Residential childcare has had an image which, at the very least, is not a positive one. It has been blamed for weakening family links and leading to poor educational and health outcomes for children (Biehal et al. 1995; Mendes and Moslehuddin 2004; Stein 2002). However, children and young people enter residential care institutions for a variety of reasons, and by examining the experiences of children and young people in Bangladesh; we can see that residential childcare has the potential to offer a positive option for many disadvantaged children and young people.UNICEF estimates that there are more than 49,000 children in residential care in Bangladesh (UNICEF 2008), but this figure fails to include thousands of children who live in madrasahs. There is neither a uniform childcare policy nor formal aftercare support provision in Bangladesh; instead, the government, NGOs and faith-based orphanages (i.e. madrasahs) all have their own approaches and methods and there has been no research conducted on young people in and after care. The aim of this study was to explore the experiences of residential care from the perspectives of a group of young people who had lived in residential childcare institutions in Bangladesh with a view to making improvements in residential childcare in the future.
Qualitative methods were employed for data collection, using in-depth semi-structured interviews with 133 young people (aged between 12 and 26) who had left the care system and observation of the four institutions where they had lived: one run by an NGO (for sex workers’ children), two run by the government and one faith-based orphanage (madrasah) run by the religious community. All of the fieldwork was conducted and transcribed in Bangla.
The findings of this study show that young people had mixed feelings about their lives in care, preparation for leaving care, and aftercare support; moreover, their experiences were diverse. Overall, most said that they had benefited from being in care and the institution had had a largely positive impact on their lives. However, the experience for those who had been evicted was much less favourable; these young people suffered a range of hardships after leaving care.
The findings also show that there was a connection between the in-care experience and the success of a young person in the outside world. The type of institution, its culture, systems and practices, the amount of care received and socio-cultural-religious influences all played a part. The research further indicated that although some young people developed a measure of resilience to face the problems of their everyday lives, they were not fully able to overcome them due to societal discrimination. Those who did best where those who had developed positive attachments with at least one trusted adult, who acted as a mentor and strengthened their commitment and self-motivation. The findings demonstrate that aftercare support varied from institution to institution, but overall, was informal in nature.
The study concludes by setting out implications for building better residential childcare policy and practice in Bangladesh. It identifies a number of avenues for further research, suggesting that lessons for the minority world may be learned from this study, namely the notion that the whole community should take responsibility for its children; and attention should be paid to faith and religious beliefs in children’s upbringing. The study has also demonstrated that improving financial resources may not necessarily lead to better outcomes from children and young people. Instead, building relationships with adults, peer groups, parents, and community offer the best chance for good outcomes.
The main finding in this research is that time spent in residential childcare in Bangladesh was, on the whole, a positive experience for this group of young people, giving them opportunities for education, healthcare, relationships and social networks that they would not have had otherwise; after leaving care, their life chances of jobs, higher education and marriage and family life were improved as a direct consequence of this. This is in contrast to the research conducted in the UK and other developed countries which has highlighted negative outcomes for ‘looked after’ children (Biehal et al. 1995; Dixon and Stein 2005; Mendes and Moslehuddin 2004; Porter 1984; Stein 1999 and 2002). My findings also differ from studies conducted by some international NGOs in developing countries that portray residential childcare as detrimental and damaging for children (Jayathilake and Harini 2005; Lalzallana 2008; Martin and Sudrajat 2007; Tolfree 2005; UNICEF 2008).
There are other aspects of my study, however, which are much more in tune with existing childcare research. For example, my findings have confirmed the importance of attachment and relationships in ensuring that young people’s experience is a positive one (Bowlby 1951; Howe 2000; Tizard 1986; Schofield et al. 2000), as well as the negative consequences of stigma and social discrimination on young people’s lives (Elmer 2005; Goffman 1968; Kroger 2003; Triseliotis 1973). Interestingly, the research has drawn attention to the reality that for some young people, material benefits (such as good food and clothing) may be less significant to their developing a sense of self and well-being than religious belief and spiritual guidance; the young people who had a religious upbringing did especially well in terms of education and careers in the future. The group who fared least well across the board were those who had been evicted from their institutions.
The main findings from across the four findings chapters are presented next.
Experiences of Education
The study found that, overall, the young people in the study valued education and acknowledged that their institutions had played a positive role in their education, unlike experiences from research in the UK (Ajayi and Quigley 2006; Berridge and Brodie 1998; Biehal et al. 1995; Dixon and Stein 2005; Fletcher-Campbell 1998; Francis 2008; Hayden et al. 1997; Jackson and Sachdev 2001; Martin and Jackson 2002; Stein 1994; Rutter 2000). The young people who achieved most educationally were those who remained in care for a long period of time – a number of years.
This is in marked contrast to research carried out in the UK (Chakrabarti and Hill 2000; Sinclair and Gibbs 1996) where it was found that poor educational outcomes of children were associated with longer periods of stay in care institutions. Those whose care was disrupted (critically, through eviction) fared worst educationally. Moreover, a poor education impacted negatively on life chances as a whole. The madrasah education system, although narrowly-focused, was found to result in good outcomes for most young people, in terms of jobs as well as social acceptance.
No evidence was found from this study to show that educationally enriching environments, for example, a quiet or private place to study or having access to better quality educational resources produced better educational outcomes. Rather, it was found that increased material support seemed to contribute little to educational success, thus differing from findings of UK research (Berridge and Brodie 1998; Harker et al. 2005). Most children who did well educationally pointed to the importance of a quality relationship with a significant adult who cared about them; they understood that this was vital for their success, thus supporting other studies (Aldgate and McIntosh 2006; Cashmore et al. 2007; Dixon and Stein 2005; Francis 2008; Jackson and Sachdev 2001).
Moreover, low expectations (and sometimes too high expectations) and lack of care and guidance were found to impact negatively on young people’s educational success. As well as young people’s own attitude, a sense of determination, confidence and commitment were found to be important factors for educational success. Finally, young people from the NGO home and government institutions suffered significantly in terms of stigma and social discrimination because of their birth identity, care history and mothers’ profession (as a sex worker), which all adversely affected their educational outcomes.
Experiences of Healthcare
The study highlighted that healthcare practices in the institutions varied due to policy, funding and beliefs. Furthermore, management of the institutions and staff attitudes had a direct influence on healthcare practices. The study found that children from the madrasah were certainly happier and appeared healthier than their counterparts in the other institutions, even though they lacked medical facilities.
The study also identified that the quality and quantity of food mattered less to the young people than we might have anticipated; instead, ‘spiritual food’ was also found to be significant for some young people, especially those living in the madrasah. This is supported by a number of studies (Bergin 1983; Frankel and Hewitt 1994; Koenig 1997) that found that a strong faith in God or a benevolent spiritual entity contributes to good physical and mental health.
Relationships with staff and other peers were critical again, as was contact with birth families, in order to keep children well, physically and mentally. Finally, the study suggests that medical treatment and nutritious food are not the only things necessary for health and wellbeing, rather a number of factors are interrelated to promote wellness in a person: emotional health, mental health, healthy social relationships, safety and security, encouragement and interdependency, and most importantly, spirituality and religious beliefs.
Experiences of Personal Relationship, Identity and Social Networks
The study noted the importance of friendships with peers for developing confidence and well-being, self-esteem and resilience. Friendships made while in care were often continued after leaving care. This was also the case for relationships with adults, and young people said that they appreciated greatly the continuing concern of a staff member long after they had left the institution. They also, however, welcomed continuing contact with family members and the wider community. It should be remembered that the majority of children in all the institutions were not orphans or without families. Rather, parents had placed their children in residential care for a number of reasons (especially poverty, education, religion and safety), and a large number of children returned to their families after leaving care.
My findings demonstrated that regular family contact contributed to young people’s positive outcomes, thus agreeing with Frost et al. (1999) who argue that those young people who retain good family links are better able to create and maintain social networks in the longer term. For them, the certainty of having family provided self-esteem, confidence and assertiveness, thus promoting resilience in them. This study has shown that resilient young people did better educationally, had the ability to ignore past discriminatory experiences, were able to develop social networks outside the care institutions and could easily overcome life’s knocks. They were better able to cope with the world outside of the institution and to do so much more easily than their counterparts. They managed to develop a positive self-image image of the world and their part in it, supporting previously conducted research (e.g. Borge 1996; Dziech and Hawkins 1998; Fowler 1996; Garmezy 1993; Gilligan 1999; 2005; 2012; Quinn 1995; Rutter 1984; 1990; Sinclair and Gibbs 1996).
Interestingly, there was no evidence from this study that a smaller unit produced better outcomes for children, or that a smaller unit was more likely to lead to better quality attachments for young people. On the contrary, this study has shown that in larger institutions, where more residents were able to get to know more people, having multiple attachments was even more beneficial; children and young people turned to each other for support, and in doing so, they were able to build stronger relationships and to develop greater social skills. They also learned to become more independent and so were, arguably, better prepared for life beyond the institution.
Staff continuity, at the same time, seemed less important to young people than staff attitudes; hence a relatively new staff member might readily become a ‘special person’, because young people were able to build relationships quickly. The study has shown that extra-curricular activities were helpful in allowing children and young people to have positive experiences and so build resilience that helped young people to cope in the real world after they left care. Stigma around birth identity and care history, and social discrimination, on the other hand, were found to be barriers for success, as supported by Ibrahim’s (2010) study of Jordanian care leavers.
Experiences of Transition, Leaving Care and Aftercare Support
The study found that support for care-leavers matters in Bangladesh, just as has been demonstrated in many earlier UK studies (Ajayi and Quigley 2006; Biehal et al. 1995; Biehal and Wade 1999; Dixon and Stein 2005; Martin and Jackson 2002; Pinkerton and McCrea 1999; Sinclair and Gibbs 1998; Stein 2002; Stein and Munro 2008). Those who were evicted early from institutional care were highly vulnerable to abuse and exploitation (through gangsterism and prostitution, etc.); their educational and healthcare outcomes were much reduced and their life chances diminished. Supporting young people beyond care was not, however, found to be easy for some institutions, not least because young people may not wish to be identified as care-leavers because of the stigma attached to both birth identify and care itself.
Madrasah young people, who received no formal preparation for leaving care (as it is understood in the UK) and no formal support after care, nevertheless did best in the world beyond the institution. This reminds us that having formal procedures in place may be less important that informal supports from family and social networks; also that the impact of stigma (of birth and care identity) may be difficult to overcome, no matter how much willingness there is on the part of institutions to support young people who leave care.
My study also confirms that young people’s social integration is much more effective if society understands the problems faced by such young people after leaving care, and thus takes some responsibility for supporting them in integrating and being included. Nevertheless, the study has shown that institutions have a key role to play in continuing to support young people after care, especially when there is little or no family support mechanism available.