Psychosocial Health Outcomes of Children Following Family Reunification: Longitudinal Analysis of Randomised Controlled Trial Data

Abstract

This longitudinal study examined the psychosocial health trajectories of children following reunification from residential care and the associated contextual factors. Data were drawn from a randomised controlled trial evaluating the effects of a parenting programme on the successful reunification and reintegration of 1–13-year-old children with their families, in nine districts in Uganda. Families were randomised to receive either a basic reintegration package consisting of a reunification grant and case management (standard intervention) or an enhanced package consisting of the basic package plus 13 bi-weekly training sessions of a parenting programme (enhanced intervention). Data were collected from caregivers at home and the residential care facilities, as well as the children (n = 55 dyadic pairs) through prospective interviews at baseline (before reunification), and at 6- and 12-months post-reunification. Predictive growth curve analyses assessed longitudinal changes in child psychosocial problems (externalizing, internalizing, total behavioural problems) and associated contextual factors. In age, sex, and study arm stratified analyses, we found declining linear trajectories in children’s psychosocial problem scores at 6 and 12 months post-reunification. Taking covariates into account, persistent externalizing, internalizing, and total behavioural problems at endline were associated with children’s depressive symptoms, caregiver characteristics and quality of caregiving. Our findings suggest that children who are reunified from residential to family-based care have fewer psychosocial problems post-reunification compared to their time in residential care. These findings did not differ by age and sex of the child or type of reintegration package received. Although findings from our small single study have limited generalizability and should be interpreted with caution for policy and programming, they underscore the potential benefits of reunification programmes for children’s psychosocial well-being.