Alternative Care
for Children in Uganda
A government and civil society partnership
to support the Alternative Care Framework

First Response: Prevent separation

Uganda is a signatory to the United Nations Convention on the Rights of a Child and to the African Charter on the Rights and Welfare of the Child, both of which state that every child shall be entitled to the enjoyment of parental care and protection and shall, whenever possible, have the right to reside with his or her parents.

A child should be allowed to grow-up free of abuse, violence, exploitation and neglect, yet children are vulnerable to these in many different situations: families, schools, alternative care, in work environments and on the street. Child Protection Services prevent and respond to child abuse, exploitation and neglect, and family separation.

The most important and most complex response

Preventing separation is the first and most important option in the Alternative Care Framework. When this stage in the continuum of care is well developed, all the remaining options fade in importance. This is where the majority of investment should be directed and where capacity needs to be built. It is also the most complex of the options.

How should protection support be delivered?

Child Protection Programs should be both preventive, minimising children's risk of facing violence, abuse, exploitation and neglect, and responsive, providing specialised services in cases where children are at especially high risk for, or have experienced, child protection violations.

Recognising that children have different needs at different ages and stages in their development, child protection programs should be developmentally appropriate and address specific needs of early childhood development, middle childhood and adolescence.

The focus on Strengthening Families and Communities so as to protect children represents a major paradigm shift within the protection field and requires new policies, partnerships and programming approaches.

Government, Civil Society, communities and families all play critical roles at different levels of the system and all share responsibility to protect children. Although families are ideally a child's primary caregiver, many families find this role challenging without community support.

For communities to support families and ensure that children and families access a range of essential services, they must have the support of government and civil society. A well-organised, well-functioning social service system creates an environment for government and non-government, communities and families to care for children to the best of their ability.

Key Child Protection Activities

  • Strengthen Child Protection Systems at every level: Government, Civil Society, Community and Family. Build connections between levels of child protection networks.
  • Mandate policies that safeguard children as part of all OVC programs and partner collaborations. Promote child protection training for staff and partners.
  • Strengthen Government Capacity: Work with trained partners who have technical expertise to perform high-quality, child-sensitive child protection work.
  • Strengthen families to provide nurturing environments and to reduce risks of poverty, food insecurity, illness, including HIV and child abuse.
  • Provide children, families and caregivers with life-skills training and education to build self-esteem, resiliency and awareness of available support services.
  • Prioritise the Child's Best Interests to determine the most effective prevention, early intervention and alternative care options.
  • Consider residential care as a last resort. As a last resort, it should be time-limited, including a transition plan.
  • Promote legal protection to ensure child rights, birth registration, access to basic services, inheritance rights and to prevent harmful practices such as child labour, early marriage, child trafficking and female genital mutilation.
  • Advocate for enforcement of strong child protection legislation at all levels and training of law enforcement officers.
  • Register each child's birth to ensure child rights and access to basic services. These services are vital in protecting against child abuse and exploitation.
  • Integrate child protection activities within existing health services such as maternal and new-born health, prenatal care and within school-based programs.
  • Base policies and practices on international standards such as the U.N. Convention on the rights of the Child, and operate within local laws and policies, such as the Children Act and the official Alternative Care Framework.

Why do we want to prevent child-family separation?

Research shows relation between parenting quality and child development (Bowlby 1982; Sroufe 2005; Rutter 2007 etc.). Research also shows poorer outcomes for children in alternative care, particularly younger children in large scale residential based care (cognitive and socio-emotional development); (Bucharest Early Intervention Project 2003; Leiden studies 2012; Schoenmaker et al. 2014).

There is evidence of longer term negative outcomes for children who have been in care into adulthood; in relation to access to higher education, incarceration, employment and mental health.

What are the factors that lead to separation?

  • Poverty.
  • Illness and parental death, including HIV/AIDS pandemic but also mental health issues.
  • Disability.
  • Lack of access to good quality services close to home, particularly education.
  • Violence, abuse and neglect in the home.
  • Family breakdown and reconstruction (aftermath of divorce and remarriage).
  • Discrimination and social exclusion (including minorities, single parent and children born out of wedlock).
  • Emergencies, including armed conflict and natural disasters.
  • Displacement and migration (children left behind or children migrating for work).
  • Inappropriate policies that support the institutionalisation of children.

Why is this relevant?

Parental death (orphanhood) is not the primary reason for children not living with their biological parents. A significant percentage of children who are not living with their parents still have one or both parents alive.

Understanding the pull and push factors resulting in separation is important. It is the basis of knowing what needs to be done in terms of family and parenting support. We need to understand who the caregivers are to meet their particular needs. Single parent families tend to be poorer and face a range of risk factors, including access to social services, lack of social support, greater care support needs. Research has also shown that kinship care givers tend to be older, poorer and face issues of health and access to social services.

Key focus areas

  • Prevention of abandonment and relinquishment of infants and young children.
  • Support to pregnant and young mothers in maternal health units with a system of social worker referral and response.
  • Home visitation/outreach programs to strengthen parenting skills, improving parent-child relationship and connect parents to sources of support.
  • Support to primary caregivers of children with disability. Short-break (respite) services for children with disabilities.
  • Early referral by community members of families at risk of separation and case management.
  • Prevention of separation as a result of emergencies or crises. Family Tracing and Reintegration services following an emergency with family support programs.
  • Reintegration services for children in residential care, living on the streets and for children who have been trafficked.

Key concerns

Many interventions are at piloting level in Uganda. There is a need for better evidence of impact and of scaling up.

Family and community strengthening programmes recognise that there are issues with targeting OVC rather than caregiving for all children in family.

Support to kinship caregivers is still variable and unregulated as is the area of subsidies for formal kinship care and foster care.

There is a strong focus on babies and very young children, particularly for fund-raising because of the emotional pull, yet (while better statistics are still wanting) the majority of children in alternative care were placed when they were older (school-age). More emphasis is needed on teenage relationships, reproductive health and parenting education, including a focus on early marriage, prevention of early pregnancies and parenting education.

Most prevention interventions rely on functioning community level professionals/para professionals working with families. More information is needed about the importance of informal support networks and peer support.

Many studies and assessments provide a static view, whereas the reality is ongoing change; transitions in families through divorce and remarriage, transition from primary to secondary school and transition to independent living.


There is the urgent need to eliminate placement of under 3 year olds into institutional care and to tackle the vested interests in the use of residential care which relies on the separation of children from their families.