to institutional policy as well as in the daily regime, Epworth Children’s Village claims that the ill-effects of institutionalization can be minimised or even avoided. Epworth’s programming is aimed at avoiding ‘warehousing of children’ and strengthening their emotional resilience and increasing their capacity for learning. The deinstitutionalisation strategy is been anchored on effective tracing, reunification and reintegration as processes on a continuum, which ensure that children remain integrated with society to which they will be returned.

Tracing of families, relatives or looking for foster parents for the children in residential care can be a laborious process that requires professional determination. Epworth’s experience reveals that some family members avoid identification fearing that the child will be immediately discharged into their care. In most cases the family circumstances require intensive intervention before the child is brought into the picture.

The Children’s Act provides that a designated social worker to facilitate the reunification of a child  and must investigate factors which caused the child to leave home; address those causes and take precautionary action to prevent a recurrence; and provide counselling to both the child and the family before and after reunification. Reunification is a relatively short process which follows after effective social work intervention. The success of the pre-placement intervention is determined by the efficacy of the social work services while their consistency and sufficiency which will determine the stability of the placement.  Thus, in the absence of effective support from the statutory social workers, institutional social workers often need to run support programmes to create conducive conditions for effective reunification.

Reintegration ensures the maintenance of continuous, frequent and regular contact with an adult outside the institution which enables the child to cope while in care. Even when the child’s own family had been indifferent or rejecting, and when the child had never lived permanently with the parental substitute, this is needed. Crucially the child needs to find someone who cares sufficiently to maintain a stable and enduring relationship.

Upon satisfaction with the degree of integration, the social worker makes recommendations for placement. In our case this reintegration process is given adequate professional post-placement support to ensure the health, safety and security of children during at least two years of initial bonding.

Learning from our experience

The Epworth family reunification project has enhanced the interaction between our children and society. There is evidence that institutional care differs both in quantity and quality from that in a normal family setting; and that the young the child on admission and the longer s/he  remains institutionalised, the more likely that many aspects of his development will be adversely affected. With this reflection, our programming has improved in the following main ways:

  • That childcare is no longer simply a matter of physical care, but a mixture of child-focused, professional-intensive processes aimed at providing effective therapy, holistic child development and eventual reintegration.
  • Through the process of matching children to families we now realize that childcare services must be culturally relevant as institutions operate in representative capacity for those communities they serve.
  • Professional post-placement support and material provision are integral components of reunification for most deprived families.
  • Training and support for foster families need to be carried out as a continuous process to ensure effective resettlement of children.
  • Reintegration process needs to be given adequate professional post-placement for at least two years to ensure health and safety of the child
  • Above all, we now realize that just as children, staff members need deinstitutionalization in order for them to appreciate that they are not meant to create good children for the institution but rather a relevant institution to serve society. This project gave our organization introspection into our practice and put us into a constantly evolving staff development mode.

Issues in the policy arena that effect successful delivery

Pringle (1980) states that, a willingness to devote adequate resources to the care of children is the hallmark of a civilised society as well as an investment in our future. However, reality on the ground is that the Department of Social Development suffers from serious underfunding as evidenced by:  

(a) High staff turnover among ‘designated social workers’; Decisions about placements are often delayed while new staff becomes familiar with the case. A child’s file can be transferred to two or three social workers a year, who would all leave without having contact with the child. In this regard, case supervision by the statutory social workers is impossible. Epworth has thus had to rely on their institutional social worker relying only on the statutory social worker for legal processes.

(b) Large caseloads: The designated social workers’ capacity is devoted to dealing with crisis work because of inadequate staff and resources. In Epworth’s case, tracing, reunification and reintegration, which should be functions of statutory social workers, have to be done by the internal social worker and staff. Post-placement support is also done by the institutional social worker to ensure effective integration. The institution is not funded to carry out this post-placement support, yet it is necessary to ensure the success of child placements.

(c) Marginal institutional grants do not match statutory standard service requirements and limit institutional capacity to implement effective programmes. Tracing, reunification and reintegration processes are integral components of an effectively managed care programme. While statutory social workers are too few or too busy to do it, institutions are not funded to do so either. Effort needs to be put towards resource allocation and matching policy to practice. Reunification policy is  is structurally neglected yet institutions are not funded to implement it.

Implications for reunification progammes

Epworth Children’s Village deinstitutionalisation processes are intended to ensure that care leavers are given the same level of care and support their peers would expect from a reasonable parent and that they are provided with the opportunities and chances needed to help them move successfully to adulthood. In the face of marginal statutory support, child care organisations need to find ways to source funding to deliver programmes the ensure that:

  • Every child in care receives a comprehensive pathway plan that maps out a clear route to independence.
  • A multi-disciplinary team is designated an adviser who will coordinate the provision of support and assistance to meet the needs of the young person (with emphasis placed on helping the young person into education, training or employment).
  • Continuing assistance for care leavers aged 18 to 21, especially with education and employment, is provided and should continues to the end of the programme, even if it takes some past the age of 21.

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