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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From Maid to Mother: Transforming Facilities, Staff Training, and Caregiver Dignity in an Institutional Facility for Young Children in Nepal

Amy Conley Wright, Dhirendra Lamsal, Mukunda Ksetree, Aalok Sharma and Kenneth Jaffe, 11 Mar 2014

Infant Mental Health Journal has published an important Special Issue on Global Research, Practice, and Policy Issues in the Care of Infants and Young Children at Risk. This article provides a case study of a project to improve the health, safety, and development of children birth to 6 years old in a large orphanage in Nepal.

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The Right of Boys and Girls to a Family. Alternative Care. Ending Institutionalization in the Americas

Inter-American Commission of Human Rights, 05 Mar 2014

This report by the Inter-American Commission on Human Rights (IACHR) analyzes children’s right to live and be raised by their families, and establishes the resulting obligations for States when it comes to supporting and strengthening families’ ability to raise and care for their children.

Institutionalization of Children in the Czech Republic: A Case of Path Dependency

Victoria Schmidt and Jo Daugherty Bailey, 01 Mar 2014

Despite the development of alternative forms of care, international and domestic pressures for change, and over 20 years of efforts at deinstitutionalization, the Czech Republic has one of the highest rates of institutionalization of children in E

Children's Reintegration: Longitudinal study of children's reintegration in Moldova

Dr Helen Baños Smith, 28 Feb 2014

This important report documents a 22-month longitudinal study of the reintegration of children in residential care in Moldova.

Addicted to Orphans: Donor influence in Uganda's child protection system

Kristen E. Cheney, 21 Feb 2014

A presentation on the "Orphan Industrial Complex" at the Young Lives and Globalization in Africa workshop at the University of Liège, Belgium on 21st February 2014.

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How the Republic of Georgia has Nearly Eliminated the Use of Institutional Care for Children

Aaron Luis Greenberg and Natia Partskhaladze, 30 Jan 2014

The Infant Mental Health Journal has published an important Special Issue on Global Research, Practice, and Policy Issues in the Care of Infants and Young Children at Risk. This article documents how between 2005 and 2013, the Government in the Republic of Georgia closed 32 large, state-run institutions housing children without adequate family care.

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Escape the Box Campaign

Kansas State University Staley School of Leadership Studies, 12 Jan 2014

Escape the Box is an initiative designed to help raise awareness and try to put a stop to the rapidly growing, money making businesses that many orphanages have become.

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Abandoned by the State: Violence, Neglect, and Isolation for Children with Disabilities in Russian Orphanages

Human Rights Watch , 2014

This Human Rights Watch report gives a detailed overview of the situation faced by children with disabilities in orphanages in Russia.

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Nepal 2014 Human Rights Report

Embassy of the United States in Nepal, United States Department of State • Bureau of Democracy, Human Rights and Labor, 2014

This report, published by the US Embassy in Nepal, includes a segment on human rights issues related to orphanage voluntourism and donors, child abuse in child care homes, and a lack of Government regulation of institutions.

The Transition Process out of Group Home Care

Marisa Famalette Boylan - PsyD Clinical Dissertation, Alliant International University , 2014

This qualitative study explored the experiences of adults who had lived in group home care as adolescents and transitioned back into the community at the end of their treatment.

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