Interim and alternative care

Interim care refers to care provided to separated children while families are traced and before decisions are reached about permanent care. Alternative care is the care provided for children by caregivers who are not their biological parents. This care may take the form of informal or formal care.

When should we use interim and alternative care?

  • When children have been separated from parents and caregivers during the emergency and cannot be immediately reunited
  • When government systems are overwhelmed or not fully developed to cope with the need to provide alternative care for children who have been separated

An understanding of both the pre-existing child protection system and the impact of the emergency is vital for planning an appropriate interim care response and for building the capacity of a community to protect and care for their children, both in the immediate aftermath of an emergency and in the longer term. External agencies should support and build the capacity of government, and national and local organisations and groups, to lead on the planning, management and delivery of care and protection work.

Staff and caregivers should enable children of all ages, in keeping with their degree of mental and emotional maturity, to express their views and be actively involved in matters affecting them. All decisions about childcare placements and discharge should be made in consultation with the child, his or her caregivers and parents or other legal guardian, and in accordance with the legal process.

Interim care

It is important to prioritise support to family-based alternative care options in emergencies. Avoid support through residential care, as this can increase the likelihood of a family separating and can undermine children’s wellbeing. If residential care is the only realistic care option, facilities should be supported to achieve minimum standards of care and strong protection procedures. The placement in interim care should be temporary while family-based care options are developed. Children should not be in temporary residential care for more than 12 weeks.

  • When realistic and appropriate, children should be kept within their community of origin, and sibling groups should be kept together
  • Develop a care plan for each child in interim or alternative care as quickly as possible and in consultation with the child, his or her family and other important people in the child’s life

Supporting and developing interim care programmes:

Family-based care

  • Identify, support and build on relevant traditional mechanisms for providing care for children who are outside of family care which are already happening – encourage and support the community in spontaneous foster care
  • Strengthen the existing foster care system – identify, screen and support caregivers within the community with whom children can be placed for agreed periods. If there is a formal foster care system, programming may support expansion and strengthening of the system
  • Recruit, screen and train emergency standby foster caregivers and maintain contact at regular intervals with them:
    • Since foster care placements should be prioritised for infants and young children, and children with special needs, caregivers should be trained accordingly to provide the appropriate support
    • Where necessary, define policies on how foster families will be supported and compensated and ensure that resources are available to provide agreed supports, and to monitor the wellbeing of children placed in foster families

Supporting child and peer-headed households

  • For older teenagers, and even some child-headed households, supported independent living may be explored – where there are older siblings capable of caring for younger siblings, or where adult support is available or can be arranged, this may be a suitable care option
  • Ensure that community-based monitoring and support is available and children in child-headed households have access to tracing services, if required

Families, alternative caregivers and children living independently must have access to basic services and supports to enable them to care for themselves and their children. Social protection mechanisms, including but not limited to cash transfers, can play a vital role in strengthening vulnerable households and families who have taken in additional children.

Residential care or interim care centres

Where there is a shortage of foster caregivers, where older children do not want live with a substitute family, or when it is in the child’s best interests to be in supervised group-living arrangements, make use of existing residential care that meets agreed quality standards. Ideally these should be based on a small-group care model. As in normal families, children in group care should ideally be of mixed ages and abilities – avoid placing children of all the same age or disability in one placement, unless they are siblings, as this reduces the opportunities for children to learn from and be stimulated by each other. It can also put greater pressure on the caregivers.

If none of the above options is sufficient, consider how the capacity of existing informal and formal care options can be increased to cope with additional demand or to improve the quality of care to meet basic agreed standards. If this is not feasible, appropriate or sufficient, consider setting up other temporary care provisions, eg, emergency shelters, interim care centres.

Children must have mechanisms to report abuse, neglect or other concerns and plans must be in place for responding to children’s reports within their families, and in all forms of placement.

Follow up

  • Systematically follow up all children in interim or alternative care at least every 12 weeks
  • All children in interim care should receive follow up visits, and have their care placements reviewed regularly, to monitor their protection situation and wellbeing
  • Evaluate how children in (family-based and residential) care are spending their day. Refer children to local schools and community-based activities (e.g. child friendly spaces). Consider setting up day centres/non-formal education for children in temporary care if they cannot be enrolled in school.

Supporting and developing alternative care programmes for children who cannot return to families:

Make no permanent decision about a child’s alternative care arrangement as long as there is a chance of tracing family members, before available tracing avenues have been exhausted, and never, in any event, within the first year of the beginning of active tracing unless their are exceptional circumstances

If it is not possible to reunite a child with his or her family, or not in a child’s best interests to do so, consider alternative long term care options. Children should not be left in interim care placements indefinitely without a review process to decide what long term care options will be best.

Decisions on long term care should be taken through a judicial, administrative or other recognised procedure, and should be based on a thorough assessment of the child’s best interests, needs, and available care options. A permanent family placement is likely to be in a child’s best interests.

Alternative long-term care options can include:

  • adoption
  • supported independent living for older children
  • remaining in formal foster care

Adoption may be national or international and involves a permanent change in legal status using legal mechanisms. The Hague Convention on the Protection of Children and Cooperation in Respect of Inter-Country Adoption (HC-93) provides the legal framework for making sure that international adoption is carried out in the best interests of children. Family tracing should be the first priority and inter-country adoption should only be envisaged for a child once these tracing efforts have proved fruitless, and where stable in-country solutions are not available.

Additional tools and resources

The information on this page is primarily taken from the Minimum Standards for Child Protection in Humanitarian Action (Standard 13: Unaccompanied and Separated Children) and the Alternative Care in Emergencies Toolkit

Additional tools and resources for alternative care are available here

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