Children, to realise their full potential, should grow up in safe, resilient and supported families and have unimpeded access to developmental pathways.
Starting in June 2016 and continuing, One Child One Family Hope and Homes for Children SA has been working in close partnership with the Gauteng Department of Social Development together to lead and support on the systemic gap analysis, service design and implementation of contextualised, evidence-based care reform for a pro-active, child-in-family-in-community deinstitutionalised child protection system, as intended by the South African Children’s Act 38 (2005) as amended 41 (2007), and supported by the various regional and international child protection instruments.
In South Africa, despite its progressive rights-based child protection legislation, the child protection system in practice is reactive, rescue-and-remove oriented and heavily reliant on institutional care as the first resort.
Results from the action research ‘snapshot’ assessment of children living in institutional care in South Africa, conducted by One Child One Family Hope and Homes for Children SA (OCOF HHCSA) in the period (August 2015 – March 2016), show that more than 80% of 3104 children assessed are not orphaned but have been placed into Child and Youth Care Centres resulting from family breakdown, abuse, neglect and abandonment. The data also shows that children, once placed into Child and Youth Care Centres, remain in these institutions for between two to ten years. The Research Report on Long-Stays in Institutions conducted by the Gauteng Department of Social Development), concurs with the initial findings of the OCOF HHCSA assessment and goes on to investigate the reasons for the long-term institutional care of children, part of which is attributed to the lack of work done with biological families to enable children to be sustainable and safely reunified with their families.
What is Institutional Care and Why Is It Harmful?
Institutional care is any residential setting where children and young people are subjected to an institutional culture. Institutional care is, by its very nature, depersonalised, follows a rigid routine and children experience lack of individual support and treatment. Institutional care lacks consistency, permanency and continuity; contributing to mental health problems and socialisation problems for care-leavers as they exit institutions, ill-prepared to negotiate the outside world and build supportive eco-systems and interpersonal relationships.
Institutional care harms not only the children and young people living in institutions; it harms all of us. Families who have experienced the removal of their children are left fractured and unsupported by rehabilitation or support services.
Drivers of vulnerability leading to family separation and institutionalisation of children in South Africa and globally include poverty, disability, marginalisation, migration, trafficking, lack of access to health, education or family support services. In South Africa, behaviours such as substance addiction, violence and among the highest gender-based violence rates globally, places children at increased risk and demonstrates the negative impact of a reactive, institution-reliant mindset and practice on family resilience and agency.
This is why the evidence-based care reform process is so important; with the emphasis on strengthening families and communities through implementation and scaling up of a comprehensive, efficient, monitored and supported Prevention, early intervention, linkage to services and post-placement support model.
Working together with care reform champion Gauteng Department of Social Development, we have developed the ground-breaking ACTIVE FAMILY SUPPORT-KHUSELA (AFS-KHUSELA) Community Development model, which places agency back into the heart of communities, working through networks of paraprofessionals, ordinary community members and service providers, overseen by a statutory social worker. This model has been extensively tested in urban, peri-urban and rural communities; including very marginalised communities on the Cape Flats. The early data on outcomes for family strengthening in the face of extreme violence and gangsterism in Hanover Park and neighbouring communities, demonstrates excellent outcomes on resilience, risk, protective factors and wellbeing domains.
Together, we have supported the development and implementation of three critical pathway programmes for care reform in Gauteng Province. These are:
- The Moratorium on the entry of children under three years of age into any form of institutional care. The AFS-KHUSELA model provides alternative family-based care options for these children in the form of screened, trained and supported Temporary Safety Parents with whom children at risk can be placed for a period of 90 days while work is done with the biological families to allow for reunification or alternatively, placement into foster-care or domestic adoption.
- The Reduction of Long-stays programme. This programme aims to transition and reunify children with complex case histories and links with specialist NGOs that support work with trafficked children and undocumented minors.
- The Independent Living Programme. This programme includes children aged 11 years to 24 years who are living in institutions or are in formal foster-care. It is graded programme where children and young people are prepared for transition out of the institutions into community-based care options and linked with corporates, training and academic opportunities to enable access to and support for these children on developmental pathways.
The AFS-KHUSELA community prevention model provides early identification, efficient and timeous linkage with services, provision of supported alternative family-based care options and post-placement support services; thereby preventing family breakdown.
Core to our work is longitudinal monitoring and evaluation of outcomes for children and families in the programme, on Risk, Protection, Resilience and Wellbeing Metrics.
Care reform is a process of systemic change, resulting in a deinstitutionalised, pro-active, child-in-family-in community focused child protection system. Children and young people are central to all development. It demands an evidence-based approach to the social compact from all-of-government, civil society, communities and business to provide the statutory support services, specialist support services, basic service delivery and developmental pathways to strengthen and support families in communities, in the best interests of children and young people.
Most importantly, as articulated by Professor Ndangwa Noyoo, Director of the Southern African Policy Development Nexus with whom we are working in partnership for the external evaluation, guidance and support for the care reform process in South Africa; deinstitutionalization as the result of care reform is “..no situated in a vacuum. It builds forward on the Family Policy and Community Development Policy and is true to the African family norms and the philosophy of Ubuntu..”
There is a clear line-of-sight between the implementation of care reform and achieving the Sustainable Development Goals, for example.
UN Sustainable Development Goal 1: End Poverty
Poverty is a key driver of family breakdown and separation of children, globally and in South Africa. Intergenerational poverty as a consequence of longstanding inequity and exclusion, rooted in forms of discrimination, is perpetuated by institutional care. Children who have been in institutions can suffer multiple disadvantages in adult life which all predispose the likelihood of them falling into the poverty trap. The children of adults with a history of institutional care, are themselves more likely to become institutionalised. Historically, poverty alleviation attempts have focused on a perverse system of removing children from poor families and placing them ‘where the resources are’, i.e., institutional care, rather than the resources going to the child (and family).
Care reform means that resources should be redirected away from harmful institutions towards family support and community services; which will support building the resilience and capabilities of families in communities; and end the cycle of harm. Key recommendations for care reform include that policies and programmes developed in this area focus on building the capabilities and resilience of families and communities.
Supporting families in communities and ending the institutional mindset will impact Sustainable Development Goal 5, Gender equality, through providing targeted support services to young mothers within community-settings. As we know, there is an alarming rate of teen pregnancies in South Africa and many of these children will end up in institutional care. Young mothers, overwhelmed by the responsibilities, lack of support and unwilling to face conventional and conservative norms, often tend to abandon their babies. In a pro-active, child-in-family-in-community based child protection system, there will be support for these young mothers and they will be less likely to end up in institutions, thus perpetuating the cycle.
Care reform for a pro-active, child-in-family-in-community based deinstitutionalised child protection, family and community strengthening system is a human imperative. It is our collective responsibility to nurture, strengthen and support families, building resilience and capacity and linking with clear and supported developmental pathways.
Dr Sello Mokoena is Director for Research and Policy Development at the Gauteng Department of Social Development and Lourenza Steytler Foghill is Country Director at One Child One Family, Hope and Homes for Children SA.