Evidence for impact on de-institutionalization: A systematic review of the current status, gaps and future directions of translatable research on alternative care
Abstract
Background: The transition from institutionalized care to alternative family-based care arrangements for children and youth without available parents is an important policy aim around the world. It is timely to document the evidence to date on de-institutionalization (DI) and identify the gaps stalling translation of DI findings to policy or practice. Vulnerable children and their (alternative) parents deserve family-based DI reform that is sustainable and successful in improving their lives.
Method:: We conducted a narrative review of studies on de-institutionalization conducted in the last five years. Our systematic search identified 161 pertinent studies covering 67 countries across most continents. Main results: The majority of the studies were qualitative, used some type of 'convenience' sampling, and had a modest number of participants (but with a broad range, 1 – 5351). Remarkably few studies included children under 6 years of age. Despite small samples and relatively weak designs, the majority of the studies suggested policy implications of their results.
Recommendations:: Much work has been done, but the majority of DI research does not meet the requirements of transparency and replicability, perhaps due to the specific circumstances of performing DI research. To overcome these shortcomings, we suggest for DI studies to create more replicable evidence with translatable impact on governments, policymakers, sponsors and practitioners.
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