This article is part of a special edition of the journal Psychosocial Intervention focused on the state of child protection in a wide variety of countries with special attention to out-of-home care placements, principally family foster care and residential care, though several aspects related to adoption were included as well. The articles in this special edition review the systems and practice in 16 countries in North America, Scandinavia, Western and Central/ Eastern Europe, Southern Europe and Australasia. The countries were chosen to represent very different cultural contexts, historical backgrounds, and social welfare systems. The main aim is to make an international comparison of important historical background, legal framework, current figures, research trends, and key challenges for the future in a sample of countries representing the most important models of welfare regimes (liberal welfare systems, liberal-conservative, social democratic, the so called 'Mediterranean' model, and countries in transition from communist state system). 

This article closes the special issue by highlighting a series of themes arising from the review to encourage reflection on the way in which societies try to guarantee the welfare of children and their families.  Matters such as the use of residential care and its role in the current child care system, the over-representation of ethnic minorities in foster care in several countries, the growth of kinship foster care versus non relative foster care, the situation of unaccompanied young people asylum seeking, the use of adoption as a permanent solution, the challenges of the transition to adulthood from care, the relevance of the professionalization and models based on social pedagogy, evaluation and planning based on data, and the current financial crisis and its impact on child care systems are some of the topics that are reviewed.

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For other articles in this special edition, please click on the links below:

• Overview of out of home care in the USA and Canada 
• Child protection and out of home care: Policy, practice, and research connections Australia and New Zealand
• The 'dance' of kinship care in England and Ireland: Navigating a course between regulation and relationships (For a summary of this article see Focus on Kinship Care section below)
• Out of home care in Norway and Sweden - similar and different
• Different sizes, similar challenges: Out of home care for youth in Germany and the Netherlands 
• Out of home care in France and Switzerland
• Child protection in Italy and Spain: Influence of the family supported society
• The challenge of reforming child protection in Eastern Europe: The cases of Hungary and Romania 

Emerging research suggests that biological relatedness contributes to differential treatment between children being raised by kin and the biological children in the caregiver's household. This potential concern may be elevated especially when household resources are stretched thin. For this study conducted in and near Kampala, Uganda, 518 youth (8 to 18 years old) and their caregivers were interviewed individually, examining the association between relatedness and perceived food and work equity, and school attendance. The authors review the literature on kinship care, with a particular focus on Sub-Saharan Africa where it is widely utilized, both for purposes of training a child or lending support to a relative (purposive or voluntary fostering), and in times of crisis in the parental household (crisis or involuntary fostering). Both types of care are typically arranged informally between relatives, with little or no supervision by authorities. Research shows that kinship care in that sub-region has increased dramatically in the past two decades due to AIDS, and the resulting orphan crisis has stretched the traditional safety net of kin care to breaking point, with limited resources in those households becoming even further stretched. 

In line with previous research findings, the study finds that grandparents are caring for the majority of children who do not live with their biological parents (69%) compared with only about 18% living with aunts and uncles. The study also finds that children living with grandparents do not tend to perceive intra-household discrimination but also demonstrates that many grandparent-led households experience extreme poverty. Household income, but not relatedness, was negatively associated with food inequity. However, relatedness was positively associated with perceived disparity in the distribution of work among children living in the household, and with children's school attendance. 

This chart illustrates preliminary research findings seeking to understand how orphan status affect the school attendance of children in Africa and the extent to which living in kinship care can act as a protective factor in this context. Although numerous studies have examined the effects of orphanhood on schooling outcomes, the results have been mixed, both in terms of whether orphans are significantly less likely to be enrolled in school but also, when they are found to be, whether it is orphan status or poverty that is responsible for this. Research has also indicated that kinship care can mitigate against the adverse effects of orphanhood on schooling, but that the closer the relation between the child and the kin, the higher the education investment. In other words, a child living with a grandparent would be more likely to be attending school than a child who is living with more extended family (and vice versa).  This concept is known as 'Hamilton's rule'.

Using data from the Demographic and Health Surveys (DHS) in 5 African countries (Malawi, Mozambique, Niger, Uganda and Zimbabwe) from 2004 to 2012, the chart analyses data on school attendance together with data on orphan status (one or both parent dead) and the relationship to the head of the household (who the child lives with), compared to non orphans living with one or both parents. The findings confirm Hamilton's rule for those five countries and that living with one or both parents was a protective factor regarding the likelihood of school attendance. 

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Informal kinship care practices are widespread in the West Central Africa region. An estimated 15.8% of children in West Central Africa do not live with their biological parents. However, only a very small number (0.002%) are thought to live in formal alternative care (including residential care)while the majority live in informal care alternatives, especially with their extended family in kinship care. A regional Save the Children participatory research initiative was undertaken to build knowledge on endogenous care practices within families and communities, especially informal kinship care, in order to better understand how the practice works and provide recommendations for programming to increase the care and protection of children. The research was conducted in the Democratic Republic of Congo, Nigeria and Sierra Leone, and was primarily qualitative and exploratory. Similar research was underway in Niger and was planned for Senegal.  Child researchers were actively involved in each stage of the research.  

The research identified key factors influencing kinship care arrangements in the 3 countries, including family poverty, the significance of local traditions, increasing value for education and lack of access to secondary schools, polygamy and family breakdown, accusation of witchcraft, conflict and displacement, outbreak of diseases including HIV/AIDs, and urbanization and migration. It also provides an overview of positive and negative experiences of children living in kinship care identified through the research. 

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This fascinating paper provides a brief overview of the looked after system in the UK and the equivalent care system in Ireland before going on to explore similarities and differences in how different jurisdictions navigate a course between legislation, regulation and providing enduring relationships for children in family based placements. It focuses in particular on the use of kinship care and explores some of the implications of some differences in how the two state systems approach the regulation of kinship care and manage related support arrangements. Consistent with international trends, family placement (unrelated and kinship care) is now the dominant form of care across the UK and Ireland: ranging from 57 per cent of placements in Scotland to close to 90 per cent in the Irish care system. Ireland also shares with Australia the distinction of having the lowest rate of reliance on residential care internationally (10% or less), whereas England has a slightly higher reliance, currently standing at 12 per cent. This is particularly noteworthy considering the high rates of placement in institutions in Ireland until the early 1970s. 

Data from the 2001 UK Census has shown that the vast majority of kinship care arrangements in the UK were informal (over 90%) with little if any involvement by children's care authorities. Yet there has also been a significant growth in the use of formal kinship care in the UK and Ireland in the last 20 years. However, the proportion of children in formal kinship care in England remains low compared to other parts of the UK, standing at 11 per cent compared to 15, 25 and 27 percent in Wales, Scotland, and Northern Ireland respectively. Ireland makes the greatest use of formal kinship care (29%) and also has one of the highest rates of placements with families globally. 

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This Handbook produced by Save the Children aims to provide guidance for Save the Children staff, NGO partners, Community Child Protection Groups (CPGs) and community volunteers in Myanmar. The Handbook highlights that communities in Myanmar have historically and traditionally cared for and protected orphaned, abandoned and vulnerable children within the extended family.  Many children have been left with grandparents, older siblings, aunts, uncles and others as parents migrate to other areas or neighboring countries for work.  The majority of kinship care situations are informal, having been arranged by parents themselves or within the family.  In most cases, it does not mean that children are actually moving from one household to another as households in Myanmar usually consist of the large extended family. 

The handbook highlights the benefits of kinship care but also some of the risks associated with it, and discusses the range of possible support needs which kin carers and children in their care could benefit from, with a particular focus on mitigating against the risk of unfair treatment of those children. The guidance underlines the key role of community level Child Protection Groups (CPGs) in identifying the needs for support and conducting assessments to ensure protection concerns and support needs are addressed. It lays out a Support and Supervision Framework to help identify how much effort to put into providing support and supervision to families providing kinship care and sets out a 9 Steps Process for Supporting Kinship Care.

In this presentation Professor Connolly of Melbourne University reviews recent trends in the use of kinship care in Australia, and highlights that, although kinship care has always been a major part of children's care systems, there has been an important shift over the past twenty years toward the use of extended family systems to support and care for vulnerable children. In 2010, statutory kinship care in Australia overtook foster care as the primary form of alternative care placement. Professor Connolly discusses the serious gaps in research in that context resulting in policy and practice responses not sufficiently informed by the evidence needed to better inform decision-making.  She also highlights what this shift means in the context of a 'residual' model of child protection, which Australia and nations with similar social service systems (NZ, UK, US, Canada) have adopted, whereby services for parents and children tend to be provided only when substantial child safety concerns are already present rather than delivering preventive social support services before such concerns become manifest. 

Professor Connolly argues that Australia has paid very little attention to the nature and scope of informal kinship care and the interplay between informal and formal support networks needed to strengthen good outcomes for vulnerable children. She suggests that what is needed is a re-engineering of kinship care support in Australia that goes beyond the current focus on statutory kinship care.

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This position statement by Save the Children recognises that the word 'family' has different meanings to people around the world, encompassing diverse family structures, relationships, and power dynamics, across countries and cultures, and that it is also a dynamic concept with new variants on traditional family structures have emerged in response to social change, conflict, urbanization, HIV/AIDS and other crisis. The statement highlights that the family is central to numerous international legal instruments, including the UN Convention on the Rights of the Child, but that none of these instruments define it. The Committee on the Rights of the Child has emphasized, however, that it is a concept reaching beyond the so-called nuclear family model and encompassing a range of care-giving environments, including the extended family and other traditional and more recent arrangements, provided these are consistent with children's rights and best interests. The organisation then clarifies its own understanding of families as "social groups connected by kinship, marriage, adoption or choice. Family members have clearly defined relationships, long-term commitments, mutual obligations and responsibilities, and a shared sense of togetherness. Families are the primary providers of protection, support and socialisation for children and youth."

The statement reviews the critical role and responsibilities of families to ensure that children survive, thrive and develop according to their age, gender and their evolving capacity, and the responsibility of the States to support parents and care-givers in their child-rearing role, as laid out in international and regional treaties. 

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Ending harmful institutions for children in Georgia, Save the Children. 

Georgia's child welfare reform has made important strides over the past eight years focusing largely on ending harmful child institutionalization. The child welfare reform process that started in 2005 is being implemented by the Government of Georgia with support from the international community and local NGOs. This video by Save the Children highlights some of the issues and the work of its project to support the Government in this reform process. 

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A Mother's Dream: The real life stories of India's baby-factory surrogate mothers , Journeyman Pictures.  

This documentary produced investigates the reality behind India's commercial baby surrogate industry. 

Making babies for money is big business in India. The Ananksha clinic is the largest outfit producing infants for clients, often foreigners, who can't conceive themselves. For the women who get pregnant on demand it's a way of escaping poverty but it's still deeply traumatic.

To view the trailer and find out how to watch the full documentary, please click here

To view the presentation, please click here

52. The Committee is concerned that institutionalization of children is still widespread in Catholic organizations and that family-type alternatives are still not given priority, as indicated by the opening of new institutions in many countries. The Committee is also concerned that the Holy See has not adopted guidelines on the placement and monitoring of children in Catholic alternative-care institutions and still does not have a policy for the de- institutionalization of children placed in Catholic organizations.

53. The Committee urges the Holy See to adopt a policy for the de- institutionalization of children placed in Catholic institutions and for the reunification of children with their families, where possible. The Committee also recommends that the Holy See take all necessary measures to ensure as a matter of priority that children under the age of three are not placed in institutions. The Holy See should also adopt guidelines for the placement, adequate periodic review and monitoring of children in all Catholic alternative-care settings, in order to ensure the application of standards and to prevent abuse. In doing so, the Holy See should take into account the Guidelines for the Alternative Care of Children annexed to General Assembly resolution 64/142 of 20 December 2009.

In 2013, Better Care Network (BCN) initiated an important process of developing a new Strategic Plan identifying the main strategic focus for its work over the next four years (2014-2017). The plan is based on an analysis of BCN's achievements to date, the strategic areas in which BCN can have most impact in the future by working with key actors to strengthen the response to children without adequate family care. 

The Strategic Plan was developed with the support of Global Child Protection Services through a collaborative process that included: 60 interviews with key informants; an on-line survey to which there were 141 respondents; and internal and external literature reviews. The information gathered was presented in a Background Paper, which formed the basis for discussion at a two-day workshop with the Steering Committee and Secretariat, at which strategic priorities and organizational arrangements for the next four years were agreed. The Strategic Plan was endorsed by the BCN Steering Committee. 

To read the BCN Strategic Plan, please click here