Exploring the prevalence, forms, risk factors and interventions associated with violence against children in alternative care settings: A scoping review

Violence against children (VAC) in alternative care settings, including foster care, residential care, and kinship care, is a significant global concern. This scoping review synthesises evidence from 77 studies published between 2014 and 2024 across high, middle, and low-income contexts, examining the forms, risk factors, consequences, protective features, and interventions associated with violence in care. In line with PRISMA-ScR guidance, the review maps patterns in the evidence base but does not estimate pooled prevalence across settings.

Neglect was the most frequently reported form of maltreatment, often linked to poverty and limited external support, including in some informal kinship care contexts. Residential settings were commonly associated with reports of physical abuse and peer violence, while findings on sexual abuse varied across contexts. Emotional abuse was reported in all care settings.

Identified risk factors included placement instability, inadequate caregiver support, poverty, and prior exposure to violence. Reported consequences ranged from poor mental health and disrupted relationships to heightened risks of revictimisation. Evidence on effective interventions was sparse, although supportive caregiver–child relationships and trauma-informed models were noted as protective.

Important gaps remain in longitudinal and disaggregated evidence, particularly in low and middle-income contexts and with respect to peer violence, children with disabilities, and LGBTQI + youth. While this review focuses on violence, it is essential to caution that many children experience alternative care as protective and nurturing, and our findings should not be interpreted as suggesting that all care arrangements are harmful. Strengthening family-based care, ensuring robust oversight, embedding protective, child-centred practices, and prioritising reintegration where possible are critical to reducing risks and promoting children’s well-being.