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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Stories of Leaving Care in India: Struggling, Moving On and Surviving

Udayan Care, 2017

The case studies outlined in this publication draw upon earlier work, which suggested that young people leaving care may broadly fall into one of three groups: those successfully ‘moving on’ from care; those who are ‘survivors’; and those who are ‘strugglers’.

Advocating for Social Services for the Benefit of All Children and Their Families

Opening Doors, 2017

This report from Opening Doors discusses the Opening Doors II pan-European campaign launched in Chisinau.

Romania: Children in Public Care 2014

Manuela Sofia Stănculescu (main author), Vlad Grigoraș, Monica Marin, Cătălina Iamandi-Cioinaru, Emil Teșliuc, Georgiana Blaj (Neculau), Bogdan Corad, VoichiŃa Pop, Andreea Trocea - The World Bank and UNICEF, 2017

This book presents the results of this research on more than 52,000 children placed in public care in Romania (in special protection) who receive family or residential-type protection services as well as on the children at risk of separation from their families from the source communities.

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Bulgaria: Country Fact Sheet

Opening Doors For Europe's Children, 2017

The Bulgaria Country Fact Sheet provides short details on the state of institutional care in Bulgaria.

Towards the Right Care for Children: Orientations for reforming alternative care systems – Africa, Asia, Latin America

Samantha Chaitkin, Nigel Cantwell, Dr. Chrissie Gale, Dr. Ian Milligan, Catherine Flogothier, Claire O’Kane, Dr. Graham Connelly - European Union, CELCIS, SOS Children's Villages, 2017

This synthesis report contains findings of a study that conducted research in six South and Central American, Asian and African countries for the purpose of gaining understanding of the nature, extent, and scope of institutionalization and the feasibility of deinstitutionlisation.

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.

Past Still Haunts Bulgaria’s Disabled Children

Maria Milkova, Sofia Botevgrad, Byala Apeldoorn – Balkan Insight, 22 Dec 2016

This article discusses Bulgaria's challenges since the shut down of its crowded institutions, which housed disabled children.

Dr. Charles Nelson: Neglect Profoundly Impacts a Child's Brain

WGBH Forum , 19 Dec 2016

As part of NOVA's look at childhood education, Dr. Charles Nelson came to this Boston Cafe Sci to share his research on the effects of early profound adversity on child and brain development.