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The Economic and Social Consequences of Family-Based Care

The Economic and Social Consequences of Family-Based Care. Chris Desmond FXB Center for Health and Human Rights Harvard University. Context and consequences . T he vast majority of children in Africa, orphans included, live with family

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The Economic and Social Consequences of Family-Based Care

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  1. The Economic and Social Consequences of Family-Based Care Chris Desmond FXB Center for Health and Human Rights Harvard University

  2. Context and consequences • The vast majority of children in Africa, orphans included, live with family • Many families are, however, facing difficult times and this has consequences for children (not just orphans) • Health (mental and physical), education, security, opportunities for the future • Not just limited categories of families (child-headed households, skip-generation etc) • There are also consequences for others • Family, economic and social costs • When children fall out of the family system the impacts may be even greater

  3. Are the consequences inevitable or costs of inaction? • Some are inevitable, but many can be avoided • Children can survive a great deal when appropriately cared for • Steps can be taken to: • Strengthen families (directly and indirectly) • Reintegrate children into the family system • Provide replacement care when other options have failed (never orphanages) • Resources are limited, and how they are allocated needs to be given careful thought

  4. Efficient vs. Cheap • Important to distinguish between efficient and cheap interventions • Need to dispel the idea that children in poor countries are cheap to care for • Difference between marginal and total cost. • All depends on what you consider to be care • What is needed is ways to identify efficient interventions

  5. Identifying efficient responses Production line or cake baking?

  6. THE SAFE Model

  7. Identifying efficient responses • Need to consider the integrated nature of care • One reason why orphanages are not only bad, but inefficient • One reason to be cautiousof CEA results • Need to consider sets of actions to avoid inappropriate conclusions • Need to consider the trade-offs between efficiency and equity • Need to have open discussions: You should only accept the results of economic analysis to the extent to which you agree with the values on which it is based

  8. What to consider? • What constitutes adequate care? • Is the intervention addressing the integrated nature of care? • Does the intervention’s design inappropriately consider the environment fixed? • What are the equity / efficiency trade-offs?

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