Professionalisation of caregiving evidence brief

Professionalisation of caregiving evidence brief
29 Oct 2019


The purpose of this evidence brief is to provide up-to-date evidence about professional models for caregiver financial assistance, drawn from the existing national and international literature. This includes information on the impact these models have on the recruitment and retention of caregivers, and on caring for children and young people with additional or high needs. It is intended that this evidence brief will help to inform a review of financial assistance for caregivers that is currently being undertaken by Oranga Tamariki.


A search for peer-reviewed and grey literature was conducted using several academic databases and Google Scholar. The relevant identified literature included a mix of narrative reviews, policy documents, and primary empirical studies (largely involving surveys or interviews with current or former caregivers). In total, 45 articles and reports were included in the final evidence brief.

Key Results

Models of financial support for caregivers:

  • Models and details of financial support systems for caregivers vary widely across international jurisdictions.
  • Many jurisdictions, such as most US states, only provide maintenance or ‘board’ payments intended to cover the direct costs of caring for a child
  • A small number of jurisdictions, such as Sweden and France, pay a salary or wage to caregivers.
  • Skill-based payments are another professional model used internationally, most notably in the UK and Canada.

Risks and benefits associated with professional models of care: 

  • The most common risk identified for professional caregiving models related to the possibility of incentivising financial motivations for caregiving, rather than attracting individuals who were interested in supporting children and young people.
  • The potential for the professionalisation of caregiving to be associated with tighter expectations and responsibilities, and afford less independence for caregivers was seen as another potential downside of these models.
  • Other identified risks were more practical in nature, including a lack of leave provisions associated with some models, leading caregivers to forego much-needed respite or leave.
  • In general, studies often found that a majority of caregivers were opposed to a salary or wage for caregivers, because of the risks outlined above.

Impact of professional models of care on recruitment and retention:

  • The general consensus in the literature is that the adequacy of financial reimbursement has a large impact on caregiver satisfaction and perceived ability to provide a loving, nurturing and enriched environment for children and young people in care.
  • However, the literature also broadly suggests that financial remuneration (including professional models of payment) does not have a large impact on motivating people to become caregivers.
  • Professional models of financial support (including higher levels of financial support in general) appear to have a clear positive link with caregiver retention
Page last modified: 03 Nov 2023