January 19, 2017 -- Nearly 80 percent of adolescents living in Cambodia's orphanages have one or more living parents, according to a study by researchers at Columbia University's Mailman School of Public Health. The first research of its kind assessing the literacy and health of children living outside of family care in Cambodia, the study estimated a total of 48,775 children - close to one percent of all children in Cambodia - were living in residential care institutions. The vast majority of these children are school-aged. Poverty and lack of educational opportunities in their home communities were cited as the primary reasons for family separation. Lindsay Stark, DrPH, associate professor of Population and Family Health at the Mailman School of Public Health, led the research. Findings of the study are published online in the journal BMJ Open.
Recognizing that existing census information and other data sources excluded children living in residential care institutions, Dr. Stark partnered with the National Institute of Statistics in Cambodia to develop tools for establishing a nationally representative estimate of the number, distribution and basic characteristics of these children.
"Our goal was more than a simple head count," noted Dr. Stark, who is also director of research at the CPC Learning Network. "We also assessed literacy and health and looked at the reasons why children entered residential care, whether or not they had parents, and if they did, whether their parents lived nearby," she says.
A child living in residential care was defined as anyone under the age of 18 years who was sleeping in the institution for at least four nights per week during the data collection period. More than half of the estimated 48,775 children living in residential care institutions in Cambodia are between 13 and 17 years of age.
"Many of these children aren't orphans in the traditional sense, but are placed by their parents in residential care as a last resort, after the existing social welfare program fails them," Dr. Stark continued. She points out that this is a large problem for many developing countries where orphanages and other residential care facilities have essentially become the family's social safety net. "Our objective was to generate inclusive data to guide policy makers and service providers in recognizing and protecting these children."
Data was collected through a multistage process. First, researchers reviewed government lists and conducted key informant interviews to construct a complete roster of institutions in selected study sites. Then the researchers visited all of the identified institutions to count the number of children who were present and gather information about their demographics and well-being. Finally, a model was developed to get a national estimate using the data from the selected sites.
A video produced by the Mailman School describes the study in greater detail, as well as a sister study on homeless urban children in Cambodia.
"All children have the fundamental right to grow up in a loving and protective family environment," said Dr. Stark. "A large part of an entire generation is being institutionalized and that has tremendous implications for Cambodia's future. We need to understand the scale of the issue and the reasons this is happening in order to give every child in Cambodia a fair chance." Further study will assess progress towards the national goal of reducing the number of children outside of households.
The study was funded by USAID. In addition to the Cambodian National Institute of Statistics, Dr. Stark partnered with UNICEF, Friends International, and Moulathan Consulting.