Feb. 16 2016

Children on Their Own in Cambodia

Mailman School Study Looks at Youth Living in Orphanages and on the Streets

Confronted with the question of why so many Cambodian children live in orphanages, government officials point to a startling fact. Many of these children aren’t orphans, at least in the traditional sense. Their parents place them in residential care, often for better educational opportunities. Other Cambodian youth are living on the street or in informal dwellings, sometimes away from family. But an accurate estimate of how many young people are living in these vulnerable situations is unknown.

A new video describes a Mailman School-led study to assess the size of the problem. Interspersed with footage of children in informal settlements and orphanages, researchers and officials describe the growth of residential care facilities in Cambodia, many which are operated or funded by foreign charities, including religious groups. There is concern that some of these facilities may not be operating in the children’s best interests. Studies in Romania and elsewhere have documented cognitive, emotional, and physical development delays for youth in similar institutional settings.

“Growing up in a family, however it is constructed, usually leads to the healthiest children across all areas of development,” says Lindsay Stark, associate professor of Population and Family Health who directed the study. “If a large part of an entire generation is being institutionalized, we need to understand the implications for children, and what that will mean when they become adults.”

Funded by USAID, the Cambodia study employed surveyors to travel throughout the country to tally the number of children living in residential care. But according to Stark, the goal was more than a simple head count. “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 second arm of the study used a method called capture-recapture to assess the number of homeless youth. Two waves of interviews gathered basic identifying information from children age 13 and older. The portion of children counted twice provided the basis for estimating the total. Beth Rubenstein, a researcher in Population and Family Health, believes it is likely the first time the method has been used on a national scale for homeless children. “We may have a better picture of homeless youth in Cambodia than in anywhere else in the world,” she says.

There is increasing international mobilization around the importance of family care in child development. The U.S. Government Action Plan on Children in Adversity, which provided the impetus for the Cambodia study, looks at ways to reduce the number of children outside of family care. To carry out the study, the Mailman School partnered with the Cambodian National Institute of Statistics, UNICEF, Friends International, and Moulathan Consulting.

Last summer, MPH students Anjoli Anand and Saeed Rahman joined Rubenstein in Cambodia to work on the study as part of their practica experience. The pair helped with planning, training, and overseeing data collection.

In the new video, Anand speaks to the purpose of the study: to guide policy changes. “Without defining what the problem is, it’s really hard to direct funding and direct programing to address the situation,” she says.

The results of the research will be published in coming weeks. The researchers say they hope it is only the first in a series of similar efforts in other countries. “Too often, vulnerable children everywhere are kept out of sight and forgotten,” says Stark. “We need to understand their circumstances so we can find ways to give them a better shot at a happy and secure future.”