This chapter appears in Child Maltreatment in Residential Care: History, Research, and Current Practice, a volume of research examining the institutionalization of children, child abuse and neglect in residential care, and interventions preventing and responding to violence against children living in out-of-home care settings around the world.
Abstract
Millions of children orphaned by or separated from their parents are particularly vulnerable to maltreatment. Preventing and mitigating the effects of maltreatment requires understanding the context in which maltreatment occurs. A vastly disproportionate number of the world’s orphans live in South Asia and sub-Saharan Africa, where poverty, civil unrest, and economic insecurity compromise the capacity of family-based care. While studies of children in select destitute orphanages have demonstrated the effects of severe early deprivation, they do not represent the heterogeneity of institution-based care in general or the heterogeneity of institution-based care in low- and middle-income countries (LMICs) specifically. Furthermore, the only large-scale, multi-country study designed to compare average experiences in both institution-based and family-based care indicates the prevalence, and incidence of maltreatment is similar in both types of care. Increasing advocacy for global deinstitutionalization is inconsistent with emerging evidence about institution-based care as compared to family-based care. Furthermore, such sweeping action would remove a critical safety net for many orphans. Long-term positive outcomes are much more likely to come from improved understanding of the essential elements of quality caregiving in all settings, caregiver training and support, and innovative models of orphan care.