Reaching for home Global learning on family reintegration in low and lower-middle income countries - Save the Children's Resource Centre

Reaching for home Global learning on family reintegration in low and lower-middle income countries - Save the Children's Resource Centre
© Save the Children

                      Reaching for home
                      Global learning on family reintegration in low
                      and lower-middle income countries
This report is made possible by a generous                   • Elena Giannini, Save the Children (global
grant from the GHR Foundation. It is written                    emergency programming)
by Joanna Wedge, with assistance from Abby                   • Denis Godwin, Children and Youth as
Krumholz; the literature review was conducted                   Peacebuilders (Uganda)
by Lindsay Jones.                                            • Luke Gracie, Friends International (Cambodia)
                                                             • Rebeka Kofoed, Friends International (global
The Interagency Group on Reintegration is                       programming)
currently chaired by Family for Every Child,                 • Matilde Luna, Relaf (Argentina)
and is comprised of UNICEF, the Better Care                  •Siobhan Miles, Butterfly Project (Cambodia)
Network, War Child Holland, USAID, the Child                 • Pjua Mohanto, Shakti Samuha (Nepal)
Protection in Crisis Network, World Vision,                  • Patrick Onyango, TPO or Transcultural
Women’s Refugee Commission, International                       Psychological Organisation (Uganda)
Rescue Committee, Save the Children, Retrak,                 • Maggui Pilau, consultant (Paraguay)
Home: Child Recovery and Reintegration                       • Delia Pop, Hope and Homes (global
Network, and Maestral International.                            programming)
                                                             • Carly Reed, graduate student researcher
In addition to the insights of the Interagency                  (Columbia)
Group members, the author is grateful to the                 • Roop Sen, Sanjog (India)
following individuals for donating their time for            • Rebecca Smith, Save the Children (global
interviews, and for sharing contacts and relevant               programming)
documents:                                                   • Sarah Uppard, independent consultant
                                                             • Dr Mike Wessells, Professor, Mailman School
• Lopa Bhattacharjee, Terre des Hommes (India)                  of Public Health, Columbia University
•C laudia Cabral, Associação Brasileira Terra
  dos Homens or ABTH (Brazil)                                Reviewers, interviewees and their organisations
•F atimata Diabaté, Women’s Legal Association/              do not necessarily endorse all content.
  AFJCI (Cote d’Ivoire)
•A nanda Gallapatti, Good Practice Group (Sri

2     Reaching for Home: Global learning on family reintegration in low and lower-middle income countries

4    Summary
8    Section I - Introduction
9    Section II - Understanding separation and reintegration
12	Section III - Determining the suitability of reintegration
    and developing a reintegration plan
14   Section IV - Preparation processes
27   Section V - Reunification
28   Section VI - Post-reunification support
34   Section VI - Critical issues
41	Section VIII - Principles of promising practice and
46   References
50   Annex 1: Template for key informant interviews

        Reaching for Home: Global learning on family reintegration in low and lower-middle income countries   3

Introduction                                                      the community (usually of origin), in order to
                                                                  receive protection and care and to find a sense
This inter-agency, desk-based research
                                                                  of belonging and purpose in all spheres of life.
aims to arrive at a clearer understanding of
reintegration practices for separated children
                                                                  The exclusion from this definition of adoption
in low and lower-middle income countries.
                                                                  or placement in alternative care is not in any
The research pulls together learning from
                                                                  way intended to diminish the validity of these
practitioners and academics working with a
                                                                  options for children. However, these processes
range of separated children, such as those torn
                                                                  are qualitatively different from return to family
from their families by emergencies, children
                                                                  of origin; they require both different forms of
who have been trafficked or migrated for
                                                                  support and different research and analysis in
work, and children living in institutions or on
                                                                  order to develop useful recommendations.
the streets. Practitioners and researchers who
work with these different population groups are
                                                                  Both the United Nations Convention on the
for the most part unaware of the approaches
                                                                  Rights of the Child (UNCRC), and the Guidelines
and methods used in other areas of child
                                                                  for the Alternative Care of Children (welcomed
protection, and this research aims to consolidate
                                                                  by the UN in 2009) acknowledge the importance
experience and create opportunities for dialogue
                                                                  of supporting the reintegration of separated
and shared learning. The findings are based on
                                                                  children back into their families. Article 39 of
an in-depth review of 77 documents, a short
                                                                  the UNCRC explicitly talks of children’s right to
online survey involving 31 practitioners and
                                                                  social reintegration, and the Guidelines highlight
policy makers, and key informant interviews
                                                                  that priority should be given to preventing
with 19 individuals with expertise in children’s
                                                                  separation from or promoting return to family of
                                                                  origin. Other international guidance around child
                                                                  protection in emergencies and child labour also
Defining reintegration                                            highlights the importance of family reintegration.
and children’s right to
reintegration                                                     The stages of the
There is no global definition of the term                         reintegration process
‘reintegration.’ There is now general agreement                   This paper argues that reintegration is a process
that reintegration is a process and not an event,                 which unfolds over months, if not years. Over
and involves more than the simple physical                        that period, the ultimate goal of reintegration is
placement of a separated child back within a                      not just the sustained placement of the child
family. Some definitions focus on reintegration to                with family members, but instead concerns
family of origin, others indicate that reintegration              itself with the child being on a path to a
may involve entry into a new community and/or                     happy, healthy adulthood. The stages of the
new family through supporting adoption, foster                    reintegration process include:
care or independent living. For the purpose of
this report, the narrower conceptualisation is                    1. Careful, rigorous and participatory
used, with reintegration defined as:                                 decision making about the suitability
                                                                     of family reintegration, and, if deemed
The process of a separated child making what                         appropriate, then the development and
is anticipated to be a permanent transition back                     regular review of a reintegration plan.
to his or her immediate or extended family and

1. In addition to literature based on global or regional experiences, the researchers reviewed country-specific materials
    from Afghanistan, Brazil, Bulgaria, Cambodia, Cote d’Ivoire, DRC, Ethiopia, India, Liberia, Mexico, Moldova,
    Mozambique, Peru, Rwanda, Sierra Leone, Sri Lanka, South Africa, Uganda and Zambia.

4       Reaching for Home: Global learning on family reintegration in low and lower-middle income countries
2. P
    reparing the child, family and                         Principles of
   community for reintegration. Here, careful
   decisions must be made about how the child               promising practice
   is cared for whilst awaiting reintegration,              The paper suggests that, in addition to
   and whether children outside of alternative              ensuring support through each of the stages
   care can be supported through drop-in                    of the reintegration process, there are
   centres, or should be placed in alternative              several principles of promising practice for
   care. In relation to choices between different           those attempting to ensure the successful
   alternative care options, in line with global            reintegration of children.
   guidance, it is recommended that other
   options than transit centres are developed;              1. Respecting the individual’s journey: A
   this is owing to the fact that large group                   standardised approach to reintegration fails to
   residential care facilities have been shown                  make contact with the range of experiences,
   to be harmful to child well-being. Careful                   needs and situations that separated children
   decisions also need to be made about the                     face. A child and his or her family need to be
   speed of reintegration, with some children                   involved in establishing the benchmarks for
   able to return to families almost immediately                success and allowed the time and, as far as
   and others requiring longer-term support. In                 possible, the resources it takes to achieve
   preparing families, approaches that aim to                   them.
   build on existing strengths to address the               2. Rights-based and inclusive
   root causes of separation have proven to be                  programming: Staff and volunteers working
   valuable. Coordinating responses from a wide                 in the field of reintegration should receive
   range of community actors is a key part of                   training in children’s rights. There should be
   the reintegration process. Support needs vary                greater equity between the opportunities
   but commonly include skills development,                     available to separated children with more
   economic strengthening, therapeutic support                  attention paid to groups that are neglected
   and counselling and mediation, and efforts to                and/or poorly understood in reintegration
   change attitudes to address the stigma that                  efforts, such as young offenders and children
   drove children to leave their communities.                   in residential care.
3. C
    arefully planned reunification, with a                 3. Gendered perspective: Reintegration
   recognition that the moment of first contact                 programmes must adopt a gendered
   with family and community is an important                    perspective to ensure awareness of and
   one, and that children may have ambivalent                   sensitivity to the special circumstances and
   feelings about returning home, even when                     experiences of separated girls, such as those
   they do so willingly.                                        relating to sexual health, stigma, and cultural
4. E
    xtensive follow-up support. This                           gender biases. In addition, the reintegration of
   commonly includes household-level economic                   sexually-exploited boys must be given better
   support, which must be offered through                       consideration.
   specialist agencies. Support for children’s              4. Child participation: Decisions about
   education is seen as vital, and both peers                   reintegration should be made with children,
   and siblings play a crucial role in successful               and not for children, resulting in more relevant
   reintegration. Given the overarching shift to                and responsive reintegration support. Staff
   a systems approach to protecting children,                   (and volunteers) need to be chosen, trained
   follow-up support is increasingly offered                    and supported to enable this approach with
   through a wider programme for all vulnerable                 children, as it does not come easily to many
   households at the community level.                           adults, even when well-intentioned.
                                                            5. Taking a holistic view of the child: In
                                                                developing reintegration programmes, it is
                                                                important to consider the range of factors that
                                                                affect child well-being including: household
                                                                economic security; legal identity; education,
                                                                training and employment; self-esteem and
                                                                confidence; stigma and discrimination;

            Reaching for Home: Global learning on family reintegration in low and lower-middle income countries   5
spiritual, cultural and religious connections;                 are created with local actors, including
    and exposure to violence, abuse or neglect.                    the children in question, and that creative
6. S tandard operating procedures and                             and thoughtful ways of programming are
    national guidelines: Individual agencies                       enabled that shift power to the community
    should develop written standard operating                      in order to achieve improved relevance and
    procedures (SOPs) that fall within national and                sustainability.
    global guidance. This is not a quick initiative,         11. Long-term investment: Reintegration
    but a process that brings together staff,                     support is not something that can be offered
    children, their families and others to develop                to children on a temporary basis, as it
    common goals and procedures.                                  requires dedication, consistency and quality
7. Monitoring, reporting and evaluation:                         – all of which require a long-term investment
    Organisations should have an effective system                 in time, funding, and resources. That said,
    to track the impact of their programme                        organisations should devise exit strategies
    activities. This should include a strong record               to avoid dependence on the services of the
    keeping system, ethical data collection                       agency, and to promote local ownership of
    methods for use with children that include                    reintegration processes.
    sensitively and appropriately gathering their
    views, and robust mechanisms to assess the
    multiple components of child well-being.
                                                             Moving forward
8. C oordination and collaboration: This is                 Many of the principles of promising practice
    essential in the context of low and lower-               outlined above are not currently adhered
    middle income countries where funding and                to. For example, commonly: the impact of
    resources will inevitably be in short supply. A          reintegration programmes is poorly assessed
    clearly articulated need to coordinate efforts           or not assessed at all; local ownership and
    can be a catalyst for governments to get                 coordination between actors is weak, and the
    involved in reintegration efforts and to live up         specific needs of girls are not recognised within
    to their responsibility to protect and promote           programmes. Additional issues include the
    the well-being of their youngest citizens. It            following.
    is also a reminder for agencies to respect
    other actors’ specialisations, especially in                • Insufficient attention is paid to addressing
    providing quality therapeutic interventions and                the root causes of separation, leading to re-
    economic strengthening. A critical aspect of                   separation in many cases.
    this principle is mapping the local community               • Limited attention has been given to
    and devising a strategy to maximise its ability                assessing the cost-effectiveness of different
    to support children.                                           interventions.
9. C ultural and family sensitivity: Respect                   • Agencies face challenges in determining
    for local ways of knowing and doing is                         the degree to which programmes should
    important for devising strategies of support                   be targeted to support just reintegrated
    that will address relevant issues, and avoiding                children, or more inclusive of other
    formulised programmes. Wherever possible,                      vulnerable groups within the community.
    local stakeholders should be included in                    • Cross-border and long-distance
    the planning around a child’s reintegration                    reintegration causes particular problems.
    at the earliest possible moment to ground                   • There is limited knowledge of effective
    reintegration practices in the local reality and               reintegration strategies for young offenders
    tap into existing local support structures.                    and children leaving care.
10. Local ownership: Reintegration is primarily                • Children’s role in separation and
      a social process and thus needs to be                        reintegration is often poorly acknowledged
      firmly understood and championed by local                    and the experiences of self-reunifying
      actors and the structures in which they                      children, who return home with no agency
      operate. This entails tapping into the social                intervention, are not understood.
      and financial resources of the community                  • There is limited political will for and
      that exists around the returned child. It                    investment in effective reintegration
      means ensuring that measures of success                      programmes.

6     Reaching for Home: Global learning on family reintegration in low and lower-middle income countries
operating procedures, as well as providing
In order to start to address these challenges,                   sample indicators with wide applicability.
four broad recommendations can be made for
those engaged in the design and development                   Across all of future work on reintegration, the
of reintegration programmes.                                  child protection community needs to mobilise
                                                              to ensure that none of its interventions are
1. Create more opportunities for dialogue                    unintentionally causing significant harm to
    across settings, through the continuation of              children. A particular example is of the children
    the inter-agency group on reintegration that              trafficked across borders who are languishing
    developed this research and, for example, a               for months – if not years – in shelters.
    common webinar series, an annual journal or
    a conference on family reintegration.                     Achieving more successful reintegration
2. C ollectively strengthen the process of                   processes that lead to better outcomes for
    evaluating reintegration interventions,                   children requires not only improvements in
    through providing on-line monitoring and                  individual programmes, but also wider policy
    evaluation training to staff in country, enabling         reform in areas such as child protection,
    agencies in countries with high levels of                 social protection, health care and education.
    separation to undertake peer evaluations                  Ideally, such change will take place in an
    and mentoring staff working with children                 integrated manner through the wider reform
    on indicator selection. Here it is essential              of child protection systems. Actors across the
    to involve children in the development of                 sector should come together to advocate for
    indicators of success.                                    more and better use of resources to promote
3. Undertake key pieces of high-quality                      the appropriate and effective reintegration
    joint research, including more longitudinal               of children. The aforementioned research,
    research, and research on the following                   particularly around cost-effectiveness, could
    issues.                                                   be used as an impetus for wider policy
    • Factors to consider when determining                  reform around children’s reintegration. Areas
       whether children preparing for reintegration           for advocacy may, for example, include
       should be placed in a form of alternative              national governments being encouraged to
       care vs. receiving support through drop-               develop and adopt evaluative methodology,
       in centres, and in determining the most                standards, guidelines and/or standard operating
       appropriate forms of alternative care.                 procedures for reintegration interventions, and
     •G  roups of reintegrating children about               efforts to ensure that child welfare workforce
       whom very little is currently known e.g.               strengthening includes specific measures to
       reintegration from care and detention, the             improve the capacity to support sustained
       reintegration of girls, children with disabilities     reintegration.
       and children affected by HIV.
     •T  he role of information and communications           Reaching for Home represents just the
       technology in reintegration.                           beginning of the tearing down of boundaries
     •T  he economic strengthening of families at            between ways of working to protect separated
       risk of and ‘recovering’ from separation.              children, and of building bridges towards a more
     •T  he cost-effectiveness of different                  globalised approach to assist all of them in their
       approaches to post-reunification support.              reintegration journeys.
     •T  he role of siblings and peers in a child’s
4. D evelop a toolkit to inform and
    strengthen emerging practices around
    the world. This could include a clear
    definition of family and broader social
    reintegration, clarification around themes,
    case examples of tested methodologies for
    assessment and evaluation, guidance on
    developing locally contextualised standard

              Reaching for Home: Global learning on family reintegration in low and lower-middle income countries   7
Section I - Introduction
The family is the optimal environment for the                     Methods used and scope of
growth and development of the vast majority of
children (UN 1989). Yet, due to a myriad of push-                 the report
pull factors, millions of girls and boys around                   A number of different methods were used
the world are separated from their families and                   to compile the evidence base for this report.
deprived of much needed parental care, love                       Through a combination of recommendations
and support (DeLay 2003a). Their reintegration                    by global experts and key informants, as well
into their families and communities has become                    as a search of academic databases (including
a priority for child protection agencies around                   ProQuest Research Library, Science Direct,
the world. Yet a solid evidence base for many of                  EBSCO Publishing, JSTOR and Sage Journals),
the interventions carried out by these agencies                   almost 190 organisational reports and academic
is missing (Feeny 2005).                                          documents were compiled and included for a
                                                                  preliminary assessment, with 77 selected for
With that in mind, this inter-agency, desk-                       more in-depth review.3
based research aims to arrive at a clearer
understanding of reintegration practices for                      A short online survey was created and
separated children in low and lower-middle                        circulated to international child protection
income countries.2 The research pulls together                    networks and field-based staff and consultants
learning from practitioners and academics                         known to the researchers. Thirty-one people
working with a range of separated children, such                  responded. Finally, the researchers conducted
as those torn from their families by emergencies,                 nineteen interviews with key informants (see
children who have been trafficked or migrated                     Acknowledgments) in the field of reintegration.
for work, and children living in institutions or on               The selection of these grass-roots activists,
the streets. Practitioners and researchers who                    practitioners and global experts was based
work with these different population groups are                   on recommendations by interagency group
for the most part unaware of the approaches                       members and other key informants.
and methods used in other areas of child
protection. Rather than dividing the literature                   There are some noteworthy limitations.
according to crude categories of children,                        Researchers were only able to read and
this research offers the first attempt to share                   interview in three languages (English, French
learning and promising standards of practice                      and Spanish). This inevitably means that some
across the board. Through this consolidation of                   enlightening material and informants were
experience and knowledge, the research lays                       omitted, particularly from parts of Asia and
the groundwork for opportunities for dialogue                     the Middle East. Even from Latin America,
and shared learning that will result in more                      despite much effort, it proved difficult to
effective programming and better support to                       access materials in Spanish and it was not
enable separated children to move into the next                   possible to draw from Portuguese sources.
phase of their lives.                                             In addition, owing to the limits of time and
                                                                  resources, the researchers did not interview
                                                                  children to gain their perspectives, nor did they

2. In addition to literature based on global or regional experiences, the researchers reviewed country-specific materials
    from Afghanistan, Brazil, Bulgaria, Cambodia, Cote d’Ivoire, DRC, Ethiopia, India, Liberia, Mexico, Moldova,
    Mozambique, Peru, Rwanda, Sierra Leone, South Africa, Sri Lanka, Uganda and Zambia.
3. That selection was made using the following criteria: i) relating to low-lower-middle income countries (as defined by the
   World Bank); ii) a significant focus being on children; and iii) useful to achieve a balance across the globe, populations
   and programme settings ( conflict, disaster and development settings).The only exception to these criteria was a
   small group of documents on reintegration from juvenile detention facilities in South Africa, as many children came from
   areas that would meet the low-lower-middle income country criteria. Please see the bibliography for the results.

8       Reaching for Home: Global learning on family reintegration in low and lower-middle income countries
find substantial documentation of their voices                using examples from the field to illustrate the
through the literature4;this is problematic given             range of activities in place. Throughout each
the importance of boys’ and girls’ agency                     stage, common practices and divergences in
throughout the reintegration process.                         the literature and in the field are identified and
                                                              discussed, including a brief examination of
                                                              evidence about boys and girls who skip the first
Outline of the report                                         stage of this process and are only brought to the
This document begins with an introduction                     attention of a child protection agency once they
to separation, narrows down the discussion                    are home. The report then looks at cross-cutting
to ‘family reintegration’ and then provides a                 critical issues, and presents emerging principles
definition of that term; it proceeds to examine               of practice from the field, before concluding with
the different stages of the process – determining             a vision of shared learning to guide a stronger
suitability for reintegration, preparation,                   and more common approach to supporting the
reunification, and post-reunification support –               family reintegration of separated children.

Section II – Understanding separation
and reintegration

The issue of separated children                               and maintaining relationships, building self-
                                                              esteem and avoiding behavioural problems.” (p.
Poverty, disability, domestic abuse and armed
                                                              35). It is clear that efforts to both prevent initial
conflict are just some of the factors that cause
                                                              separation and to support the child returning to
separation and force children around the world
                                                              family and community life are needed.
into precarious circumstances (Smith and
Wakia 2012). Children may become separated
from their families through street involvement,               The right to reintegration and
trafficking, incarceration, placement in residential
care, incorporation into armed forces and
                                                              guidance on its fulfilment
groups, or in the aftermath of a natural disaster,            The United Nations Convention on the Rights
amongst other reasons. In some cases, parents                 of the Child (UN 1989) lays out the right of each
or other family members decide that children                  child who has been separated from his or her
should be separated, and in other cases                       family or usual caregiver to be protected, and
children leave home themselves.                               to be supported in returning to the care of that
                                                              family as appropriate. Article 39 stipulates that
All forms of separation increase the likelihood               member states shall:
of a child’s neglect and/or exposure to
potential exploitation and abuse (Tolfree 2006;               “…take all appropriate measures to promote
Tobis 2000). According to UNICEF (2006a):                     physical and psychological recovery and social
“Separation increases a child’s vulnerability to              reintegration of a child victim of: any form of
health problems (inadequate nutrition, risk of                neglect, exploitation, or abuse; torture or any
disease) and psychological difficulties in forming            other form of cruel, inhuman or degrading

4. T
    wo notable exceptions are No Place Like Home? (Delap 2004) and Feeling and being a part of something better:
   children and young people’s perspectives on reintegration (Veitch 2013).

              Reaching for Home: Global learning on family reintegration in low and lower-middle income countries   9
treatment or punishment; or armed conflicts.                  rehabilitation/restoration/integration/follow-up) to
Such recovery and reintegration shall take place              refer to similar or even the same concept. This
in an environment which fosters the health, self-             has caused widespread discrepancies both in the
respect and dignity of the child.”                            literature and in practice about what reintegration
                                                              entails and how it should be achieved. As it
The state is the ultimate duty-bearer in this                 stands, global practice lacks cohesion, resulting
regard; however, the responsibility and obligation            in a broad range of concepts and approaches,
to protect children and promote their reintegration           involving a wide array of actors, children, and
fall on everyone in society.                                  settings.

In 2009, the United Nations welcomed the                      In some cases, reintegration is understood
Guidelines for the Alternative Care of Children               simply as the physical placement of a separated
(hereon referred to as ‘the Guidelines’), which               child back within the family of origin. This view
established the primary goal of support for                   sees it as a singular event, culminating in the
separated children to be the return to the                    reunification of a child with the family, at which
biological family, or family of origin. Article 3             point reintegration has been achieved. In the case
reads:                                                        of juvenile offenders, despite growing efforts with
                                                              such international instruments as the UN’s Riyadh
“The family being the fundamental group of                    Guidelines and Rules for Juveniles Deprived
society and the natural environment for the                   of their Liberty, ‘successful reintegration’ all
growth, well-being and protection of children,                too often appears to be one-dimensional – the
efforts should primarily be directed to enabling              prevention of recidivism (Muntingh 2005).
the child to remain in or return to the care of his/
her parents, or when appropriate, other close                 However, there is a clear trend towards
family members. The State should ensure that                  reconceptualising reintegration as a far more
families have access to forms of support in the               nuanced and complex process rather than an
caregiving role.”                                             singular event, occurring in stages over time,
                                                              stretching far beyond the reunion of the child with
Other important international documents are                   his or her immediate family (Reimer et al. 2007),
also relevant for the reintegration of separated              and reaching deep into the community itself
children. These include the Paris Principles                  (Betancourt 2010; Chrobok and Akutu 2008;
and Commitments (dealing with children                        Hamakawa and Randall 2008; interview with P
associated with armed forces and armed                        Onyango). DeLay offers the following: “Successful
groups), the Interagency Guiding Principles on                reintegration requires an emphasis on helping
Unaccompanied and Separated Children (used in                 children re-create a sense of belonging and
emergency settings) and the Labour Convention                 purpose in all spheres of their life: family, school,
182 (on the worst forms of child labour).                     peers, and community.” (cited in Williamson
                                                              2008, p. 12). For some child protection actors,
Using this collective guidance, the global child              the term is only used after the child is placed in
protection community bases its interventions for              the family (Terre des Hommes 2009), although
separated children on the premise of ‘the child               the vast majority articulate a longer process
within the family; the family within the community’,          that also includes a preparatory phase and
though as discussed below there are cases when                the reunification itself (Asquith and Turner
reintegration is not appropriate.                             2008; Reimer et al. 2007; interviews with L.
                                                              Bhattacharjee, D. Godwin and C. Cabral).
Definitions of ‘reintegration’                                Some actors question the possibility of children
Despite its articulation as a societal obligation,            reintegrating when they either could not thrive
the term ‘reintegration’ lacks a clear and concise            in or did not know their family or community
operational definition. Over the years, various               of origin (McBride and Hanson 2013; personal
organisations involved in child protection have               communication with E. Garcia Rolland, 8 August
attached different meanings to it, as well as                 2013). This may have been because of family or
used other terms (e.g. transition/reinsertion/                societal violence, neglect or abuse by parents,

10     Reaching for Home: Global learning on family reintegration in low and lower-middle income countries
etc. They prefer to aim towards and speak of                       In order to focus the scope of this research, the
social integration or (re)integration.                             report focuses on ‘family reintegration’ and uses
                                                                   the following definition:
In addition, there is considerable debate around
the diversity and constitution of the ‘family’ in                  The process of a separated child making
the context of reintegration (Feeny 2005). As the                  what is anticipated to be a permanent
United Nations High Commissioner for Refugees                      transition back to his or her immediate or
(UNHCR) and the IRC’s guidance on determining                      extended family and the community (usually
the best interests of a child (UNHCR and IRC                       of origin), in order to receive protection and
2011) states:                                                      care and to find a sense of belonging and
                                                                   purpose in all spheres of life.
“Family structures vary significantly across
cultures and thus, for instance, the nuclear family                Thus the report does not discuss independent
is not always the most common household                            living,7 adoption, long-term foster care or
composition. In many societies, the child                          programming for those institutionalised or
‘belongs’ to the extended family: childcare is                     fostered children who are aging out of alternative
shared among a wide social network and children                    care. This definition stresses that reintegration is
can have multiple caregivers. It is important to                   a process, which can be completely self-driven
understand factors like this when discussing                       or assisted by various externally-guided efforts
family composition and relationships with the                      which may include planning and preparation,
child during BID [best interest determination]                     reunification with family and community, and
interviews.” (2011, p. 20).                                        support and follow up.

The Guidelines indicate that reintegration exists                  By excluding adoption and placement into all
only with the return of a child to the biological                  forms of alternative care, this definition neither
parents or family of origin (i.e. extended family                  aims to diminish the value of these options
members or ‘usual’ caregiver). However, the                        for some children, nor dismiss the idea that
literature review and interviews for this research                 returning to families and communities of origin
indicate that a significant number of actors                       may not be in the best interests of the child,
consider a broader range of placements as                          and that in some cases, periods in alternative
successful end points of reintegration5;these                      care or adoption may be the most appropriate
include long-term foster care (including some                      choices for children. However, in line with the
interpretations of kafala)6, supporting an older                   Guidelines, it acknowledges that these processes
child to live independently, and domestic                          of placement into new families or alternative care
adoption. They feel that this wider lens helps                     are qualitatively different from the process of
to account for the different circumstances and                     reintegrating children back into their own families,
realities of separated children.                                   requiring different forms of support for children
                                                                   and caregivers.

5. In the absence of a standard definition, and wishing to generate the widest perspective on the topic, the literature review
    used the following: “The process of a child without parental care making the transition back to his or her own parent(s)
    and community of origin, or where this is not possible, to another family who can offer care which is intended to be
    permanent though not through formalised adoption.” Key informants were asked to define the term, which was usually
    personal and not institutionalised.
6. A
    variety of means for providing child care for vulnerable children, recognised under Islamic law, which does not
   recognise adoption as the blood bonds between parents and children are seen as irreplaceable. Kafala may include
   providing regular financial and other support to children in need in parental, extended family or residential care.
   Alternatively, as referenced in the UNCRC, it may involve taking a child to live with a family on a permanent, legal basis,
   and caring for them in the same way as other children in the household, though children supported under kafala may not
   have the same rights to a family name or inheritance (Cantwell and Jacomy-Vite 2011; Ishaque 2008; ISS/IRC, 2007).
7. A handful of agencies did explicitly mention reintegrating children into independent living arrangements. While
   interventions to support this form of alternative care have many similarities to other reintegration efforts, there appear
   to be some notable differences: predominantly available in towns and cities versus rural areas; predominantly with
   older adolescent boys; and understandably more focus on community mediation and less on (extended) family. Further
   exploration is warranted to draw out lessons learned in programming across the contexts and population profiles.

               Reaching for Home: Global learning on family reintegration in low and lower-middle income countries      11
children transition to a new way of living
  In summary, separated children are a                       within a community and usually – though
  widespread and troubling phenomenon                        not exclusively – within their immediate
  because they are vulnerable to neglect and a               or extended family. This report, however,
  host of violations of their right to protection.           focuses only on reintegration into the
  Under the UNCRC, they have a right to                      immediate or extended family of origin, rather
  family reunification and reintegration support.            than encompassing adoption or alternative
  While there is no global definition of the term            care (including independent living) as, whilst
  ‘reintegration’, there is agreement that it is             these may be valid choices for children,
  a process and not an event, which helps                    they involve different processes and require

Section III - Determining the suitability
of reintegration and developing a
reintegration plan
different forms of support.                                  home or be placed in another care option
In any discussion on reintegration, it must be               must be made on a case-by-case basis,
noted that there are inevitably situations wherein           considering the best interest of the child (UNGA
returning a child to the original caregivers or              2009). Ensuring best interests determination
extended family may not be in his or her best                (BID) is a governmental responsibility, but it is
interests, or even possible at this point. This              intensely time-consuming and specific to each
may be due to a history of abuse or other child              individual. As a result, it is often a process
protection concerns, or parental incapacity                  that falls by the wayside or is systematically or
or death. In these cases, another care option                sporadically given to UN and NGO partners;
must be sought which often aims to keep                      this is particularly true in an emergency setting.
the child in a family-based care setting, either             The BID process hands tremendous power to
through long-term foster care or adoption. Best              the agency in question, and thus it is paramount
practice indicates that the use of large-scale               that organisations use their full resources to
institutions for children should be phased out,              understand the situation of each child they
though smaller-scale group homes may offer                   are trying to assist, the surrounding context,
an appropriate temporary care option in some                 the full extent of the resources that can be
instances (Delap 2011; UNGA 2009). Supporting                brought to bear, and any agency (or worker)
the independent living of an older child or                  bias; the “importance of this analysis cannot
adolescent is also an option that has been used              be underestimated, for organisations risk
sparingly by agencies, where the child is seen               enacting a grave disservice to the children they
to exhibit adequate maturity and survival skills             are trying to help if they do not at least make
to live on his or her own or with siblings, with             themselves aware of the preconceptions that
support and supervision.                                     may be distancing them from the child’s reality
                                                             of experience” (Feeny 2005, p.8).
Decisions about whether a child should return

12    Reaching for Home: Global learning on family reintegration in low and lower-middle income countries
In line with the UNCRC, most agencies have                   (interview with M. Pilau). As long as there is
created meaningful spaces for children to                    a stabilised, safe family relationship or even
participate in decision making regarding                     one adult relative with whom the child has an
their reintegration, sharing their thoughts and              attachment, preparations to reintegrate the child
concerns. Good practice indicates that a child               can commence (interview with C. Cabral).
must express a desire to reintegrate with his or
her family for the process to be initiated. If the           Some agencies tend to have written tools (or
child expresses reticence to return, all agencies            guidelines with criteria) to help staff assess the
surveyed explore these feelings to try to                    current situation of a family and its potential to
uncover the roots of resistance and see if there             reintegrate the child successfully. For example,
is potential to improve the situation. In these              the IRC developed a tool to help screen
cases and where distance permits, measures                   families or potential caregivers called the Family
such as mediation and conflict resolution have               Willingness and Suitability Scale (DeLay 2003a);
been used successfully with children and                     while the Associação Brasiliera Terra dos
families (Williamson and Cripe 2002). There is a             Homens (ABTH) and others in the Safe Families,
common recognition that the ability to explore               Safe Children network use an ‘eco-map’ that
these sensitive matters rests in large part on the           places the family in the middle and maps what
skills and perceptiveness of the worker, as well             services it currently uses. Increasingly, agencies
as on the tools used (interviews with C. Cabral,             are approaching family assessment from a
R. Sen, D. Pop, and R. Smith).                               strengths-based perspective that helps the
                                                             various family members articulate what they are
Likewise, it is equally important for the parents            contributing to a child’s development, and thus
or caregivers to express their willingness to be             is more likely to engender good will between the
reunited with the child, as both have the right to           family and case worker (interviews with S. Miles,
decline. As one child suggests:                              D. Pop and C. Cabral).

“Before we are reintegrated our families should              In emergency settings, where NGOs and UN
come and see us here, talk to us and give us                 agencies often assume great responsibilities for
the feeling that they want us back. The social               individual children, a number of specific tools
workers also should guide us in the process.”                have been developed to assist to determine the
(A child from residential care in the process of             best path of reintegration for a child based on
reintegration, cited in Family for Every Child and           his or her specific circumstances. UNHCR and
Partnerships for Every Child Moldova 2013)                   IRC’s BID guidance (2011) and the interagency
                                                             Alternative Care in Emergencies Toolkit (Melville
Many organisations start by arranging a meeting              Fulford 2013)8 consider the main factors of the
with the parents or caregivers either with their             reason for separation, history of abuse, both the
own staff, or with a social worker from the                  child and the family’s willingness to reunite, the
community, wherein discussions take place                    material resources available to meet the child’s
to ensure that the family is not only willing and            basic needs, the physical health and capacity of
committed, but also possesses the tools and                  the family to care for the child, and the special
resources to be able to promote the rights and               needs of the child. Where resources exist and/
best interests of the child in the home (Smith               or legislation mandates it, the assessment
and Wakia 2012). This process may take many                  and planning for individual case management
visits; for example, one informant said that                 are done with workers from the relevant local
some agencies in Paraguay often contact up                   government department (interviews with L.
to 10 family members to get a sense of the                   Gracie and M. Pilau).
family dynamic and context, which can take
two to three months. Through this assessment                 For children who have been trafficked or
process and a dialogue with the child, they then             recruited (voluntarily or not) by fighters, including
identify the most suitable living arrangement                gangs, and may be at risk of (re)abduction or

8. These can be found at and

             Reaching for Home: Global learning on family reintegration in low and lower-middle income countries   13
at the very least harassment, security may be a              reassuring a child of the safety in returning to
major consideration in the reintegration process.            the home community, or the child and family
In order to feel secure, some children formerly              may determine that it is too dangerous and
associated with fighters will want assistance                delay the return or move elsewhere. Similarly,
to acquire official paperwork signed by the                  if a child and family decide to pursue a legal
relevant authorities before they return (LeGrand             case against a trafficker who still holds power
1999). Liaising with the local chief, warlord or             in their community, they may decide to relocate
security forces can be an important step in                  or postpone the child’s physical return home

  Thus in summary, it is of fundamental                      agency has at its disposal, as well as the
  importance to undertake a thorough,                        skill, perceptiveness and knowledge of
  participatory process to ascertain whether                 an experienced child protection worker.
  it is in a child’s best interests to seek                  That plan should be reviewed during
  family reintegration and to develop a plan                 the reintegration process, as amongst
  accordingly. This assessment takes time                    other things, family dynamics, resource
  and requires the full resources that an                    opportunities and security change.

Section IV – Preparation processes

(interview with P. Mohanto).                                 at them. Perhaps as a consequence of these
As mentioned above, those working on the                     greatly varying circumstances, this research
reintegration of varied groups of children have              found a spectrum of efforts around preparation,
demonstrated the need for well-thought-out                   some with very low intensity, and others with
planning and preparation as the first stage                  high levels of sophistication and intensity.
in the reintegration of a separated child. The               This section outlines the range of common
child’s age, the causes of separation and the                preparation activities, organised according
relationship of the child to the family, the nature          to their focus on the child, family and wider
and duration of the separation, and the level of             community, highlighting examples of promising
trauma endured are some of the factors that                  practice.
influence the content and level of intervention
needed during this phase. In some cases
of short separation, this phase may be very
                                                             Preparing the child
straightforward. In other cases, where the child             Determining children’s identities
has not been well-treated by the family prior to             For separated children in situations of armed
separation, has been in conflict with the family,            conflict or where the social welfare system is
or has experienced significant violence or abuse             very weak, preparing for reintegration may begin
during the separation, the level of preparation              with determining their identities (Bjerkan 2005).
needed prior to reuniting the child with his                 Older children may be able to provide tracing
or her family will be far greater. In yet other              information, but children who are younger, are
instances, it is the family or community who                 traumatised or have a disability cannot at times
does not wish to or feel able to receive the child,          (de la Soudiere et al. 2007; DeLay 2003b). Under
and thus, substantial engagement is targeted                 these circumstances, it can be a challenge

14    Reaching for Home: Global learning on family reintegration in low and lower-middle income countries
to establish and confirm the child’s identity               The model is also used in emergency settings.
particularly if he or she lacks any written proof           In refugee and internally displaced persons
of identity (Melville Fulford 2013). This can be            camps, organisations often establish ‘child-
fairly common in low income and/or emergency-               friendly spaces’ which serve as a central point
affected countries, where children may lack                 for recreational and therapeutic services, as
birth records or any documented proof of who                well as a meeting point for a separated child
they are. Thus agencies have to devise creative             and his or her worker. In eastern Democratic
strategies to help them identify ‘home’ and ‘self’.         Republic of Congo, self-demobilised (and other
                                                            vulnerable) children can access reunification and
Creating transitional space                                 reintegration support from such centres, which
Children who are preparing for reintegration may            also provide a bridge into the wider community.
be placed in some form of alternative care, or
continue to live elsewhere and be supported                 However as with residential programmes (see
through drop-in centres. Alternative care may               below), concern has been raised over ‘charity-
include placements in temporary residential care            oriented’, drop-in programmes that provide
(transit centres), or family-based placements.              ‘too much’ for the children; the critique being
In this section, these differing options are                that this can undermine reunification and
examined. More space is devoted to transit                  ultimately reintegration efforts by enabling street-
and drop-in centres as the most common form                 involved children in particular to continue living
of support, and therefore where the greatest                independently (Volpi 2002), particularly when
amount of literature exists. However, this is in            boys and girls can use the services of multiple
no way intended to diminish the value of family-            agencies simultaneously (Feeny 2005).
based placements for many children. Overall,
this evidence suggests no one size fits all                 Transitional accommodation
approach, and the need for a range of options               Transit facilities (also known as interim care
available for children.                                     centres) provide temporary shelter and a
                                                            safe space for children to live while they are
Drop-in centres                                             supported towards reintegration. They are most
Organisations assisting street-involved children            commonly used with trafficked children and
towards reintegration often favour a drop-in                former child soldiers, although variations of this
centre approach; it is seen as model which                  type of transitional housing do exist with other
honours the boys’ and girls’ independence,                  population groups, such as children living on the
reduces agency dependence, keeps                            streets, those who were incarcerated or were
reintegration with the family as the central                domestic workers.
focus of all activities, and is a community-
wide resource for all issues on family unity.               The goal of transit care, as stated by the
For example, Retrak invites street children in              majority of agencies, is to promote a smoother
Ethiopia and Uganda to attend daily activities              transition from separation to reintegration by
at drop-in centres where they gain access to                preparing the child physically, mentally and
needed health care, education, food, counselling            socially. While it is somewhat controversial,
and recreation activities, but where initiating             where the child has been significantly harmed
family connections and encouraging reintegration            during the separation, whether due to exposure
is the overarching goal (Adefrsew et al. 2011).             to abuse, sexual violence, substance abuse, or
Retrak also demonstrates high-quality practice              deprivations in basic needs, the use of good
in the collection of baseline data on all children          quality, transitory care is thought by some to be
who enter the centre, usually during one-to-                extremely beneficial (Williamson 2006; Jareg
one sessions with a social worker. This enables             2005). In some cases there may be also be legal
Retrak staff to “…understand the situation of               requirements (e.g. with unaccompanied refugee
each individual child, to decide on the level of            children or children leaving juvenile detention) or
intervention required and monitor the child’s well-         security reasons (e.g. with former child soldiers
being” (Corcoran and Wakia 2013, p.14).                     or trafficked children) where temporary shelters
                                                            are deemed necessary.

            Reaching for Home: Global learning on family reintegration in low and lower-middle income countries   15
However, not all of the literature supports                   for some children in some circumstances,
the use of transit centres, even for children                 alternatives must be sought to large-scale
who have experienced trauma. Some of the                      institutional type transit centres for all children.
early literature on the reintegration of former
child soldiers incorporated the assumption                    In addition to the size of the facility and the way
that the children had been damaged by the                     that care is organised, the research indicated
experience and needed to be psychologically                   several other elements to quality care within
healed through a structured programme and/                    transit centres.
or particular period of time in interim care.
Experience shows, however, that family                        • Engaging children in the daily running
reintegration was not just the goal for these                   of the transit centre: This may include
children it was central to the process of healing               creating and supervising a cooking/cleaning
as well (Boothby et al. 2006; Williamson                        rota or it may be an advisory council to
2006). The research demonstrates that some                      the management; it may be determining
organisations have been inclined to take the                    recreational activities or some input in the daily
position a priori that time in a rehabilitation                 schedule. Participation is very important in a
facility is necessary to heal ‘damaged’ children.               longer-term centre.
Others have argued that determination of                      • Developing multiple conflict diffusion
issues such as whether to place a child in a                    mechanisms: Some separated children
centre versus a foster family, should be based                  are used to a high level of autonomy and
on a technically sound individual assessment,                   may have significant anger and impulse
as opposed to a blanket assessment based                        control issues (e.g. children with addictions,
on which category the child fits into (see also                 former child soldiers, children who have
information below on ‘gatekeeping’ in regard to                 lived on the streets for an extended period).
residential care in general, which applies equally              Conflict diffusion mechanisms include skilled
to transit centres). It should be noted that many               counsellors who can truly listen to concerns
of the services provided by residential facilities              and reframe them as realistic immediate and
could also be provided at drop-in centres or                    short-term steps; space to exercise and to
as community-based programmes, something                        express emotions safely; and a means to
which warrants further comparative research.                    dance, or listen to or create music (Armstrong
                                                                2008; McMillan and Herrera 2012).
The advisability of the use of transit centres                • Developing children’s capacity to act
to prepare children for sustained and positive                  autonomously: When working with trafficked
reintegration depends not only on the nature                    children, participatory principles need to be
of the child and his/her experiences, but                       role-modelled in the centres as the children
also on the nature of the transit centre itself.                may have spent many months or years
According to the Guidelines, not all residential                stripped of their autonomy and ability to make
care, including transit centres, is the same.                   decisions.
Large-scale institutional care is acknowledged                • Creating culturally appropriate
as harmful to all children owing to the lack of                 conditions in the transit centres that are
opportunity for attachment with a consistent                    comparable to those found at home: This
carer and other issues, such as enhanced risk                   has been shown both to promote sustained
of abuse of a child, both of which would have                   reintegration and to lessen jealousy from peers
immediate and longer-term negative impacts on                   (UNICEF 2006a). In situations where children
reintegration. Instead, the Guidelines suggest                  perceived a higher quality of life in the centre
that all residential care facilities, including transit         (in terms of food availability, comfort, access to
centres, should be organised around small                       education and training, recreational materials
group care, allowing children to form bonds                     and psychosocial support), they were much
with carers and gain the individualised attention               less likely to want to return home (LeGrand
they need. The compliance to quality standards                  1999; Simcox & Marshall 2011, p.10).
of care is central for all residential type of care.          • Balancing this with meeting children’s
The recommendations in the Guidelines suggest                   basic needs: Agency workers (and donors)
that whilst small group homes may be suitable                   recognise the need to ensure that their

16     Reaching for Home: Global learning on family reintegration in low and lower-middle income countries
charges are as healthy and nutritiously fed as              former boy soldiers indicates that a stay of over
 possible before they leave for a more food-                 six months actually hinders children’s social
 insecure setting, even if life at home may mean             development and reintegration (Boothby et
 periods of hunger and deprivation. They aim                 al. 2006). Other organisations suggest that in
 to strike a balance between the importance                  some exceptional circumstances of entrenched
 of providing high-quality transitional services             inter-generational violence, an extended stay is
 and the risk of creating dissatisfaction with               essential towards properly preparing a child for
 the home setting (interviews with S. Miles, P.              the journey ahead (for example, JUCONI can
 Mohanto and D. Godwin).                                     support children up to a year or more in their
“I now have good clothes and a proper haircut;
I have proper food now as compared to before.                Even with a similar population profile, results can
I now eat good fish.” (Formerly trafficked boy,              vary significantly. For example, a transit centre
aged 12, living back at home in Ghana – cited in             run by Save the Children in the Democratic
Veitch 2013)                                                 Republic of Congo housed former child soldiers
                                                             for a period of only one to three months with
• Locating transit centres as close to home                 comparable success (Bernard et al. 2003) to the
  as possible: This eases the reintroduction to              Mozambique case study. Even in looking at one
  parents or caregivers over a period of time.               population profile (trafficked women and girls) in
  Several informants spoke of an ideal scenario              one setting (Cambodia), the Butterfly Project is
  providing opportunities for the family and                 finding wide variances in approaches to transit
  child to meet with increasing frequency and                care, including the lengths of stay (interview with
  length, and with decreasing supervision. This              S. Miles).
  proximity can be difficult in vast, insecure and/
  or under-resourced contexts or with cases                  These differing conclusions regarding how long
  of cross-border family separation; agencies,               a child should remain in residential care are likely
  such as Retrak, have demonstrated that high                to reflect both the different needs of individual
  rates of successful, sustained reintegration are           children, and the quality and purpose of the care
  achievable even when the distance is large.                on offer. For example, in the JUCONI example
  There are also, of course, other exceptions to             cited above, extended stays in small group
  this rule, and some children have expressed                residential care are part of efforts to provide
  that distance from their communities helps                 extensive therapeutic support to children and
  during the initial stages of reintegration, as it          their families to help overcome high levels of
  allows them time to heal, recover and prepare              family violence and develop more healthy intra-
  in peace and quiet (Delap 2011).                           family relationships.
• Provide adequate services and support:
  Children who are preparing for reintegration               While there cannot be one length of time that is
  may need varying services and support                      suitable for every child’s individual situation, it
  including counselling, education and                       would appear that more rigorous comparative
  vocational skills training and health services.            research is needed to evaluate the different
  These are discussed in more detail below.                  approaches to the placement in and use of
                                                             use interim care facilities and to establish a
There is a significant debate around the optimal             more evidence-based rationale for the time in
length of time for a child to stay in a residential          transitional care. As a starting point, Melville
facility prior to reunification with the family              Fulford (2013) lays out three main considerations
(LeGrand 1999), and examples from across                     in determining the length and level of
the globe. Many argue that a prolonged stay                  intervention during this phase: the length of time
in this type of setting may lead to negative                 the child has been separated, the experiences
consequences for the child, not the least                    he or she has endured and their consequences
of which is additional separation from the                   on his or her physical and mental health, and
family. For example, a longitudinal study of                 the assessed capacity of the receiving adults.
the reintegration programme at Lhanguene
Rehabilitation Centre in Mozambique with

             Reaching for Home: Global learning on family reintegration in low and lower-middle income countries   17
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