Extra-familial Care Research Articles

Gender and policies on paid family care: Overview of debate and theoretical reflections

Objective: This article discusses the implications of systematically including policies on paid family care in the concept of care policy for older people for theorizing the relationship between such policies and gender inequality. Background: In theoretical debates about the relationship between gender and care policy, most welfare state researchers agree that policies that support extra-familial care promote women’s participation in formal, paid work and can thus reduce gender inequality. By contrast, the role of policies that offer pay and elements of social security for family care in promoting gender equality is up for debate. Method: This article addresses the aforementioned debates’ key arguments by discussing the relationship between gender equality and care policies that actively support family caregivers. The argument is contextualized with examples of empirical findings from the literature. Results: We argue that, to some degree and under specific conditions, new policies on paid family care have the potential to reduce gender inequality. Conclusion: The article contributes to theoretical debates about gender and care policy by evaluating the implications of systematically including policies on paid family care in the study of care policy. This inclusion could clarify the circumstances under which policy support for family caregivers can contribute to fostering gender equality.

New forms of family care in cultural and institutional contexts. Introduction to the Special Collection

Objective: This special collection aims to contribute to theory and research on the cultural and institutional contexts of care and on the relationship between care policies, gender and the family. Background: Since the 1990s, many European welfare states have not only extended social rights and infrastructure related to extra-familial care, but have also expanded support for care by family members. So far, research on family care in the context of contemporary care policies remains scarce. Method: The special collection’s seven articles present theoretical debates related to family care and apply research on cross-national differences and intergroup differences using a variety of quantitative and qualitative methods. Results: By taking a multidimensional perspective on family care for older people, the special collection offers new insights into institutional and cultural family care contexts, the social risks and scope of action connected with family care and the consequences of the development of care policies for the relationship between family, gender and care. Conclusion: The special collection demonstrates that the systematic analysis of the development of family care in its institutional and cultural contexts, as well as the consequences for the development of social risks and scope of action connected with family care, enhances our understanding of the changing relationship between family, gender and care.

Seroprevalence of SARS-CoV-2 antibodies and associated risk factors in children less than 6 years of age in the canton of Fribourg, Switzerland (COVPED study): a population-based cross-sectional study.

To date, few data are available about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in young children and the role of early-life childcare arrangements in transmission of the virus. In this study, we assessed the SARS-CoV-2 seroprevalence in children less than 6 years of age in the canton of Fribourg and identified risk factors associated with seropositivity. The COVPED study is a population-based cross-sectional study in children less than 6 years of age living in the canton of Fribourg, Switzerland, who presented to a private paediatrician or the paediatric emergency department of the Fribourg Hospital during a 9-week period between 11 January and 14 March 2021. Immunoglobulin G antibodies against SARS-CoV-2 trimeric spike protein were measured in capillary blood samples using an in-house Luminex assay. A mean fluorescence intensity ratio of above 6 was considered as positive. Metadata was collected through electronic questionnaires. Logistic regression analysis was performed to assess the risk of seropositivity and associated factors. A total of 871 children, with a median age of 33 months (range 6 days to 5 years 11 months) were included; 412 (47%) were female. Overall, 180 (21%, 95% confidence interval [CI] 18-24%) children were seropositive. Age as continuous variable was not associated with seropositivity risk, apart from a higher rate in children less than 3 months of age. Univariable analysis showed that female sex was associated with a lower seropositivity risk (unadjusted odds ratio [OR] 0.69, 95% CI 0.49-0.96; p = 0.03). Day-care attendance was also associated with a lower seropositivity risk (OR 0.67, 95% CI 0.47-0.95; p = 0.03), whereas all other childcare arrangements were not associated with seropositivity. No association was found between the number of children and adults present in extra-familial care and seropositivity. Multivariable analysis identified the number of household members above the age of 12 years being positive for SARS-CoV-2 as the main risk factor for seropositivity in children (adjusted odds ratio [aOR] 7.80, 95% CI 4.65-13.07; p <0.001 for one household member, aOR 22.07, 95% CI 13.49-36.11; p <0.001 for two household members and aOR 32.20, 95% CI 9.30-111.55; p <0.001 for three or more household members). The number of household members tested positive for SARS-CoV-2 (PCR test) is the main exposure risk to seropositivity for children less than 6 years of age. But the family size is not associated with an increased risk of infection. In young children, extra-familial care does not increase the risk of becoming SARS-CoV-2 seropositive, neither does the number of contacts present in extra-familial care. As adults and children will be vaccinated and new virus variants will be circulating the risk of exposure for young children will likely change and needs further monitoring.

Boundary Crossers: How Providers Facilitate Ethnic Minority Families' Access to Dementia Services.

Providers who work closely with ethnic minority people with dementia and their families are pivotal in helping them access services. However, few studies have examined how these providers actually do this work. Using the concept of "boundary crossers," this article investigates the strategies applied by these providers to facilitate access to dementia services for ethnic minority people with dementia and their families. Between 2017 and 2020, in-depth video-recorded interviews were conducted with 27 health, aged care, and community service providers working with ethnic minority people living with dementia across Australia. Interviews were conducted in one of seven languages and/or in English, then translated and transcribed verbatim into English. The data were analyzed thematically. Family and community stigma associated with dementia and extra-familial care were significant barriers to families engaging with services. To overcome these barriers, participants worked at the boundaries of culture and dementia, community and systems, strategically using English and other vernaculars, clinical and cultural terminology, building trust and rapport, and assisting with service navigation to improve access. Concurrently, they were cognizant of familial boundaries and were careful to provide services that were culturally appropriate without supplanting the families' role. In negotiating cultural, social, and professional boundaries, providers undertake multidimensional and complex work that involves education, advocacy, negotiation, navigation, creativity, and emotional engagement. This work is largely undervalued but offers a model of care that facilitates social and community development as well as service integration across health, aged care, and social services.

Cooperation between child and adolescent psychiatry and youth welfare concerning socio-educational residence for children and adolescents

Kinder- und Jugendpsychiatrie und Kinder- und Jugendhilfe betreuen viele gemeinsame Kinder und Jugendliche. Insbesondere bei den schwierigsten Kindern und Jugendlichen ist eine Kooperation am meisten gefordert. Viele dieser schwierigen Kinder und Jugendlichen kommen aus schwierigen Lebensverhältnissen, sind häufig traumatisiert und zeigen stark externalisierendes Verhalten. Die Unterbringung in einer extrafamilialen Wohnform stellt die Beteiligten aller Systeme häufig vor große Probleme.Die Kinder- und Jugendpsychiatrie kann auf allen Ebenen wertvolle Beiträge leisten. Einerseits im Rahmen der spezifischen Kinder- und Jugendpsychiatrischen Diagnostik und Behandlung, ganz besonders im Konsiliar- und Liäsondienst und/oder in kooperativen Einrichtungen oder Betreuungsformaten. Dieses Angebot wird anhand der von der Kinder- und Jugendhilfe angebotenen Wohnformen diskutiert und konkrete Vorschläge zur Umsetzung diese Kooperation dargestellt.

Re-conceptualising the relationship between de-familialisation and familialisation and the implications for gender equality – the case of long-term care policies for older people

AbstractThis article explores how far the concepts of de-familialisation/familialisation are adequate to the classification of long-term care (LTC) policies for older people. In the theoretical debate over LTC policies, de-familialising and familialising policies are often treated as opposites. We propose re-conceptualising the relation between de-familialisation and familialisation, arguing that they represent substantially different types of policy that, in theory, can vary relatively autonomously. In order to evaluate this theoretical assumption, this article investigates the relation between the generosity level of LTC policies on extra-familial care, and the generosity level of LTC policies on paid family care, introducing a new multi-dimensional approach to measuring the generosity of LTC policy for older persons. It also explores the consequences of this for gender equality. The empirical study is based on a cross-national comparison of LTC policies in five European welfare states which show significant differences in their welfare state tradition. Data used are from document analysis of care policy law, the Mutual Information System on Social Protection, the European Quality of Life Survey and the Organisation for Economic Co-operation and Development. The findings support the argument that de-familialising and familialising LTC policies can vary relatively independently of each other in theory. It turns out that we get a better understanding of the relationship between LTC policy and gender equality if we analyse the role of different combinations of extra-familial and familial LTC policies for gender equality. The paper brings new insights into the ways welfare states act in regard to their LTC policies. It helps to clarify how the concept of de-familialisation/familialisation can be understood, and what this means for the relationship between LTC policies and gender equality.

Down syndrome – a challenge for Latvian health care and education system

Down syndrome (DS) is a genetic disorder. From 1997 to 2015, 473 DS patients were born in Latvia. Prenatal diagnosis allows terminating pregnancies with high risk of DS. The aim of our research was to assess the impact of environmental quality (family and extra-familial care) on the child's development, range of services for DS patients, and to identify the optimal early support system. Families and specialists were interviewed to analyze differences between children in families and institutional care clients. State financial support for a DS child in the family is less than to a child in institutional care, and does not provide adequate rehabilitation services. Conclusion: the environment (family/institution, available resources, and rehabilitation services) where the child grows up after the birth, determines both their quality of life and level of independence development. If the somatic problem-solving path is clear, then social integration needs to be improved. Support of inter-professional teams for the families is necessary immediately after the diagnostic statement in order to ensure a more favourable family environment and to reduce the risk of institutionalization. Despite the potentially higher early intensive rehabilitation costs, in the course of time we can predict that it will provide an economic effect on the state and improve the patient and their family's quality of life.

Institutions and Discourses on Childcare for Children Under the Age of Three in a Comparative French-Czech Perspective

The article compares the development of policies pertaining to care for preschool children in the course of the second half of the 20th century in France and in the Czech Republic. It aims at identifying the key factors that led to the differentiation of the policies and institutions in the two countries, especially with respect to support for extra-familial care and formal care institutions (nurseries). We build on the theories of ‘new’ institutionalisms and we apply framing analysis, which allows us to understand the formation of ideas that precede policy changes. Specifically, we discuss the role of expert discourse and the framings of care for young children in the process of social policy change. We argue that expert knowledge in interaction with the political, economic, and demographic contexts and how it has been presented in public have had a fundamental impact on the formation of childcare policies and institutions in the two countries.

Extra-Familial Care: Perspectives from India

This paper aims to give an overview of out-of-home care in India. It looks at the history and culture of extra-familial care in the country, the urgent need for organised out-of-home care, and tries to understand the role of the state, including legislation and policies. The belief that individual families should solve their children's problems is deeply ingrained. There are different support systems that cater to the children's needs and right to healthy living in home and with family. While the government and community choose and decide for the children of the country, the government drags its feet in drafting policies which recognise that large number of children are growing up without families. More research is needed to look at the need and quality parameters for out-of-home care. Action from both government and non-government organisations (NGOs) will require a large number of institutions that, in turn, will require sufficient budgets and trained staff to ensure an environment of protection, support and appropriate development for an estimated 20 million children in need of good quality out-of-home care in India.

The responsibilities of extra familial care institutions’ children as important personality characteristics development process

The questions about how and in which living activity areas the responsibility of extra familial care institutions’ children as important personality characteristic is developed, in this paper are investigated. Responsibility category includes the problem of philosophy and sociology – the extent of which a person is able and can be the subject (the author) of his activity, as well as specific questions: the ability of the person knowingly (intentionally, voluntarily) to execute determined requirements and to perform specified tasks; to make certain choice; to achieve determined results, as well as to solve the issues. The concept of responsibility is described in various scientific papers. Executed empirical research creates the possibility to clarify the views of staff and children on the importance of responsibility and the possibilities of its development in extra familial care institutions.

Between Ideology and Economy: The "Time Politics" of Child Care and Public Education in the Two Germanys

The article compares the discourses and policies of the “time politics” of public, that is, institutionalized, extra-familial care and education of pre- and elementary school children in East and West Germany. The FRG and the GDR represented two highly distinct welfare and education systems, which referred to each other in a complex relationship of “distancing and interconnection.” Proceeding from the concept of the “path dependency” of societal and political developments, the article analyzes which factors worked together when, how, and in which concrete historical contexts to form specific discourses and policies of the “time politics” in both German states.

Taken into custody: girls and convent guardianship in Renaissance Florence

This study examines the widespread practice of placing girls in the temporary care of convents in Renaissance Florence, a practice called serbanza. During the turbulent years from 1480 to 1530, guardianship became one of the most important social services offered by female religious communities, which sheltered girls in increasing numbers. Serbanza was the major form of extrafamilial care for young girls of the middling and artisan classes, as well as for the vulnerable rich, before the advent of large‐scale custodial institutions in the later sixteenth century. Based on extensive archival records, this study documents how patterns of guardianship changed in response to political turmoil and concerns over female honour. I argue that convent guardianship formed part of the institutional and experiential foundation of female culture that cut across lines of neighbourhood and class, and introduced girls to a distinctive kind of constructed community. Boarding girls on a regular basis also raised important issues for internal monastic governance and ecclesiastical supervision. Nuns balanced the financial and social benefits of guardianship against the disruption of monastic routines and the disapproval of clerical officials. These tensions were resolved only by the reorganization of convent life and the development of new custodial institutions under Cosimo I. (pp. 177–200)

Eldercare as “Woman's Work” in Poor Countries

This article explores gender and eldercare by examining four issues concerning the activities of women giving and receiving eldercare: (a) the need for an ethnographic and comparative focus; (b) some important differences between poor and rich countries in the structure of eldercare and in eldercare roles for women; (c) continuity and change in the role of women as caregivers and care receivers, women empowered and women in need; and (d) family structures for eldercare focusing on the tensions surrounding cultural principles and circumstances governing caregiver selection. The discussion calls for more research concerning the actual and potential roles of both women and men in eldercare. Women who provide eldercare in most poor countries would benefit from extrafamilial health care, services, and material resources that alleviate poverty as well as from improved education, whereas men in most countries will continue to avoid eldercare as long as it is regarded as “woman's work.”

Applying Organizational Ecology to the Family: The Case of Who Persists in Providing Foster Care

The conditions under which we care for children have become increasingly diverse (Aquilino, 1991; Rodman & Pratto, 1987; Rosewater, 1989). This is due not only to profound changes in the family itself, resulting from changing patterns of divorce, remarriage, childbearing, employment, and single parenthood (Aldous, 1990; Bumpass & Castro Martin, 1989; Bumpass & Rindfuss, 1979; Bumpass, Sweet, & Castro Martin, 1990; Cherlin, 1978; Menaghan & Parcel, 1990). It is also due to the proliferation of extrafamilial forms of child care provision (Belsky, 1990; Camasso & Roche, 1991; Hofferth, 1985; Kagan, 1989). Increasing numbers of children are now being cared for regularly in a wide variety of contexts by someone other than a parent (U.S. Bureau of the Census, 1988).The emergence of this diversity has raised important issues and questions concerning implications for the well-being of children. Hence, the effects on children of different types of intra-and extrafamilial caring arrangements have been studied extensively (for reviews, see Belsky, 1990; Furstenberg, 1990; Ihinger-Tallman, 1988; Menaghan & Parcel, 1990). A major underlying theme is the need to minimize disruptions and instability in children's lives because the emotional stress otherwise induced may have long-term, negative effects for a substantial minority (Bumpass, 1984; Bumpass & Rindfuss, 1979; Furstenberg, 1990; Moen & Schor, 1987). However, despite this emphasis, the literature contains few studies reporting empirically informed explanations of the longevity of extrafamilial child care arrangements. We know little about the survival patterns of extrafamilial child care providers, and, in particular, about the survival patterns of the many families who take on the task of caring for others' children. Since the survival of care-providing arrangements would appear to be a precondition for limiting socioemotional stress to children due to change and instability, this is a relatively significant oversight.We attempt in this article to contribute some increased understanding of factors underlying the survival patterns of families who care for other's children. We study the history of a population of foster homes over a 23-year period, exploring general arguments adapted from organizational ecology that might account for observed patterns of exits. Our purpose is mainly exploratory. We aim not to test hypotheses and formally confirm theoretical arguments, but to appraise the viability of generalizing propositions and concepts from organizational ecology to the study of extrafamilial care arrangements. We believe that demonstrating the viability of such an approach may contribute to the development of substantively informed theory of the dynamics of caring in modern societies.We choose to study foster homes because of the availability of files recording when individual families become foster homes, and the changes over time in the statuses and circumstances of these families and of the children for whom they provide care. Thus, relatively fine-grained event history data are available for individual families and children. This is important because the methods of dynamic analysis used to test arguments about the survival patterns of different units of study presume temporal data structures that contain an adequate representation of how individual units change at any point in time.THEORETICAL BACKGROUNDAn examination of the research literature on extrafamilial forms of child care shows that there has been little direct study of their survival patterns. While this literature does identify profitability and changes in government funding as factors affecting the supply of child care at any given time (e.g., Hofferth & Phillips, 1987), researchers have not addressed the question of how these and other factors influence the overall stability and longevity of child care arrangements. To the extent that research has addressed the issue of longevity, it is has done so on an inferential basis, and mainly from the perspective of factors associated with individual decisions by parents or care providers to stay in or to leave particular care arrangements (e. …

The family in a changing world

Increasing numbers of young mothers in the work force, more and more children requiring extrafamilial care, high rates of divorce, lower rates of remarriage, increasing numbers of female-headed households, growing numbers of zero-parent families, and significant occurrences of child maltreatment are just some of the social indicators indicative of the family in a changing world. These trends and their consequences for children are described and then examined from the perspectives of microeconomic theory, the relative-income hypothesis, sex-ratio theory, and one form of modernization theory. The paper concludes with a preliminary examination of the added explanatory power provided by evolutionary theory.

Early Environmental Experiences and School Achievement in the Second Grade: An Israeli Study

This study was an attempt to replicate, in an Israeli sample, findings from American studies regarding the relationship of demographic variables, the quality of the early environment, and sociocognitive growth in children. In the first part of the study, the environment of 178 2-year-old Israeli children was assessed. Families with higher social status (SES) and fewer children were significantly more likely to provide enriching environmental experiences to their 2-year-old. In the second phase of the study, 149 of the sample were located and their school achievement assessed at the end of Grade 2. Path analysis revealed that the family's SES and number of children had both a direct and an environmentally mediated effect on children's achievement in school, and that differences in the quality of the environment at 2 years accounted for a large part of the variability in achievement both between and within social classes. As in the American studies, free exploration of developmentally challenging objects, and in particular fine-coordination toys and picture-books, was an important feature of a good rearing environment. In addition, contact with peers and extrafamilial care in the 3rd year were found also to have some unique predictive power of sociocognitive performance. The results are congruent with a model that SES and family configuration have a decisive effect on child-rearing practices and the latter, in turn, determine the course of children's cognitive and social development. The possibility was entertained that class-related differences in parental concepts of age-appropriateness contribute to the SES differences in the type of environmental experiences accorded to young children.

Introduction to special section: Extra-familial care arrangements for the elderly

Introduction to special section: Extra-familial care arrangements for the elderly

The influence of maternal employment, attachment pattern, extrafamilial child care, and previous experience with peers on early peer interaction

The influence of maternal employment, attachment pattern, extrafamilial child care, and previous experience with peers on early peer interaction