["Child &Family Social Work, Volume 31, Issue 2, Page 782-797, May 2026. ", "\nABSTRACT\nGlobally, millions of children are adopted or placed in alternative care settings (i.e., residential, foster, or kinship care). The current study explores the factors leading to separation from parents and adoption or placement in alternative care by investigating orphanhood status, perceived antecedents to placement, types of alternative care placements, and regional and Human Development Index (HDI) differences in these variables. A multinational convenience sample of 1054 adults who had experienced separation from their biological parents for at least 6 months during childhood and were adopted or placed in alternative care completed an online survey regarding their separation and care experiences. Orphanhood status varied significantly by region and HDI categories but suggested that 80.7% of participants had at least one living biological parent while residing in alternative care. Global data revealed that family stress, parental death, abandonment, and poverty were perceived as the primary reasons for adoption or placement in alternative care. However, findings suggested that antecedents to placement were interwoven and complex and varied significantly by region and HDI categories. Results highlight the complex nature of separation and placement experiences and the need for local data when developing services for children and families. Implications for public policy and practice are included.\n"]