Social care services address a wide range of human development needs, including nutrition counseling, maternal and infant care, early child development, foster child care, assisted living and career development for the disabled, services for the elderly and others. The demand for social services is evident, stemming from diverse sources such as the AIDS epidemic in Africa, the costs of market transitions in the countries of Eastern and Central Europe, and economic shocks in Latin America and Asia. In Africa alone, the number of children orphaned as a result of AIDS is projected to be 44 million by 2010.
The public sector traditionally plays a principal role in organizing the supply of social care services, either through:
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directly supplying the service;
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contracting out the supply of the service to a private or NGO supplier according to service standards; and/or
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by setting standards for service provision by a competitive private sector.
Community-based social services have gained increased policy attention in recent years among developing countries and international agencies. While community-based care has been common in developed countries for many years, and is the defacto informal source of care for many communities in the developing world, it is only recently that such models have challenged the traditional institutional approach in a formal sense. There is evidence that placing a child or an adult into institutionalized care can often be more expensive per client served than more inclusive approaches which are designed to support individuals within their own families and communities. Institutional approaches also produce worse outcomes than community-based approaches for many individuals.
Changing traditional financing systems are necessary, but not sufficient to support effective community-based social care provision. Other components of change include reforms to ensure quality of provision such as standards and accreditation, training, information to clients, and monitoring procedures, along with those which improve the needs assessment process.
The international community is increasingly supporting community-based social care services. For example, World Bank lending for community-based social care has grown cumulatively from US$33.4 million in 1985 to over US$1.6 billion by 2000.
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