PDF(Pubmed)
Abstract：
Tens of millions of children lack adequate care, many having been separated from or lost one or both parents. Despite the problem\'s severity and its impact on a child\'s lifelong health and wellbeing, the care of vulnerable children-which includes strengthening the care of children within families, preventing unnecessary family separation, and ensuring quality care alternatives when reunification with the biological parents is not possible or appropriate-is a low global priority. This analysis investigates factors shaping the inadequate global prioritization of the care of vulnerable children. Specifically, the analysis focuses on factors internal to the global policy community addressing children\'s care, including how they understand, govern, and communicate the problem.
Drawing on agenda setting scholarship, we triangulated among several sources of data, including 32 interviews with experts, as well as documents including peer-reviewed literature and organizational reports. We undertook a thematic analysis of the data, using these to create a historical narrative on efforts to address children\'s care, and specifically childcare reform.
Divisive disagreements on the definition and legitimacy of deinstitutionalization-a care reform strategy that replaces institution-based care with family-based care-may be hindering priority for children\'s care. Multiple factors have shaped these disagreements: a contradictory evidence base on the scope of the problem and solutions, divergent experiences between former Soviet bloc and other countries, socio-cultural and legal challenges in introducing formal alternative care arrangements, commercial interests that perpetuate support for residential facilities, as well as the sometimes conflicting views of impacted children, families, and the disability community. These disagreements have led to considerable governance and positioning difficulties, which have complicated efforts to coordinate initiatives, precluded the emergence of leadership that proponents universally trust, hampered the engagement of potential allies, and challenged efforts to secure funding and convince policymakers to act.
In order to potentially become a more potent force for advancing global priority, children\'s care proponents within international organizations, donor agencies, and non-governmental agencies working across countries will need to better manage their disagreements around deinstitutionalization as a care reform strategy.
Drawing on agenda setting scholarship, we triangulated among several sources of data, including 32 interviews with experts, as well as documents including peer-reviewed literature and organizational reports. We undertook a thematic analysis of the data, using these to create a historical narrative on efforts to address children\'s care, and specifically childcare reform.
Divisive disagreements on the definition and legitimacy of deinstitutionalization-a care reform strategy that replaces institution-based care with family-based care-may be hindering priority for children\'s care. Multiple factors have shaped these disagreements: a contradictory evidence base on the scope of the problem and solutions, divergent experiences between former Soviet bloc and other countries, socio-cultural and legal challenges in introducing formal alternative care arrangements, commercial interests that perpetuate support for residential facilities, as well as the sometimes conflicting views of impacted children, families, and the disability community. These disagreements have led to considerable governance and positioning difficulties, which have complicated efforts to coordinate initiatives, precluded the emergence of leadership that proponents universally trust, hampered the engagement of potential allies, and challenged efforts to secure funding and convince policymakers to act.
In order to potentially become a more potent force for advancing global priority, children\'s care proponents within international organizations, donor agencies, and non-governmental agencies working across countries will need to better manage their disagreements around deinstitutionalization as a care reform strategy.
摘要：
背景：数千万儿童缺乏适当的照顾，许多人与父母分离或失去父母一方或双方。尽管问题的严重性及其对儿童的终身健康和福祉的影响，照顾弱势儿童-包括加强家庭内儿童的照顾，防止不必要的家庭分离，当与亲生父母团聚不可能或不适当时，确保高质量的护理替代方案是一个低全球优先事项。该分析调查了造成全球优先照顾弱势儿童的因素。具体来说,分析的重点是全球政策社区解决儿童保育问题的内部因素，包括他们如何理解，Govern,并传达问题。
方法：根据议程设置奖学金，我们在几个数据源之间进行了三角测量，包括对专家的32次采访，以及包括同行评审文献和组织报告在内的文件。我们对数据进行了专题分析，用这些来创造一个关于解决儿童护理问题的历史叙事，特别是儿童保育改革。
结果：关于非机构化的定义和合法性的分歧-一种以家庭为基础的护理取代基于机构的护理的护理改革策略-可能会阻碍儿童护理的优先考虑。多种因素形成了这些分歧：基于问题范围和解决方案的矛盾证据，前苏联集团和其他国家的分歧经验，在引入正式的替代照料安排方面的社会文化和法律挑战，永久支持住宅设施的商业利益，以及受影响儿童有时相互矛盾的观点，家庭,残疾人社区。这些分歧导致了相当大的治理和定位困难,协调倡议的努力很复杂，排除了支持普遍信任的领导层的出现，阻碍了潜在盟友的参与,并挑战确保资金和说服决策者采取行动的努力。
结论：为了有可能成为推进全球优先事项的更强大的力量，国际组织内的儿童保育支持者，捐助机构,和在各国工作的非政府机构将需要更好地管理他们在非机构化方面的分歧，这是一项护理改革战略。
方法：根据议程设置奖学金，我们在几个数据源之间进行了三角测量，包括对专家的32次采访，以及包括同行评审文献和组织报告在内的文件。我们对数据进行了专题分析，用这些来创造一个关于解决儿童护理问题的历史叙事，特别是儿童保育改革。
结果：关于非机构化的定义和合法性的分歧-一种以家庭为基础的护理取代基于机构的护理的护理改革策略-可能会阻碍儿童护理的优先考虑。多种因素形成了这些分歧：基于问题范围和解决方案的矛盾证据，前苏联集团和其他国家的分歧经验，在引入正式的替代照料安排方面的社会文化和法律挑战，永久支持住宅设施的商业利益，以及受影响儿童有时相互矛盾的观点，家庭,残疾人社区。这些分歧导致了相当大的治理和定位困难,协调倡议的努力很复杂，排除了支持普遍信任的领导层的出现，阻碍了潜在盟友的参与,并挑战确保资金和说服决策者采取行动的努力。
结论：为了有可能成为推进全球优先事项的更强大的力量，国际组织内的儿童保育支持者，捐助机构,和在各国工作的非政府机构将需要更好地管理他们在非机构化方面的分歧，这是一项护理改革战略。
