An Impact Study of The COVID-19 Outbreak and Its Consequences for Children and Youth in Two Alternative Care Systems

An Impact Study of The COVID-19 Outbreak and Its Consequences for Children and Youth in Two Alternative Care Systems

Varathagowry Vasudevan¹^*, Hashini Silva², J Thatparan³

^[1]Author, Director, Training, National Institute of Social Development, Sri Lanka
²Lecturer, School of Social work, National Institute of Social Development. Sri Lanka
³Jeganathan Thatparan, LLM (UOC), Attorney-at-Law, Visiting Lecturer, Law College, Sri Lanka

Received Date: February 20, 2023; Accepted Date: March 01, 2023; Published Date: March 06, 2023;
^*Corresponding author: Varathagowry Vasudevan. Author, Director, Training, National Institute of Social Development, Sri Lanka. Email: gowrynisd@gmail.com

Citation: Vasudevan V, Silva H, Thatparan J (2023) An Impact Study of The COVID-19 Outbreak and Its Consequences for Children and Youth in Two Alternative Care Systems. Adv Pub Health Com Trop Med: APCTM-180.

DOI: 10.37722/APHCTM.2023203

Abstract
COVID-19 has upended societies and dramatically altered everyday life across the globe. Out of these, under the influence of these unprecedented conditions, one of the most disadvantaged communities can be called the "institutionalized children."Hence the impact study focused on children in voluntary homes, especially those in family-like care models (SOS Children’s Village) (1) and total institutional care models (2), as per the literature review. This research was intended to distinguish the impact of the COVID-19 outbreak on children in family-like care models and institutional care models in alternative care settings. Both quantitative and qualitative methodologies were adopted to study the impact on the development of children and youth in the two types of care systems, especially in COVID times. Ten major child development indicators related to the evolving capacities of children were addressed in this study. A questionnaire was used to generate data from children. A total of 602 people, 80% in institutional care and 20% in family-like care, were considered the sample. The data was validated through focus group discussions. The gathered data was analyzed using MS-Excel and Minitab. Education, social relationships, reintegration into society, and emotional status were the most severely impacted components, which could have long-term consequences for youth and child development. Although there is evidence that children become accustomed to a pattern of self-directed learning and other creative activities during this COVID lockdown period, the study found that activities such as the lack of adequate facilities for online education and the need to stay close to loved ones inevitably affect their psychosocial development. The impact study recommends a smaller scale of family-like care or institutional care to fulfill the unaddressed needs and bring about systemic change, which are dire needs of policy practice in alternative care.

Keywords: COVID 19 outbreak; Development of Children and Youth

Introduction
In the face of the COVID-19 pandemic, children and young people had to undergo many changes, experiencing both positive and negative feelings, including uncertainty and complexity. Although each child is unique and has been affected differently, some of the changes that children have experienced include prolonged separation from family and friends; conflict and stress within family-like and institutional care; alternative educational platforms due to school closures and resulting increased screen time; limitations to health services; chronic worries about family, education, and one's own health; and boredom due to confinement to the same dwelling. The socio-economic impact of COVID-19 affects the most vulnerable children in Sri Lanka. The measures imposed on them will risk plunging them further into hardship and potentially bringing millions of children into poverty. Children who do not have or are at risk of losing parental care are especially vulnerable to these mounting challenges, which compound their vulnerability in situations of fragile family environments or living in various alternative care placements.

With reference to that, study was carried out in order to differentiate between the impact of the COVID-19 outbreak and its long-term consequences on children in family-like care (SOS Children’s’ village) and total institutional care. This impact assessment was conducted during the COVID-19 pandemic, paved more concern on children and youth, especially in alternative care settings and Sri Lanka, to deepen understanding of the prevailing conditions regarding the selected developmental areas. This is about the total development of children and youth for their lifespan development while focusing on COVID-19 responses and alternatives for their better care and on children and youth responses to adjustments and adaptation to the new normal.

This impact study builds on the theoretical framework that underpins the ecological system theory, which states the importance of the many environmental and societal influences that play a role in a child’s life. The systems identified in ecological theory include the microsystem, the mezzo system, the ecosystem, the macro system, and the chrono system. Community Environment for children contributes to positive and negative of educational, developmental needs, Protection, Health, Social Welfare, Physical health, Mental health in the children and youth of various alternative care. This study draws on Bronfenbrenner’s ecological systems theory, beginning first with a child’s immediate surroundings and expanding to the larger environment: Using the framework as a lens for identifying the impact of COVID-19 on children at every level in alternative care systems, namely family-like care, institutional care, and homes in Sri Lanka, the study is expected to analyze the role of the Department of Probation and Child Care Services and alternative care arrangements in Sri Lanka that influence the impact of COVID-19 on children in alternative care.

Source: Bronfenbrenner’s Ecological Systems Theory (1979) cited from L. cross& Frazer, 2010.

Figure 1: Bronfenbrenner’s Ecological Systems Theory.

Methodology

The methodology was adopted both mixed with quantitative and qualitative methods. The data for the impact assessment was obtained from the i.e. both models of children in voluntary homes, caregivers key informants and Local Process Initiative (LPI) 4 from eight Districts in Sri Lanka. The qualitative method such as focused group discussion (FGD) with children ages 12 to 14 and 15 to 18, caregivers, and service providers. Key informant interviews with managers and administrators were also conducted. The methodology for the survey focused on a sample of 602 children from a total selected population of 4112 children in the age group of Fifteen (15) to Eighteen plus (18+) in voluntary homes (Dept. of census and statistics). Data was analyzed through MS-Excel and Minitab. Chi-Square test and t-test also performed to analysis relationships between two type of care and its differences. and content analysis method. A strength-based approach was used throughout the impact assessment without using stigmatized words. The quantitative and qualitative data analysis was designed using the following identified indicators:

SN	Factors	Categories
1	Health indicators hygienic practices of COVID 19 Ø Awareness of COVID19 infection Ø Able to write symptoms of COVID 19 Ø How to protect themselves and others Ø COVID19 preventive practices adopted by children	Family-like care (SOS Children’s Villages Institutional care
2	Physical health Ø Satisfaction of food (taste/quantity/varieties) Ø Daily play and sports activities Ø Health and medical care facilities
3	Education Ø Satisfaction on online education Ø Completion of homework and schoolwork Ø Improved skills in the use of IT Ø Missed my school and friends
4	Managing the day during the COVID 19 Pandemic Ø Engage in multiple activities during the lockdown Ø Develop my life skills Ø Spent more time with friends and caregivers
5	Psychological Social-emotional Development Ø Feeling happy and safe Ø Good night’s sleep Ø Caregivers gave me their love and affection Ø Cope with changes in my lifestyle
6	Social connections Ø Social connections Ø Missed activities
7	Coping strategy Sleeping, Prayer, writing, talking to friends, home gardening, exercise, and indoor games, playing instruments, listening to music, and watching movies
8	Trustworthy person Caregiver, siblings, manager of the care institution, staff, probation officer, friends, counselor, others specify
9	Child participation The overall feeling of your participation in care
10	Children’s suggestions

Table 1: Identified Factors of Child Developmental Needs.

Results and Discussion
The profile of participants

According to the Department of Census and Statistics, the western province has the highest number of Child Care Institutions (121) with Gampaha, Colombo, and Kalutara districts reporting 55, 44, and 22 institutions respectively. To this survey, the Colombo district was selected from the western province. Apart from Colombo, 06 more Districts in Sri Lanka were selected and a total of 602 samples were collected for the study. 482 (80%) of the samples represent children from Institutional care and the rest 20% from Family-like care. As per the Department of Census and Statistics, In Sri Lanka, there are 10,632 children in Child Care Institutions out of which 6.615 (62.2%) are Female. The sample survey of Female representation in this study is 62.05 %. There is a non-response rate of 2.82 % (15 Respondents).

Impact on Physical health of children

Healthy development is an indicator that takes children through stages, whereby they obtain an increasing number of physical, mental, and emotional skills to become independent adults. The physical needs of children are in a critical period of development during which personal lifestyles choices and behavior patterns establish, including the choice to be physically active during the lockdown and pandemic period. The average of children’s responses was 3.99 and 4.20 for family-like care and institutional care respectively.It is evident from qualitative data eliciting the fact that institutional care was given much more attention and provided humanitarian services by the civil society organizations, community, philanthropies than family-like care during the COVID19 lockdown. As children of institutional care freely expressed that

“We cooked our food, so it was ok to us” “we received donations, almsgiving from known people even though we didn’t receive like we used to get.”

A Medical doctor, who was involved in treating children during the lockdown period, observed that the care system received much more attendance and physical health was good. Children were given enough medical care, food, play activities. Both groups of children have been given enough care for their physical health, however, children in institutional care are much more likely to receive more donations and material support than family-like care. During FGD with caregivers at family-like care, it was told that they were able to manage the expenses with the budget they receive and to keep the children happy they did spend from their money to prepare various types of food, which the children learned from cooking recipes available in YouTube.

Impact on Education of Children

The education of children through the traditional system of attending schools shifted to online on an untested and unprecedented scale due to the pandemic. Schoolchildren who were not properly assessed are also moving online, with a lot of trial and error and uncertainty for everyone. These nationwide closures are impacting almost 70% of the world’s student population (Pawana Devi 2021). Childcare institutions struggled to cope with the change and struggled to facilitate children's learning by providing the required devices and data connectivity. A limited number of mobile phones, tablets, and computers were not sufficient to cater to the online requirements as children in care homes do attend multiple schools and grades. Thus, all children were at a neutral level of agreement (Mean 3.42) in their responses.

As per qualitative data, both groups expressed their mixed feelings towards online education. The children missed their school and school friends. They did receive assistance from caregivers and peers to complete their homework. Children were able to learn and utilize TV channels of national educational programmes, E-thaksala, Gurugethara, and private initiatives on DP education during the COVID-19 Pandemic. Through school education, children do not simply acquire book knowledge. Going beyond that, the whole developmental process of children takes place through it. It is important to note that children in some institutional care have missed out on much of their education because they did not have access to online education. Regarding that, children are now in a more difficult situation compared to the current one. Because now they are going back to school months later, the school has covered most of the curriculum, so children have to go through the current curriculum and also cover the missed curriculum. Due to this, education has become a burden for some children.

“We had only one phone to the institution and there are 26 children, so we missed the online education”, “we couldn’t understand what teachers taught us from online because we were unable to ask questions”, “Now what we are doing at the school is completing our school notes books”,

“we got 6 computers very recently but they were also not fixed yet”, “

Children’s from Institutional care

“We wonder what our O/L and A/L children would do because they seriously saying miss their education” “children miss not only education but the social interaction too, with that, they became so rigid sometimes”

Caregivers from the institutional care

The critical factors realized in the analysis of this data and the attention of the competent authorities are that the majority of institutionalized children have developed less interest in education, they are afraid of public examinations and, because of this situation, they are eager to drop out of school. On the other hand, it was also revealed that some children in family-like care models have moved to self-directed learning with the support of the conducive environment they live in.

Managing the day during the lockdown and pandemic period

Managing a day and idle time during the COVID 19 lockdown becomes critical for children in their adolescence stage. Children in both types of care homes were able to narrate how they manage a typical day during the lockdown with the planned routine of activities. There were no significant differences found among the groups. Teenagers can certainly learn time management skills in performing day-to-day activities. All respondents were at an agreed level of the mean value of 3.52 and 3.57 among both groups.

As qualitative data reflects that both groups were having fun while managing time, voluntary homes adjusted in their day-to-day activities, for instance, children were allowed to sleep more time and get up a little later as caregivers understood that they cannot overschedule their children during the lockdown, and children were given time off from the schedule, allowed to watch films and movies of their choice.

Department of Probation and Child Care services along with voluntary homes facilitated children to involve in various activities and manage their time in a productive way such as being involved in gardening, craft making, artwork, group dance, watching TV, and group competitions. It is worthwhile to note that family-like care children were facilitated to take part in online programmes with other family-like care homes at national levels. children were also happy as they were allowed to participate in competitions organized with the help of sponsors. In discussions with caregivers of the family-like care, it was realized that those who care for children in such care centers have a better understanding of how to care for rare children. It is clear from what they said that those caregivers go beyond mere care, providing food and attention to the balanced personality development of the children. They commented on the importance of getting children involved in sports, the benefits of getting involved in the arts, and the way children interact and get socialized through various associations.

Managing time was likely better in family-like care than institutional care as one caregiver cares for 10 children. Institutional care has a dearth of caregivers who were unable to give their quality time in bigger institutions in comparison to the smaller size institutions where the ratio of caregiver to children allows more quality time for children. Also, the home environment prevalent in Family Like care provides the children with more access to devices and equipment to better manage their daily routine than in Institutional care.

LPI circle reported that Few programs (art, essay competitions) were arranged by probation for the children for making them active and engage in activities during the COVID19 pandemic. It is also important to note that institutions with a small number of children could manage their children's time effectively, and caregivers and other staff members have the time to participate in formulating appropriate programs to manage the idle time.

Impact on Psychological Behavior and Social-emotional development and Use of Coping strategies

Children’s psychological behavior, social-emotional development, and learning during the pandemic were impacted. Lockdowns, limitations on movements, inability to be with parents and relatives, new learning platforms, are some of them. As per psychological, social, and emotional development, a statistically significant relationship exists among the two types of childcare as the P-value of the Chi-Square test is 0.000. There are no statistically significant differences among the two-child cares with a p-value of the t-test being 0.785. The survey endeavored to measure this through their state of happiness, safety, and wellbeing and the coping mechanisms used to adapt to the changes. As per qualitative data gathered, children in both types of voluntary homes manage their social-emotional learning behaviors involving meditation, yoga, sathi (mindfulness) programs, gardening, handcrafts, cooking, Poya day programs, and other spiritual programs. When angry, they resorted to coping strategies such as; going to sleep, singing alone, sitting alone, writing a diary, isolating themselves, hitting or punching objects, shouting, and when sad, going to sleep, listening to music, writing a diary, talking to friends, talking to their mother, talking to parents/relatives, and when they were happy, dancing, listening to music, spending time with friends and getting involved in activities.

Children in family-like care were provided with various opportunities to participate in skill development programmes, such as group drama, art and craft exhibitions, essay competitions, etc., which enhanced the social emotional capacities of the children. But when compared to children in institutional care, children in institutional care were not provided with enough programmes to develop themselves for various reasons, such as lack of staff in the institutional care management, overcrowded children, lack of awareness of the institution etc. It could have adverse effects on the child's reintegration, and once they move into society after age 18, children are more vulnerable to long-term consequences. Most of the children's interviews felt that they spend most of their time watching TV or sleeping, and they want to do various activities, but they spend their time being lazy due to the lack of space and facilities. This situation has a negative impact on their socialization and development.

LPI circle consciously agreed that “we need more staff help to do the caregiving duty on time for the best interest of children in institutional care”

Care givers in the family like care were provided with some opportunities to break their monotonous lifestyle. More than that, as there were fewer children to look after and the set up itself provided a home environment, care givers were able to manage their time by engaging in different types of activities. On the other hand, care givers at institutional care were in a rush to manage the time and other overloaded work, hence they were unable to provide more quality time with the children. This situation creates adverse effects on both the children and the care givers because there is a high possibility of releasing the care givers' stress through the children and the children's stress through them. This situation could create conflicts among the management and children, and it directly affects the psychosocial well-being of the children.

Impact on Social connections

The COVID-19 pandemic has particularly impacted our social connections. While social distancing is an act of self-care for the best interest of public health, it is expected and normal to feel isolated and less connected with others around us. The children missed family and school friends, people in the neighborhood, outings in public places, and so on. All of these activities were entirely disrupted due to the COVID-19 pandemic lockdown. The children and their family members were disconnected, and the only way to reach out was by telephone call. Children in out-of-home care were disconnected from their family members who usually visited them, and they needed more resilience.

Qualitative data revealed that children miss schooling, tuition classes, and visiting family members. The data shows that they highly depend on these activities in order to break their monotonous lifestyle. Going to school, tuition classes provide them a chance to get out of society and be with the other members of society. Interaction with society is highly needed for their well-being. They achieve psychosocial balance as a result of this, but during this pandemic period, they have missed that opportunity.

“we were not allowed to go out of the institute, there was a period we were not allowed to visit our parents also”,

“when we were playing also, we had to maintain the distance”,

“What I missed a lot was the sports activities, if I was schooling, I would have participated to the sports meet too”

Children from family like Care

“It was such a hard time and we didn’t like it at all”, “we couldn’t talk to our parents, there should be a chance for us to talk to them as we cannot visit them”,

A child from Institutional Care

The LPI circle stated that a few cases were reported about children who were trying to escape and incidents of parents having conflicts with the care management about visiting the children during the lockdown.

Impact on Use of information technology (IT) and Mass media

Type of information, Facility, Accessibility, Adaptation, Level of usage was discussed during the FGD and there was a positive impact on the use of information technology and mass media for updating COVID19 pandemic-related health information, school notices, online education, and public educational programs.

Self-directed and peer support learning was reported and care giver’s knowledge on information technology has been increased due to the addressing immediate needs of online education and support to their children in both types of care. Another important point that arises here is the ability of children to absorb something very quickly. This is because caregivers in both types of institutions reported that children learn to use technology first and foremost. Therefore, another implication here is that through the use of innovative methods that go beyond traditional teaching methods, more productive opportunities for child development can be created. On the other hand, it was also revealed that due to the lack of monitoring during online sessions, children tend to play games, watch movies, or browse You Tube channels. It is also reported that children are tired of online classes as they have to stay a long time in front of the screens.

Conclusion
COVID-19 has affected humanity globally, and children are not spared from getting infected. However, compared with the senior citizens and middle-aged adults, children and young adults were able to combat the infection and showed milder or no symptoms. This could be due to a better innate immune response in children and young adults, but as the virus mutates, it may pose unknown threats. The research findings reveal that children in both care systems experienced a direct impact on their lifestyle due to the pandemic.

The study on factors considered to have direct impact shows there are not many striking differences between the two care systems in responding to COVID-19. Overall, there were no statistically significant differences among the two-child cares although relationships exist. Children in institutional care reported higher levels of satisfaction in terms of physical health. Qualitative data further elicits the fact that institutional care was given much more attention and humanitarian services by the civil society organizations, community, and philanthropists than family-like care during the COVID-19 lockdown.

The risk of children dropping out of school is concerning, as children and youth miss out on online lessons, which have long-term consequences for their lives. In terms of education, it was reported that, due to a lack of computers, many children faced difficulties attending online classes. Mostly in institutional care, caregivers had to prioritize the allocation of available devices to students who needed to sit for public exams, leaving the other children with no devices to attend classes, prompting the need for catch-up classes. Caregivers and peers helped children complete their homework. Access to educational programs on TV channels was better utilized by children in family-like care than in institutional care. The study also found that the care system needs technical know-how services and access to internet facilities to enhance more comprehensive responses to online education. Due to these shortcomings, education has become a burden for some children who are at risk of dropping out of school. COVID-19 responses were much more effective and were able to respond to children’s immediate needs because family-like care and small institutions outweighed big institutions.

The study also found that both groups had flexible activities and programs beneficial to children’s wellbeing while managing their day-to-day activities. Statuary support was well extended during the lockdown by promoting various activities and managing their day without idling. It is worthwhile to note that family-like care children were facilitated well and responded immediately to organizing online programs. During the closure of schools, children were able to develop various life skills of their choice, such as poetry, artwork, culinary skills, etc. This study proved that the psychological, social, and emotional developmental needs of children can be fulfilled by their family environment, which is the best microsystem for children to fulfill their developmental needs. On the other hand, when children miss school, friends and family, people in the neighborhood, or outings in public places, it could have an adverse effect on their socialization process.

Health guidelines of social isolation and restrictions also impact children and cause conflict between families and service providers. Social connectedness was disturbed, and children were resilient to it. Thus, the psychological and social-emotional impact may lead to long-term consequences for children and the care system. Further study is needed to measure their psychological impact on their lifespan.

During the lockdown, there was a significant decrease in the re-admission of children, and parents requested that their children be returned to their families. Service providers also faced complex situations trying to reach out to children in voluntary homes. It is noted that children were able to adapt to rapid changes and connect with a larger system of influences during the pandemic. The rate of adaptation and usage was extremely rapid with the transition of school education online. There were limitations in using information technology due to the lack of facilities and accessibility for all stakeholders. Skills in self-directed and peer-supported learning were developed with the use of information technology. Based on the outcome of this study, it could be recommended that, as school closures in response to the COVID-19 pandemic have shed light on numerous issues affecting access to education for children and youth in alternative care systems, educational planning is recommended for missed schools that will have long-term consequences that need immediate attention. Online learning has become integrated into care systems, which have the potential to develop their accessibility and allow children to access specialized materials well beyond addressing the learning styles of children and youth in multiple formats and in ways that can bridge time and child-friendly spaces in a creative way. A framework was required to guide an education response to the COVID-19 pandemic for distance or online learning for school children in the care system. An advocacy for schools to develop specialized service plans and timetables for assessing children at different levels and facilitating individualized or small-group catch-up classes in collaboration with alternative care systems for building gatekeeping mechanisms for school dropouts. Advocacy is needed to ensure children are regularly connected to the family using a different mode of communication as children miss their own family and it could have adverse effect for their development.

This study was intended to analyze the impact of the COVID-19 pandemic on children and youth, especially in alternative care settings in Sri Lanka, to deepen understanding of the prevailing conditions regarding the selected developmental areas. This is about the total development of children and youth for their lifespan development while focusing on COVID-19 responses and alternatives for their better care and on children and youth responses to adjustments and adaptation to the new normal. The findings are also beneficial for policymakers so that recognition and formal classification of children without or at risk of parental care are prioritized during and after any pandemic like COVID-19.

Acknowledgement: The authors acknowledged the support and cooperation rendered by SOS Children Villages Sri Lanka.

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