Families, Not Orphanages

John Williamson and Aaron Greenberg

BCN is pleased to feature the first of the Better Care Network Working Paper Series, Families, Not Orphanages

With particular attention to lower income countries, Families, Not Orphanages examines the mismatch between children’s needs and the realities and long-term effects of residential institutions. Evidence presented in this paper indicates that orphanages have been allowed to proliferate, particularly in countries impacted by conflict, displacement, AIDS, or severe poverty, and that this results in negative outcomes for children. The paper examines available evidence on the typical reasons why children end up in institutions, and the consequences and costs of providing this type of care compared to other options. It includes an overview of better care alternatives, including family preservation, family reunification, and family-based alternative care and concludes with recommendations for policy-makers.

Based on the available evidence and field experience, the authors’ position is that residential care is greatly over-used in many parts of the world.  In all too many countries, institutional care remains the default option for children without adequate family care.  The paper finds that better family-based alternatives should be developed and that inadequate imagination and resources have thus far been directed to doing so. 

It is not the intention of this paper to demonize residential care.  Neither does this paper seek to idealize family care.  As is at the heart of the Guidelines for the Alternative Care of Children, this paper highlights the importance of preventing unnecessary separation of children from their families and developing family-based care for children who need an alternative placement.  It underscores and further articulates this position with evidence from around the world, both recent and longstanding. 

©Better Care Network Working Paper

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