Reimagining Institutional Care: Children’s Emotional Well-being, Caregiver Readiness and Policy Pathways for Social Prescribing in Pakistan

Rumaisa Nawar; Faizan Mustafa; Faryal Bashir Bhatti; Saima Masoom Ali; Muhammad Hassan Ameer; Muhammad Zeshan; Zahra  Mubashar; Samen Shahbaz

doi:10.63050/jpps.23.02.1181

Rumaisa Nawar BMY Health Canada
Faizan Mustafa BMY Health Pakistan
Faryal Bashir Bhatti BMY Health Pakistan
Saima Masoom Ali BMY Health Pakistan
Muhammad Hassan Ameer Shaikh Khalifa Bin Zayed Al Nahyan Medical & Dental College, Pakistan
Muhammad Zeshan Insideout Cure, Princeton, NJ, USA
Zahra Mubashar Insideout Cure, Princeton, NJ, USA
Samen Shahbaz Insideout Cure, Princeton, NJ, USA

DOI: https://doi.org/10.63050/jpps.23.02.1181

Keywords: institutionalized children, emotional health, mental health, policy and practice reform, orphanage, social prescribing, caregiver wellbeing, community-based interventions

Abstract

Research indicates that institutionalisation can undermine children’s well-being, highlighting the urgent need for innovative, community-based interventions to alleviate trauma and foster resilience. This study aims to evaluate the emotional and behavioral difficulties of institutionalized children, assess caregivers’ well-being, and explore the feasibility of implementing social prescribing as a community-based intervention within institutional care. Ultimately, the study seeks to generate evidence-based recommendations to strengthen institutional policies and caregiving practices.

This mixed-methods descriptive study involves 263 institutionalized children aged 11–17 and their caregivers in Punjab, Pakistan from four different institutions. Strengths and Difficulties Questionnaire (SDQ) was used for assessing children’s wellbeing, while Section 4 of the Orphans and Vulnerable Children (OVC) Caregiver tool was used to evaluate caregivers’ well-being, respectively. Focus group discussions were conducted with the caregivers to further understand their readiness for social prescription.

The study revealed significant emotional and behavioral difficulties among children with varying institutional factors which were analyzed through SWOT. Prosocial scores had a weak negative correlation (r = -0.1525, p = 0.016) to the total difficulties score of children and age as a significant predicting factor (coefficient = 1.89, p < 0.01) to overall difficulties. About 51.52 % of caregivers reported having recent illnesses.

The study highlights a strong demand for social prescribing with caregivers favouring community referrals, recreational activities, and educational programs. It calls for actionable insights for policy and practice reformation within institutional care.

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Author Biographies

Rumaisa Nawar, BMY Health Canada

BioMedical Science, York University

Faizan Mustafa, BMY Health Pakistan

MBBS, Shaikh Zayed Medical Complex

Faryal Bashir Bhatti, BMY Health Pakistan

MBBS, Shaikh Zayed Medical Complex

Saima Masoom Ali, BMY Health Pakistan

PhD, University of Karachi

Muhammad Hassan Ameer, Shaikh Khalifa Bin Zayed Al Nahyan Medical & Dental College, Pakistan

MBBS, Shaikh Khalifa Bin Zayed Al Nahyan Medical & Dental College, Pakistan

Muhammad Zeshan , Insideout Cure, Princeton, NJ, USA

Rutgers University, New Jersey, USA, MD, Clinical Assistant Professor Psychiatry

Zahra Mubashar, Insideout Cure, Princeton, NJ, USA

MBBS, FMU, Pakistan

Samen Shahbaz, Insideout Cure, Princeton, NJ, USA

MBBS, FMU, Pakistan.

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