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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Dignifying Hidden Lives: The Institutionalization of Any Impact Child Development

Messias Silvano da Silva Filho, Jose Antonio de Lima Neto, Ivana Rios Rodrigues, Modesto Leite Rolim Neto - Current Pediatric Research, 16 May 2016

The results of this study suggest that the removal of a child from an institution and its transfer to an improved care environment can lead to a reduced risk of psychopathology, as well as promoting a better social, emotional and cognitive development.

Country Care Review: Thailand

Better Care Network, 12 May 2016

This country care review includes the care-related Concluding Observations adopted by the Committee on the Rights of Persons with Disabilities.

In Brief: Voluntourism

Global Study on Sexual Exploitation of Children in Travel and Tourism - ECPAT, 11 May 2016

This brief from ECPAT's Global Study on Sexual Exploitation of Children in Travel and Tourism defines the term "voluntourism" and its risks to children, with a focus on orphanage voluntourism.

Mapping Australia’s support for the institutionalisation of children overseas

Kathryn van Doore, Laura Healy and Megan Jones - ReThink Orphanages, 01 May 2016

This report “seeks to map Australia’s contribution to residential care institutions for children overseas across a number of sectors and identify opportunities for strategic engagement with various stakeholders in the Australian context.”

Charles Nelson - Romania's Abandoned Children

Charles Nelson - Brainwaves Video Anthology, 15 Mar 2016

In this video from the Brainwaves Video Anthology, Dr. Charles Nelson shares some findings from his research on the impacts of deprivation on children's cognitive and brain development through the Bucharest Early Intervention Project.

Call to Action to the Bulgarian Government

Opening Doors for Europe's Children, 24 Feb 2016

This brief is part of the Opening Doors for Europe’s Children campaign and is based on the proposal made to the Bulgarian Government by the Coalition ‘Childhood 2025’ to update the structure and content of the updated Action Plan.

Children on Their Own in Cambodia: Mailman School Study Looks at Youth Living in Orphanages and on the Streets

Columbia University Mailman School of Public Health, 16 Feb 2016

A new video describes a Mailman School-led study to assess the size of the problem. Interspersed with footage of children in informal settlements and orphanages, researchers and officials describe the growth of residential care facilities in Cambodia, many which are operated or funded by foreign charities, including religious groups.

View the Press Release and Video

Changing Mindsets and Practice: Engaging Christian faith based actors in deinstitutionalisation and child welfare systems reforms

Rebecca Nhep, ACCI , 29 Jan 2016

This tool was designed to help those seeking to assist Christian faith-based actors involved in long-term residential care programs make the transition from institutional to non-institutional (family and community-based) child welfare programs.

Alternative Child Care and Deinstitutionalisation: A Case Study of Indonesia

Claire O’Kane and Sofni Lubis - SOS Children's Villages, 10 Jan 2016

This report is a case study of alternative child care in Indonesia. Research was conducted that found that with an estimate of 8,000 institutional facilities servicing 500,000 children, Indonesia was overly reliant on institutional care.

Los Olvidados: Niños y Niñas en "Hogares": Macroinstituciones en América Latina y el Caribe

RELAF, 2016

Este documento pretende impulsar un cambio en el paradigma de la institucionalización como respuesta a la situación de los niños, niñas y adolescentes privados de cuidados familiares.