Defining Best Practice in Care and Protection of Children in Crisis-Affected Settings: A Delphi Study


  • The authors acknowledge the contributions of Deborah Tsuchida, Andrew McMahan, Ann Warner, Elisabeth Berger, and Mark Orr in the implementation of work described, and commentary on drafts of the manuscript provided by Ezer Kang, Pamela King, and Wendy Ager. The work was completed as part of the Care and Protection of Children in Crisis-Affected Countries (CPC). Initiative funded by USAID’s Displaced Children and Orphans Fund, the Oak Foundation, and the United States Institute for Peace. Statements made in this article are the views of the authors alone, and do not constitute the policy of any of these agencies. The work was conducted with respect to the Columbia University Medical Center Institutional Review Board determination IRB-AAAB7134.

concerning this article should be addressed to Alastair Ager, Program on Forced Migration and Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B-4, New York, NY 10027. Electronic mail may be sent to


Thirty specialists in humanitarian work supporting the care and protection of children in crisis settings completed a 3-phase Delphi consultation. Proposals of best practice were elicited, reviewed, and rated by participants. A high level of consensus support was reached for 55 statements. These statements emphasized utilization of existing resources, participation, and inclusivity. The influences of resilience theory, social ecology, and cultural sensitivity were clearly evident. The utilization of developmental theory could be strengthened in relation to more differentiated understanding of the operation of protective influences and conceptualization of such influences in terms of “adaptive systems.” Wider research engagement by development scientists in diverse cultural settings and clear formulation of findings for practitioners and policy makers would further support evidence-based humanitarian practice.