Improving care quality and preventing maltreatment in institutional care – a feasibility study with caregivers

Abstract

Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. By providing a manualized training workshop for caregivers, we aimed at improving care quality and preventing maltreatment in institutional care. In Study 1, 29 participating caregivers rated feasibility and efficacy of the training immediately before, directly after, and 3 months following the training workshop. The results showed high demand, good feasibility, high motivation, and acceptance of caregivers. They reported improvements in caregiver–child relationships, as well as in the children’s behavior. Study 2 assessed exposure to maltreatment and the mental health of 28 orphans living in one institution in which all caregivers had been trained. The children were interviewed 20 months before, 1 month before, and 3 months after the training. Children reported a decrease in physical maltreatment and assessments showed a decrease in mental health problems. Our approach seems feasible under challenging circumstances and provides first hints for its efficacy. These promising findings call for further studies testing the efficacy and sustainability of this maltreatment prevention approach.

Japanese residential care quality and perceived competency in institutionalized adolescents: A preliminary assessment of the dimensionality of care provision

“…These discrepancies suggest the need to consider "softer" aspects of the rearing environment, even within institutions that may be associated with better psychological outcomes in typically-developing families as they do in out-of-home care settings. This hypothesis is supported by interventions studies where improving caregiver's parenting behaviour and knowledge results in improvement in children's developmental outcomes (Hermenau, Kaltenbach, Mkinga, & Hecker, 2015;Lyons et al, 2001) and that these positive outcomes are long lasting (McCall, 2013).…”

The Impact of Organizational Structure and Funding Sources on the Work and Health of Employed Caregivers in Children’s Homes in Ghana

“…High child-caregiver ratio and increased work load imply that caregivers are even less able to carry out the duties expected of them (Bass et al 2016). Caregiver training can significantly improve the situation and dramatically improve bonding and relationships between children and caregivers (Hermenau et al 2015;Hermenau et al 2017). Thus while we confirm that the small group family-style organizational form is a better option for the children, we also recommend that more has to be done in order for it to better support caregiver work performance and health.…”

Capacitación en salud para cuidadores de hogares convivenciales de niños, niñas y adolescentes

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