Determinants and Consequences of Children Living Outside of Parental Care in Lao People’ s Democratic Republic: Views and Experiences of Adults and Young People in Family and Residential Care Mónica Ruiz-Casares 1,2 & Saithong Phommavong 3 # Springer International Publishing 2016 Abstract Introduction According to the 2012 Lao Social Indicator Survey, 6 % of children in Laos live with neither one of their parents. This study explores the determinants of child-parent separation and the consequences of existing alternative care arrangements from the perspectives of adults and young people. Method Interviews with community leaders, government au- thorities, and senior staff from residential institutions (n = 26) and group discussions with adult caregivers (n = 192) and children (n = 294) living in family-based and residential care settings were conducted in rural and urban communities in Luangprabang and Xayaboury provinces in 2013. Findings Parents were the main caregivers of children, and child abandonment was considered rare. Parental death or di- vorce, material poverty, access to school, infertility, and reli- gious and ethnocultural beliefs resulted in child-parent sepa- ration and transitions across types of care. Informal kinship care was a common care response. Recruitment of children to join ethnic boarding schools and orphanages occurred in many communities. Children were not always consulted in these decisions. Insufficient food and hygiene, emotional dis- tress, and limited mobility and contact with family were concerns in residential care. Lack of ongoing assessment of placements and variable standards of care in institutional care settings may result in child neglect, abuse, and exploitation. Conclusion and Implications A strong evidence base is need- ed to inform the development of a national alternative care strategy, policy, plan of action, and standards of care and to monitor their subsequent implementation. Caregivers and young people provide valuable perspectives to monitor qual- ity of care. Keywords Alternative care . Kinship care . Institutional care child . Laos . Lao People’ s Democratic Republic Introduction In the Lao People’ s Democratic Republic (also known as ‘Laos’), 6 % of children live with neither biological parent and 5 % of children have lost one or both of their parents as a result of death (MoH and LSB 2012). While most children live with both (84 %) or one (9 %) of their biological parents (MoH and LSB 2012), there are nonetheless instances of child separation. Children without appropriate care include, among others, orphans, children living on the streets, victims of traf- ficking and unsafe migration, and children in adult detention centers (Save the Children 2011). Concerns are being raised about Bthe breakdown of traditional family structures as par- ents and/or young people leave home to seek better opportu- nities elsewhere^ (UNICEF 2015). In some villages, migra- tion of Lowland Laotian children into Thailand is common, including many who leave without informing their parents (Wille 2001). A baseline study conducted in Luangprabang and Xayaboury provinces found that parents sent children to work outside of their hometowns or to live with relatives due to the divorce or death of one parent. In addition, parents’ * Mónica Ruiz-Casares monica.ruizcasares@mcgill.ca 1 Department of Psychiatry and Centre for Research on Children and Families, McGill University, 7085 Hutchison, Office 204.2.14, Montreal, QC H3N 1Y9, Canada 2 Centre de Santé et de Services Sociaux de la Montagne, Montreal, Canada 3 Faculty of Social Sciences, National University of Laos, Vientiane, Lao P.D.R Glob Soc Welf DOI 10.1007/s40609-016-0053-5