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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Country Care Review: Serbia

Better Care Network, 03 Feb 2017

The Committee's recommendations on the issues relevant to children's care are highlighted, as well as other care-related concluding observations, ratification dates, and links to the Universal Periodic Review and Hague Intercountry Adoption Country Profile.

“When Will I Get to Go Home?” Abuses and Discrimination against Children in Institutions and Lack of Access to Quality Inclusive Education in Armenia

Human Rights Watch, 01 Feb 2017

This report is based on Human Rights Watch visits to five state-run orphanages and ten state-run schools, including six special schools and four mainstream schools, and interviews with 173 people, in eight cities in Armenia.

Knowledge and attitudes towards disability in Moldova: A qualitative study of young people's views

Kenneth A. McLean, Samantha Hardie, Abigail Paul, Gary Paul, Iain Savage, Paul Shields, Rebecca Symes, Joanna Wilson, Catherine Winstanley, Jeni Harden — Disability and Health Journal, 25 Jan 2017

Three semi-structured focus group interviews were conducted with twelve schoolchildren, aged 13–15 years for the purpose of exploring the knowledge and attitudes towards disability of young people within Moldova.

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What does the future hold for Ukraine's children in care?

Maxim Tucker – ODR: Russia and Beyond, 18 Jan 2017

In this issue of ODR, Maxim Tucker details the deinstitutionalization challenges facing Ukraine

Sexual Behavior Among Orphaned Adolescents in Western Kenya: A Comparison of Institutional and Family-Based Care Settings

L. Embleton, J. Nyandat, D. Ayuku, E. Sang, A. Kamanda, S. Ayaya, W. Nyandiko, P. Gisore, R. Vreeman, L. Atwoli, O. Galarraga, M. A. Ott, P. Braitstein — Journal of Adolescent Health, 16 Jan 2017

The attached study compared the care environments of family-based care and institutional care to determine if care environment contributed to differences in sexual behavior and/or sexual exploitation of orphaned and separated adolescents.

Voluntourism Information Sheet – Support families, not orphanages

Linda Reynolds, Senator for Western Australia & Kate van Doore, 2017

This newsletter issue from Senator Linda Reynolds of Western Australia, written in conjunction with Kate van Doore of Griffith Law School, was written in preparation for the Australian Parliamentary inquiry on modern slavery and describes the ways in which orphanage trafficking constitutes modern-day slavery.

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An In-Depth Study of Psychosocial Distress Among Orphan and Vulnerable Children Living in Institutional Care in New Delhi, India and Their Coping Mechanisms

Abhishek Saraswat & Sayeed Unisa - IUSSP 2017, 2017

This study examined the psychological wellbeing of children in institutions and their various coping mechanisms.

Institutional Violence against Children: How to Cope with the Inevitable and the Unconquerable

Victoria Schmidt - Ending Violence in Childhood Global Report 2017, Know Violence in Childhood, 2017

This paper, produced for the Know Violence global learning initiative, looks at the violence children experience in closed institutions in the Central Asian countries, specifically the former Soviet republics: Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan.

A Child’s Right to a Family: Deinstitutionalization – In the Best Interest of the Child

Asha Bajpai - Journal of the National Human Rights Commission, 2017

Using national and international law, court observations, and field experiences, this paper argues a case for deinstitutionalization of children in India, by empowering the families, thereby protecting children's right to a family and preventing abuse and exploitation.

Latest Developments in Deinstitutionalisation across Europe

Opening Doors, 2017

This infographic provides quick status reports on deinstitionalisation in the following countries: Estonia, Latvia, Lithuania, Ukraine, Moldova, Bulgaria, Greece, Serbia, Bosnia & Herzegovina, Hungary, Poland and Romania.