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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Cuidado de niños pequeños: Modelo para la prevención del abandono y la institucionalización

RELAF y UNICEF, 01 Jul 2015

Orphanages in Haiti

Lumos, 01 Jul 2015

This video reveals the adverse conditions in the many unregistered orphanages in Haiti

Orphanages In Haiti

Effects of institutional rearing and foster care on psychopathology at age 12 years in Romania: follow-up of an open, randomised controlled trial

Kathryn L Humphreys, Mary Margaret Gleason, Stacy S Drury, Devi Miron, Charles A Nelson 3rd, Nathan A Fox, Charles H Zeanah - The Lancet, 23 Jun 2015

This study examined psychopathology at age 12 years in a cohort of Romanian children who had been abandoned at birth and placed into institutional care, then assigned either to be placed in foster care or to care as usual.

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A World Without Orphans: A Documentary Dialogue to Engage the Church the Pursuit of a World Without Orphans

Dianne Becker - Missions Dilemma, 23 Jun 2015

This post on the Missions Dilemma website features an article and 30 minute documentary film on the harmful impact of institutionalization on children.

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Social images of residential care: How children, youth and residential care institutions are portrayed?

Maria Manuela Calheiros, Margarida Vaz Garrido, Diniz Lopes, Joana Nunes Patrício - Children and Youth Services Review, 09 Jun 2015

The current study seeks to examine the social images associated with children and youth in residential care and the respective care institutions in Portugal.

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Institutionalization of children in Kenya: A child rights Perspective - Does institutionalization of children in Kenya neglect a child rights based approach?

Stephen Ucembe - International Institute of Social Studies, 06 Jun 2015

This essay examines institutional care not as a structure or facility, but as a model of care and protection for orphans and vulnerable children in Kenya.

Occurrence and Consequences of Violence among Orphaned Institutionalized Children in Menoufia Governorate

Nabila El-sayed Saboula, Amal Attia Hussien, and Eman Mohamed El-Refaee - IOSR Journal of Nursing and Health Science, 01 Jun 2015

The aim of this study was to assess the occurrence of violence among orphaned children in institutions in Egypt and its consequences on their physical and psychological health status.

Honouring the Truth, Reconciling for the Future: Summary of the Final Report of the Truth and Reconciliation Commission of Canada

Truth and Reconciliation Commission of Canada, 01 Jun 2015

In this executive summary, the Truth and Reconciliation Commission of Canada provides an introduction to the use of residential schools for aboriginal children in Canada, presents an overview of the Commission’s activities, describes the history and legacy of these residential schools, and outlines the challenges of reconciliation, including 94 recommendations, or “calls to action” for reconciliation in the field of Child Welfare among many others.

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Every Kid Needs a Family: Giving Children in the Child Welfare System the Best Chance for Success

Annie E. Casey Foundation, 19 May 2015

This KIDS COUNT policy report highlights the benefits of family care for children and the need to prioritize family settings for all children in the child welfare system in the United States.

Children in Haiti: from institutions to families

Lumos, 01 May 2015

This report, first distributed at the seminar co-hosted by Lumos and USAID on the challenge of institutionalization in Haiti, provides some background information on the effects of institutionalisation as well as the particular situation in Haiti.