Development of a Child-Informed Measure of Subjective Well-Being for Research on Residential Care Institutions and Their Alternatives in Low- and Middle-Income Countries

Well-being can be conceptualized as objective and subjective. Objective well-being refers to measurable indicators of life quality, such as household income, illness diagnosis, and educational attainment. In contrast, subjective well-being is based on an individual's perception of their own life, often referred to as happiness or life satisfaction. The distinction between objective and subjective well-being is crucial. An individual's objective well-being may not align with their subjective well-being. For instance, a child may be objectively assessed as having low well-being due to health problems or poverty, yet report being satisfied with their life. Conversely, a child may be objectively enjoying well-being due to met nutritional and educational needs, yet report being unhappy with their living situation. Well-being can be measured unidimensionally or multidimensionally. Unidimensional indicators of subjective well-being include questions such as "How satisfied are you with your life?" or responses from the Cantril Ladder tool. Multidimensional measures, on the other hand, evaluate multiple dimensions or aspects of well-being. For example, the OECD suggests evaluating adult well-being with a variety of objective measures related to income, wealth, housing, employment, education, health, and more. Conceptualizations of well-being can vary depending on the context and population. Organizations such as the World Health Organization and Oxfam have recognized this and used qualitative methods to determine which dimensions of well-being are important to specific populations. These findings have been used to create quantitative, multidimensional well-being measures to inform policymaking and practice. In the context of vulnerable children, including those living in residential care institutions, it is essential to consider both objective and subjective measures of well-being. Researchers have employed quantitative methods to examine the well-being of children in residential care, but these studies often focus on objective measures such as socioemotional development. However, children's voices and perspectives on residential care and family reintegration are also crucial to understanding outcomes and respecting child rights. The Lancet Commission on the Institution of Children and the Deinstitutionalization of Children conducted a systematic literature review to examine the effects of growing up in residential care institutions on development and mental health. The study included 55 studies that measured child physical growth, 46 studies that measured physical health, and 116 studies that measured cognition. However, the study did not include subjective measures of well-being, highlighting the need for further research in this area. In response to this need, researchers have developed a participatory, child-informed process for developing a multidimensional measure of child subjective well-being. This measure is tailored to the priorities of children who have lived in residential care. The development process involved conducting focus groups with 49 adolescents and 29 young adults who had lived in residential care. The resulting tool consists of 43 survey questions, which were administered to 180 young people in Kenya and Guatemala. Exploratory factor analysis revealed that the measure had three salient factors: care and safety, basic needs, and leisure and freedom.