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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Formation and disruption of bonds between caregivers and institutionalized children

Ruth Irmgard Bärtschi Gabatz, Eda Schwartz, Viviane Marten Milbrath, Hudson Cristiano Wander de CarvalhoI, Celmira Lange, Marilu Correa Soares - Revista Brasileira de Enfermagem, 2018

The purpose of this study was to understand the perspective of caregivers about the formation and disruption of bonds with institutionalized children in Brazil.

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Malnutrition and psychosocial dysfunction among the orphan and vulnerable children in Kaski district, Nepal

Dipendra Malla, Bishwas Acharya, Lil Bahadur Nepali, Anup KC, Pratik Gurung, Nanda Lal Gupta, Hoshiar Singh Chauhan - Progress in Medical Sciences, 23 Dec 2017

The objective of this study was to assess malnutrition and psychosocial dysfunction among vulnerable children as well as to determine the association between malnutrition and psychosocial dysfunction among orphan and vulnerable children in Kaski district, Nepal.

Emotional health and coping mechanisms among adolescents in Malaysian residential foster care homes: A comparative study with adolescents living with families

Marjan Mohammadzadeh, Esra Tajik, Hamidin Awang, Latiffah Abdul Latiff - Asian Journal of Psychiatry, 18 Dec 2017

This article presents the findings of a study that examined the emotional health status and coping mechanisms of adolescents living in residential care facilities in Malaysia, in comparison with that of adolescents living in families.

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The Effects of Psychosocial Deprivation on Attachment: Lessons from the Bucharest Early Intervention Project

Nathan A. Fox, Charles A. Nelson III, Charles H. Zeanah - Psychodynamic Psychiatry, 15 Dec 2017

The Bucharest Early Intervention Project (BEIP), a randomized controlled trial of foster/family care for young children with a history of institutionalization has provided the context to assess these relationships. This article reviews data from the BEIP with specific focus on attachment.

The Problem of Orphanages

World Travel Market London, 11 Dec 2017

This session of the World Travel Market in London focused on orphanage tourism and featured speakers from the Better Volunteering Better Care Initiative and other partners, including Save the Children, Friends International, Lumos, and People and Places.

Changing the Way We Care Final Presentation

MacArthur Foundation, 11 Dec 2017

In this video, Catholic Relief Services, Lumos, and Maestral International presented their project: Changing the Way We Care, a project aimed at ending the institutionalization of children.

Deinstitutionalisation of Europe’s Children: Questions and Answers

Opening Doors for Europe's Children, 11 Dec 2017

This resource provides quick answers to some of the frequently asked questions about the transition from institutional to family- and community-based care for children, also known as deinstitutionalisation (DI).

Deinstitutionalisation of children in Europe: What do you know?

Opening Doors for Europe’s Children, 11 Dec 2017

To accompany the release of the learning guide “Deinstitutionalisation of Europe’s Children: Questions and Answers”, the Opening Doors for Europe’s Children has prepared an online quiz to test the knowledge and tackle some of the tricky questions on deinstitutionalisation (DI).

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Hidden in Plain Sight: Modern Slavery Inquiry Report

Parliament of Australia, 06 Dec 2017

The Australian Parliament has released a Report of its inquiry into establishing a Modern Slavery Act in Australia. This Inquiry Report recognizes orphanage trafficking as a form of modern slavery to be included in the Act.

Time for Global Action: Advancing the Sustainable Development Goals

UBS Optimus Foundation & Child's i Foundation, 01 Dec 2017

In this video from Time for Global Action: Advancing the Sustainable Development Goals, Stephen Ucembe shares his experience of living in an orphanage and how institutionalization was detrimental to his development and wellbeing.

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