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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The Experiences of Jordanian Care Leavers Making the Transition from Residential Care to Adulthood: The Influence of a Patriarchal and Collectivist Culture

Rawan W. Ibrahima, David Howeb - Children and Youth Services Review Volume 33, Issue 12 - Young People's Transitions from Care to Adulthood, 01 Dec 2011

The study explores the post-care experiences of young Jordanian care leavers. Material struggles were similar to peers internationally. The distinct difference for Arab care leavers was the cultural influence. Patriarchy, family life and collectivism impact the care leavers' experiences. A cultural dimension increases understanding of leaving-care.

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Analysis of the Situation of Children in Residential Centres in Burundi

Government of Burundi, International Rescue Committee, UNICEF, 13 Oct 2011

The report of this study responds to the objectives of identifying all the residential centres for children in Burundi, including the number of children residing in them; analysing the situation of children living in the centres and developing recommendations for the next steps

All Children Count: A Baseline Study of Children in Institutional Care in Malawi

The Ministry of Gender, Children, and Community Development of Malawi; Centre for Social Research (CSR) of the University of Malawi; UNICEF Malawi, 31 Aug 2011

This study commissioned by the Ministry of Gender, Children, and Community Development and financially and technically supported by UNICEF and the Better Care Network, describes the situation of children in institutional care in Malawi.

Towards Alternative Child Care Services in Armenia: Costing Residential Care Institutions and Community Based Services

UNICEF Armenia, 01 Aug 2011

This recent study by UNICEF in Armenia costed different types of residential care and community based services.

Institutionalised childhood and adolescence: Making serious Human Rights violations visible.

Matilde Luna - RELAF, 01 Aug 2011

This paper, produced by RELAF, is part of a series of publications on children without parental care in Latin America: Contexts, causes and answers. This document, and others in the series, pertains to the broad topic of children without parental care and examines the particular situation of institutionalised children.

OHCHR, UNICEF Launch Campaign to Protect Children, Prevent Harmful and Unnecessary Institutionalization

UNICEF, 08 Jul 2011

Press release from UNICEF and OHCHR launching a joint campaign to put an immediate end to the practice of placing young children into State-run infant homes.

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At Home or In a Home: Formal Care and Adoption of Children in Eastern Europe and Central Asia

UNICEF, 01 Jul 2011

Published by UNICEF, the report At Home or in a Home, provides an overview of the major trends and concerns about children in formal care and institutions as well as adoption Central and Eastern Europe and Central Asia.

Adolescents living in orphanages in Ankara: psychological symptoms, level of physical activity, and associated factors

Karadağ Çaman Ö and Özcebe H., 01 Jun 2011

Adolescents living in orphanages are at a disadvantage with respect to mental health. The aim of this study was to assess the distribution of psychological symptoms and their association with the level of physical activity (PA) in adolescents living in orphanages.

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Scaling Down: Reducing, Reshaping and Improving Residential Care around the World

EveryChild , 12 May 2011

This paper summarizes the evidence base on residential care to promote better decision making among policy makers and child welfare practitioners

Violence Against Children in State-Run Residential Institutions in Kazakhstan: An Assessment

Robin N. Haarr , 01 May 2011

This study on violence against children in state-run residential institutions in Kazakhstan was conducted under the national Office of the Commissioner for Human Rights and UNICEF. Data was collected from six different types of state run- residential institutions for children in 3 regions using a multi-methods approach, including surveys with children ( 9-18 years old) and staffs, and interviews with young people (17-23 years old) who had left the care of these institutions.