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: Malawi

Better Care Network, 06 Mar 2017

This country care review includes the care-related Concluding Observations adopted by the Committee on the Rights of the Child.

Peer Exploitation: Findings from a Romanian National Representative Sample of Children Living in Long-Term Residential Centres

Adrian V. Rus, Ecaterina Stativa, Max E. Butterfield, Jacquelyn S. Pennings, Sheri R. Parris, Gabriel Burcea, Reggies Wenyika - Child Abuse Review, 02 Mar 2017

This study emphasises different facets of peer exploitation awareness and experience identified in closed-type institutions, including a couple of abusive behaviours that have not been previously identified in long-term residential centres.

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A Mandate to End Placement of Children in Institutions and Orphanages: The Duty of Governments and Donors to Prevent Segregation and Torture

Eric Rosenthal - American University Center for Human Rights & Humanitarian Law, 01 Mar 2017

In this article, Eric Rosenthal examines the implications of the report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan Méndez, focused on children deprived of liberty, on the placement of children in institutions and orphanages.

When the State Doesn’t Care: A Guide to Accessing Justice for Violations of Children’s Rights in Care Institutions in Eastern and Southeastern Europe and the Caucasus

CRIN, 01 Mar 2017

The aim of this guide is to enable advocates to access the legal and practical tools needed to secure an end to, and compensation for, violations of rights suffered while in institutional care.

Poverty Remains a Europe-wide Cause for Children’s Institutionalisation

Opening Doors, 01 Mar 2017

A review of the evidence on deinstitutionalisation (DI) and the status of care reforms across Europe in 2016 from the Opening Doors for Europe's Children campaign - a pan-European campaign advocating for strengthening families and ending institutional care.

Spain: Country Fact Sheet

Opening Doors for Europe's Children, 01 Mar 2017

This country fact sheet highlights the care reforms that Spain has instituted over the past few years. This sheet also provides short facts and the latest developments on children in alternative care in Spain.

Child violence experiences in institutionalised/orphanage care

Lorraine Sherr, Kathryn J. Roberts and Natasha Gandhi - Psychology, Health & Medicine, 01 Mar 2017

This systematic review addresses violence and abuse experiences in institutionalised care, including frequency and type of abuse/violence, interventions addressing violence in institutional care, the perpetrators of violence, and the connections between abuse and cognitive delays in institutionalised children.

Impact of Nutritional Status on Cognition in Institutionalized Orphans: A Pilot Study

Sanjana M Kamath, Kavana G Venkatappa, and Ergod Manjunath Sparshadeep - Journal of Clinical and Diagnostic Research, 01 Mar 2017

The aim of this study is to assess the nutritional and cognitive status in institutionalized orphans which might help to formulate effective interventions for improving the nutritional status of vulnerable children in future.

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Early life deprivation: is the damage already done?

Frank C Verhulst - The Lancet, 27 Feb 2017

In this comment piece that accompanies Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: the young adult follow-up of the longitudinal English and Romanian Adoptees study, Frank C Verhulst discusses how that study "fills an important knowledge gap on the long-term mental health consequences of early severe childhood deprivation."

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Continuity of care in youth services: A systematic review

Jan Naert, Rudi Roose, Richard C. Rapp, Wouter Vanderplasschen - Children and Youth Services Review, 22 Feb 2017

This study provides a systematic review of the literature, focusing on the conceptualization and evaluation of continuity.

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