@article {Embleton2014,
	title = {{Models of care for orphaned and separated children and upholding children{\textquoteright}s rights: Cross-sectional evidence from western Kenya}},
	journal = {BMC International Health and Human Rights},
	volume = {14},
	number = {1},
	year = {2014},
	abstract = {Background: Sub-Saharan Africa is home to approximately 55 million orphaned children. The growing orphan crisis has overwhelmed many communities and has weakened the ability of extended families to meet traditional care-taking expectations. Other models of care and support have emerged in sub-Saharan Africa to address the growing orphan crisis, yet there is a lack of information on these models available in the literature. We applied a human rights framework using the United Nations Convention on the Rights of the Child to understand what extent children{\textquoteright}s basic human rights were being upheld in institutional vs. community- or family-based care settings in Uasin Gishu County, Kenya. Methods. The Orphaned and Separated Children{\textquoteright}s Assessments Related to their Health and Well-Being Project is a 5-year cohort of orphaned children and adolescents aged <=18 year. This descriptive analysis was restricted to baseline data. Chi-Square test was used to test for associations between categorical /dichotomous variables. Fisher{\textquoteright}s exact test was also used if some cells had expected value of less than 5. Results: Included in this analysis are data from 300 households, 19 Charitable Children{\textquoteright}s Institutions (CCIs) and 7 community-based organizations. In total, 2871 children were enrolled and had baseline assessments done: 1390 in CCI{\textquoteright}s and 1481 living in households in the community. We identified and described four broad models of care for orphaned and separated children, including: institutional care (sub-classified as {\textquoteright}Pure CCI{\textquoteright} for those only providing residential care, {\textquoteright}CCI-Plus{\textquoteright} for those providing both residential care and community-based supports to orphaned children, and {\textquoteright}CCI-Shelter{\textquoteright} which are rescue, detention, or other short-term residential support), family-based care, community-based care and self-care. Children in institutional care (95{\%}) were significantly (p {\textless} 0.0001) more likely to have their basic material needs met in comparison to those in family-based care (17{\%}) and institutions were better able to provide an adequate standard of living. Conclusions: Each model of care we identified has strengths and weaknesses. The orphan crisis in sub-Saharan Africa requires a diversity of care environments in order to meet the needs of children and uphold their rights. Family-based care plays an essential role; however, households require increased support to adequately care for children. {\textcopyright} 2014Embleton et al.; licensee BioMed Central Ltd.},
	keywords = {Kenya, Orphans, Street childre, [Children{\textquoteright}s rights},
	issn = {1472698X},
	doi = {10.1186/1472-698X-14-9},
	author = {Embleton, L. and Ayuku, D. and Kamanda, A. and Atwoli, L. and Ayaya, S. and Vreeman, R. and Nyandiko, W. and Gisore, P. and Koech, J. and Braitstein, P.}
}
