Relational Continuity and Supported Transitions After Foster Care: A Critical Narrative Review of Health, Well-Being and Social Determinants

Young people transitioning out of foster care may face interconnected challenges involving health, education, employment, housing, income and continuity of support. Yet care leavers also demonstrate agency and positive adaptation when dependable relationships, practical resources and responsive services remain available. This critical narrative review examines how foster family relationships, individual agency, professional support and material conditions interact during the transition from care. The thematic synthesis draws on 28 primary empirical studies. The review draws on social–ecological resilience, relational permanence and the social determinants of health to critique approaches that frame successful transition from care primarily as an achievement of individual self-reliance. The literature was synthesised into three integrated themes: (1) relational continuity, belonging and foster family well-being; (2) supported agency, health and developmental preparation; and (3) coordinated services and enabling material conditions. On this basis, the paper proposes a Relational Continuity and Supported Transition Framework. The framework positions young adults’ health, well-being and positive adaptation as shared outcomes produced through reciprocal interactions between care leavers, supportive relationships, service systems and structural resources. Implications are presented for foster family preparation, youth-led transition planning, service coordination, social protection and future research, with particular attention to underrepresented African contexts.