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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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.

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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.

Not What It Seems: Going deeper into Ugandan Orphanages

Amanda Thorsteinsson, 27 Dec 2015

In this short video, Amanda Thorsteinsson documents the proliferation of orphanages in Uganda and the role of well-intentioned Westerners in contributing to this problem.

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Normalization of EEG activity among previously institutionalized children placed into foster care: A 12-year follow-up of the Bucharest Early Intervention Project

Vanderwert RE, Zeanah CH, Fox NA, and Nelson CA, 13 Dec 2015

The Bucharest Early Intervention Project (BEIP) examined the outcomes for children who were originally placed in institutions; these children were randomized into two groups and followed longitudinally, with some being moved into foster care and others remaining in institutional care. This study reports on the brain electrical activity (electroencephalogram, or “EEG”) of 12-year-old children in this study, in order to examine the impact of movement to foster care after early psychological deprivation as a result of institutionalization.

Dispatches: Straight Talk About Disability

Human Rights Watch, 03 Dec 2015

In this article, a Human Rights Watch researcher describes her personal experiences meeting adults and children in the Western Balkans who have spent their lives hidden away in institutions because they have a disability.

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Research methodology applied to a comparative case study of the deinstitutionalization of children in Bulgaria and Ukraine

Chrissie Gale - Scottish Journal of Residential Child Care, 01 Dec 2015

This study discusses a variance in results in eliminating use of large-scale residential institutions for children across the CEE/CIS region.