Globally, large numbers of children and adolescents are displaced by armed conflict, which poses significant threats to their mental health, psychosocial well-being, and protection. Although humanitarian work to support mental health, psychosocial well-being, and protection has done considerable good, this paper analyzes how humanitarian action is limited by excessive reliance on a top-down approach. Although the focus is on settings of armed conflict, the analysis offered in this paper applies also to the wider array of humanitarian settings that spawn increasing numbers of refugees globally.
Top-down approaches, which are driven by outside experts and practitioner agencies such as NGOs, do too little to support children’s and adolescents’ cultural identity, voice, and agency. Since top-down approaches privilege outsider conceptualizations of the problems and the indicated interventions, they tend to marginalize or weaken indigenous cultural understandings of the problems facing children and adolescents and of cultural practices that could support them. This leads to poorly contextualized programs that quietly undermine children’s and adolescents’ cultural identity and dignity. Also, the adults who lead top-down approaches do too little to learn from the voices and lived experiences of children and adolescents. Although top-down approaches frequently encourage “child participation”, they tend to do so in a manner that is limited or even tokenistic, as children and adolescents are implementing partners rather than agents who have significant power and could help to make contextually relevant decisions about program priorities and approaches.
Humanitarian work to support children’s and adolescents’ mental health, psychosocial well-being, and protection would be strengthened by complementing top-down approaches with more grounded, bottom-up approaches that feature children and adolescents’ cultural identity, voice, and agency. The paper outlines diverse, evidence-based methods and approaches for doing this, and calls attention to four priorities: cultural humility and reflexive practice; learning from the voices and lived experiences of children and adolescents; enabling the agency of and collective action by children and adolescents; and localizing aid by sharing greater power and funding with local stakeholders, including children and adolescents.
Stated broadly, the paper recommends that humanitarian stakeholders should:
- Create a better balance between top-down and bottom-up programming approaches in which children and adolescents are key actors;
- Enable flexible programing that is guided by children’s and adolescents’ lived experiences, voice, and agency; and
- Include children and adolescents as important stakeholders and actors in efforts to localize humanitarian aid.