Changing the Way We Care for Families in India

MacArthur Foundation
3 min readSep 8, 2022

A 2017 100&Change Finalist, Changing the Way We Care demonstrates family care is critical to preventing separation

Sruti, a loving mother of two young children in India, experienced the devastating loss of her husband to complications from COVID-19 in May 2020. The severe financial impact of this loss nearly forced her to send her children to live in a residential care facility, sometimes referred to as an orphanage. Despite her wishes to continue caring for her children at home, Sruti worried she would not be able to provide food or shelter for them.

The Impact of Caregiver Loss in India Due to COVID-19

Like Sruti’s children, millions of children around the world have lost one or more caregivers to COVID-19. According to the Imperial College London, between March and August of 2022, an estimated 1.9 million children in India have lost a parent or grandparent to COVID-19.

India has more children living in residential care facilities than any other country in the world. However, 80 to 90 percent of these children have at least one living parent.

Poverty pushes parents to send their kids to residential care facilities, where they are promised education, healthcare, and room and board. While some of these facilities provide these essentials, most are riddled with neglect, abuse, and pose a high risk for trafficking. Children who spend time in residential care are more likely to experience delays in their physical, cognitive, emotional, and social development, and are at high risk of physical and sexual abuse, according to research.

Most children who lose a primary caregiver still have a parent or relative with whom they can live. However, they need support — such as financial aid or social services — to do so. If there is no one in the family to keep the child, then alternative options such as foster care or adoption should be considered over residential care facilities.

Changing the Way We Care’s Innovative Support

Changing the Way We Care, a global initiative promoting family-based care for all children and a Finalist in the first round of 100&Change, knows the best place for a child is with family. When families experience a crisis, we find ways to keep them together. We do this by working with governments and local organizations to strengthen local child care systems, which include social workers, case managers, psychosocial workers, and other members of the social service workforce. We also work with others to improve family access to healthcare, education, and income.

When COVID-19 struck in India, we worked with church and government partners to implement a “cash plus care” approach. Cash plus care combines short-term financial assistance with longer-term solutions: counseling and parenting training, referrals for services, and income generation activities using individualized case management. This approach allowed us to reach 2,400 children in western India considered at risk of family separation.

India’s widespread access to mobile phones facilitated remote contact with children and parents when home visits were not possible. Using special computer software, we were able to capture data to pilot virtual case monitoring, a way for case managers to safely reach families remotely so that their support did not get interrupted. This virtual monitoring system helped us track which families needed services and where family crisis points existed so we could address them quickly.

Continued Support for Families

Thankfully, in the case of Sruti and her family, Changing the Way We Care — in partnership with the government of India and local partner Aruna — were already working together to support families on the brink of separation. Due to their interventions, the family remains together.

In our four other demonstration countries — Kenya, Guatemala, Haiti, and Moldova — we have demonstrated that strengthening families can keep them together. This is a far better response than building more residential care facilities in the face of a crisis.



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