Effects of Institutional Care

Institutionalising children has been shown to cause a wide range of problems for their development, well-being and longer-term outcomes. Institutional care does not adequately provide the level of positive individual attention from consistent caregivers which is essential for the successful emotional, physical, mental, and social development of children. This is profoundly relevant for children under 3 years of age for whom institutional care has been shown to be especially damaging.

Common issues for children in institutional care are a significantly increased risk of sexual and physical abuse, a lack of stimulation, and harsh discipline. Children in institutions are less likely to attend school, and are frequently isolated from their traditional communities. Long periods in an institution make it harder for a child to assimilate back into a family and community, and deny them access to the life-long attachments and community support systems that family relationships and communities can provide. For funders and implementing bodies, care in the community is a significantly more effective and sustainable use of resources since it avoids the high maintenance costs of institutions, and prevents many of the problems posed by institutional care.

It is widely accepted that institutions should be used as a last resort only. Countries which have traditionally relied on institutional care are now transforming their institutions into small family style group homes and actively pursuing preferences for community-based care options based around small family style units. This policy shift is urgently required in HIV/AIDS affected countries which are taking a backward step in resorting to the use of institutions to care for children orphaned or affected by the disease.

The body of literature contained in this section provides in-depth explanations of the damaging effects of institutionalisation on children and provides recommendations for alterative community care options.

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The Right of Boys and Girls to a Family. Alternative Care. Ending Institutionalization in the Americas

Inter-American Commission of Human Rights, 05 Mar 2014

This report by the Inter-American Commission on Human Rights (IACHR) analyzes children’s right to live and be raised by their families, and establishes the resulting obligations for States when it comes to supporting and strengthening families’ ability to raise and care for their children.

Institutionalization of Children in the Czech Republic: A Case of Path Dependency

Victoria Schmidt and Jo Daugherty Bailey, 01 Mar 2014

Despite the development of alternative forms of care, international and domestic pressures for change, and over 20 years of efforts at deinstitutionalization, the Czech Republic has one of the highest rates of institutionalization of children in E

Children's Reintegration: Longitudinal study of children's reintegration in Moldova

Dr Helen Baños Smith, 28 Feb 2014

This important report documents a 22-month longitudinal study of the reintegration of children in residential care in Moldova.

Addicted to Orphans: Donor influence in Uganda's child protection system

Kristen E. Cheney, 21 Feb 2014

A presentation on the "Orphan Industrial Complex" at the Young Lives and Globalization in Africa workshop at the University of Liège, Belgium on 21st February 2014.

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How the Republic of Georgia has Nearly Eliminated the Use of Institutional Care for Children

Aaron Luis Greenberg and Natia Partskhaladze, 30 Jan 2014

The Infant Mental Health Journal has published an important Special Issue on Global Research, Practice, and Policy Issues in the Care of Infants and Young Children at Risk. This article documents how between 2005 and 2013, the Government in the Republic of Georgia closed 32 large, state-run institutions housing children without adequate family care.

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Escape the Box Campaign

Kansas State University Staley School of Leadership Studies, 12 Jan 2014

Escape the Box is an initiative designed to help raise awareness and try to put a stop to the rapidly growing, money making businesses that many orphanages have become.

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Volunteering in a Children’s Home: How to do this Best?

Working Group ‘Quality of Care,’ of the Better Care Network Netherlands , 2014

This leaflet was developed by the Working Group ‘Quality of Care’ of Better Care Network. It is published by Better Care Network Netherlands. The leaflet provides useful information on child development and children’s care for those planning to volunteer at orphanages in developing countries.

Collected Viewpoints on International Volunteering in Residential Care Centres - Country Focus: Ghana

Better Volunteering, Better Care , 2014

This overview is intended to contribute to discussions on international volunteering in residential care centres as an anecdotal research piece on the situation in Ghana.

ACC International – Kinnected Program: Processes and Trends

ACC International, 2014

The Kinnected program, developed by the Australian Christian Churches International (ACCI), is working toward the reduction of use of residential care of children and aims to assist children within the context of their families. This document provides an outline of the program and an overview of the lessons learnt.