In most high-income countries, the main reasons that children are in alternative care are family abuse and neglect. In China, due to the absence of an effective child protection system, very few children receive alternative care for these reasons. In China, children receiving alternative care provided by the state are mainly children without parents. Most children who are orphaned live with extended family. If they become state wards, the child welfare institution tries to arrange adoption. Otherwise, the most common forms of alternative care are institutional care or foster care.

This chapter describes who is in care and the forms of care. These questions are important because the way in which alternative care is organized affects the childhood experience of the young people and their future opportunities. The qualities of the alternative care that they encounter might contribute to their current and future social inclusion by addressing and anticipating their current and potential disadvantages, for example, by forming family connections in adoptive or foster families. Alternatively, the arrangements might aggravate their disadvantages by layering further experiences of social exclusion, such as segregation from other children and families throughout their childhood.

Children in state care

Alternative care in China includes extended family care, adoption, institutional care and foster care. The first two forms of care are not normally referred to as alternative care in high-income countries. The data released by the Chinese Ministry of Civil Affairs (MCA) in 2005 based on a census of orphans in China are the most complete data available about alternative care in the country. Although the data were collected more than a decade ago, the types of alternative care have not changed. Excluding adoption, when children become part of a new family, most children in alternative care are cared for in their extended family (kinship care, 62.3%), followed by foster care (12.6%) and institutional care (11.8%).

In most rural areas of China, kinship is still central to social life. Extended families, particularly those in the patrilineal line, remain the central social relationship among many farming communities. Following tradition, children have the surname of their father and inherit the paternal line.

As discussed in earlier chapters, many of the young people still live in child welfare institutions in their adulthood. The impact of poor housing policy for young people leaving care potentially not only excludes them from housing, but also restricts their other social and economic opportunities, as introduced in Chapter Seven. This chapter uses the social exclusion framework to analyse the housing pathways of young people in state care who were trying to leave care at the time of the research. It considers their exclusion from the market, policy and society, and the interrelationship between these three aspects of exclusion due to their isolated childhood housing experience. It explores how the state manages their right to independent housing during their transition to adulthood and how their housing status affects other aspects of their adult life.

Without independent housing, many of the young people in care face multiple forms of social exclusion (Johnson et al, 2009). It affects not only health, education and overall well-being, but also self-identity and aspirations for social participation. Their expectations for future social relationships, their place in the community and their contribution to it can be stymied by their lack of housing options. Increasingly, too, the local governments in this research were concerned about the impact of its continued responsibility to house these young people into the foreseeable future.

Housing and social inclusion

The importance of the right to adequate housing and its key impact on social inclusion is recognized in international treaties and Chinese policy. The United Nations defines the right to adequate housing as ‘each man, woman, youth and child have access to and retain safe house and community in peace and dignity’ (UNHCHR, 2010), and calls on all countries to ensure their laws and policies on housing are appropriate for those most in need. The Second United Nations Conference on Human Settlements (Habitat II) held in 1996 passed the Habitat Agenda, which reiterated the commitment of states and governments to comprehensively and gradually fulfil the right to adequate housing (UNHCHR, 2010). It prioritizes the needs of people most likely to be excluded from housing:

China, like other countries, is changing its policy and implementation to better support young adults leaving state care. The Chinese and international communities are sharing understanding about good practice in alternative care while children are growing up, particularly by prioritizing long-term family-based support. They are also changing alternative care practices to support children during their childhood and as they reach young adulthood, so that they are prepared emotionally and practically to live independently as adults in the same ways as their peers, away from state control. As yet, opportunities to learn from the Chinese experience have been scarce (Pinkerton, 2011).

Children in state care in China are almost always children whose families cannot be found, either because their family members have died or their families have left them in a public place without any way for the state to find the family. This differs from state care in other countries, where most children in state care are children who have been forcibly removed from their families because of the risk of harm. In the future, this is likely to change as the reasons for children becoming orphaned reduce and the child protection system develops to care for children removed from abuse in their families.

This book reviewed these policy and practice changes in China for the generation of young people who grew up in state care over the last 20 years, when alternative care was beginning to shift away from institutional care and recognize the rights of children and young people to an inclusive childhood and adulthood. It examined whether social inclusion was experienced by that generation of young people leaving care and whether current policies support inclusion for children who are growing up in state care now.

Experiences of young people leaving care

The book explored whether the Chinese government supports these children and young people in state care to achieve social inclusion in their young adulthood and experience their rights to transition towards independent living in the same way as their peers in their communities. It considered this question from the perspective of the young people, looking back on their childhood, their current experiences and their future plans for independence.

Appendix: Characteristics of young people participating in the research

The remaining chapters address four aspects of the transition to adulthood of young people leaving care: establishing self-identity; employment and economic independence; independent housing; and social participation, friends, family and social networking. Each chapter examines the experience of the young people in their transition to adulthood and leaving care against the child rights and social inclusion framework. Does the welfare institution support them during their childhood and teenage years to achieve social inclusion in their young adulthood and do they experience their rights to transition towards independent living in the same way as their peers in their communities? This chapter explores the self-identity, with reference to social inclusion, of the young people in care in their transition to adulthood and the possibility of independent living. It focuses on how the various aspects of social inclusion during childhood and young adult years might affect their identity.

Formation of identity

In addition to the usual dynamic identity formation of teenagers, young people leaving care also negotiate the shedding of an identity as someone in the care of the state and the acquiring of an identity as an independent young adult. These processes have important policy implications because they imply that transition to independence of children in state care requires a care approach and environment that are supportive to positive identity formation during childhood and adolescence (Anghel, 2011).

Identity crisis is a concept proposed by American psychologist Erikson (1968). In its simplest description, identity is the perception about who the self is, how the person fits in their community, what they will become in the future and how they become the person that they want to be. During teenage years, children's rapid physiological and emotional growth repositions them in relation to the adults in their lives as they explore new ways of expressing their independence. Their sense of identity changes in relation to these adults, their peers and other people around them. Is this the same for young people leaving care in China?

Erikson argues that the dynamic changes during teenage years can also affect adulthood if questions of identity are threatened. If they fail to reach satisfaction in their identity, they may continue to experience role confusion, affecting their future life.

This chapter examines the economic security of young people with and without disabilities leaving state care as they reach adulthood. Chapter Four outlined the policies about transition to adulthood, which highlighted the policy gaps, including the age and conditions when the state might cease support to young people in state care. This chapter continues that analysis to examine the effect of the scarce policies, including the impact on the economic independence of the young people. It uses examples of the experiences of the young people in the research to examine the various paths towards economic independence or the reasons that these paths might be blocked. Some of these reasons were due to the exclusionary childhood experiences in state care. Other reasons were due to the inadequate responses to their needs and preferences in this transition stage of their young adult lives, which had the effect of continuing to exclude them from the economic and social opportunities expected of other young people. In the worst cases, irrespective of their personal capacity, it would seem unlikely that some of these young people will ever leave state care, suspending them in the status of never becoming independent adults.

This part of the research examined whether socio-economic outcomes were different for young people who had foster care or institutional care. It applies the social inclusion framework to examine how the form of state care affected the facilitators of social inclusion in their transition to adulthood and the impact of the facilitators on their economic outcomes. The facilitators considered were social contact and the use of education, health and disability support services. The outcomes are educational achievement, economic security and activity, housing, and social networks. The chapter focuses on how the children and young people in state care seek an economically independent life when they have grown up into adulthood: how do they live their life? Can they earn their own living?

The chapter is based on qualitative analysis of the field investigation in the four research areas described in Chapter One. These areas are capital cities in economically developed or moderately developed regions. The 54 young people were aged 16–38 years (see Appendix 1).

In addition to formal foster care in families, some state child welfare institutions also provide alternative care in family groups with a paid house mother on the site of the institution. This type of alternative care raises questions about whether this grouping is sufficient to simulate the benefits of family-based care in relation to outcomes for children when they are growing up, and the impact on their transition to adulthood. As an intermediate step of a smaller family grouping but still within an institution, with a paid house mother, is this sufficient to achieve the social inclusion expected for other children who grow up in the community with their birth or foster family?

The chapter examines the experience of seven young people in one city who had lived in this arrangement. It considers the differences for these young people during their childhood and as they prepared for possibilities to leave the family group care in the institution.

Approach to alternative care at the institution

The Urumqi Children's Welfare Institution is the only welfare institution for children in the city. It was founded in 1947. At the time of the research in 2012, it had 184 staff and more than 300 children. The children were from many ethnic groups because the region is diverse, with a large Chinese Muslim minority. Most of the children had communicable diseases or disabilities (90%), mainly cerebral palsy and learning disabilities. A few children with disabilities at the institution were not state wards. Their families were paying for them to receive therapy services and special education while they lived at the welfare institution. This unusual practice for child welfare institutions helps families remain intact and provides the child with access to disability support not otherwise available in the community. Some other welfare institutions are beginning to develop this practice in order to try to reduce the number of families who leave their children to become state wards so that they receive the treatment they need.

The welfare institution mainly provides family-based alternative care, including formal and informal foster care. It also provides family group care at the institution, which simulates family households in apartments built at the welfare institution.