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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Children on Their Own in Cambodia: Mailman School Study Looks at Youth Living in Orphanages and on the Streets

Columbia University Mailman School of Public Health, 16 Feb 2016

A new video describes a Mailman School-led study to assess the size of the problem. Interspersed with footage of children in informal settlements and orphanages, researchers and officials describe the growth of residential care facilities in Cambodia, many which are operated or funded by foreign charities, including religious groups.

View the Press Release and Video

Changing Mindsets and Practice: Engaging Christian faith based actors in deinstitutionalisation and child welfare systems reforms

Rebecca Nhep, ACCI , 29 Jan 2016

This tool was designed to help those seeking to assist Christian faith-based actors involved in long-term residential care programs make the transition from institutional to non-institutional (family and community-based) child welfare programs.

Alternative Child Care and Deinstitutionalisation: A Case Study of Indonesia

Claire O’Kane and Sofni Lubis - SOS Children's Villages, 10 Jan 2016

This report is a case study of alternative child care in Indonesia. Research was conducted that found that with an estimate of 8,000 institutional facilities servicing 500,000 children, Indonesia was overly reliant on institutional care.

Los Olvidados: Niños y Niñas en "Hogares": Macroinstituciones en América Latina y el Caribe

RELAF, 2016

Este documento pretende impulsar un cambio en el paradigma de la institucionalización como respuesta a la situación de los niños, niñas y adolescentes privados de cuidados familiares.

Austria: Country Fact Sheet

2016

This fact sheet highlights Austria’s process in transforming institutional care towards community-based and family-based systems.

Ending Institutional Care: Questions and answers

Hope and Homes for Children, 2016

This publication includes common questions and answers on the implications of institutional care and why it should be ended.

Addressing Social Norms that Underpin Violence Against Children in Zimbabwe: Findings and strategic planning document

Fry, D., Hodzi, C. and T. Nhenga - Ministry of Public Services, Labour and Social Welfare, 2016

This report highlights key findings from a social norms study conducted in Zimbabwe to understand the drivers of violence affecting children.

Video: Don't Create More Orphans

ChildSafe, 2016

This short video by ChildSafe in Cambodia explains how donations to orphanages, rather than helping the situation, often cause the creation of more orphans. It is estimated that about 80% of the 8 million children living in institutions around the world are not actually orphans. Donations to orphanages only fuel the orphanage industry further, so the focus should instead be on supporting families.

Watch the Video

Greece: Country Fact Sheet

Opening Doors for Europe's Children, 2016

According to this Country Fact Sheet focusing Greece, there is no database holding data on children in alternative care in Greece.

Efficacy of Family-based Care As Compared to Institutional Care: A Careful Review

K. Bhuvaneswari & Sibnath Deb - Scottish Journal of Residential Child Care, 2016

This paper aims to understand the functioning of institution in protecting the rights of children who are in need of care and protection and highlight measures for revamping the institutional care and revolutionizing family care.