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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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.

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

Analyse sur la situation des enfants dans les centres résidentiels au Burundi

Miranda Armstrong - UNICEF, International Rescue Committee, Ministere de la Solidarite Nationale, Des Droits de la Personne Humaine et du Genre, 01 May 2011

Le Gouvernement du Burundi, en collaboration avec l’UNICEF et l’ONG International Rescue Committee (IRC), a prévu de faire un état de lieux des centres résidentiels pour les enfants.

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.

Neurodevelopmental Effects of Early Deprivation in Post-Institutionalized Children

Seth D. Pollak, Charles A. Nelson, Mary F. Schlaak, Barbara J. Roeber, Sandi S. Wewerka, Kristen L. Wiik, Kristin A. Frenn, Michelle M. Loman, and Megan R. Gunnar - Child Development, 2011

Abstract

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Research, Practice, and Policy Perspectives on Issues of Children without Permanent Parental Care

Robert B. McCall - Monographs of the Society for Research in Child Development, 2011

This chapter presents conclusions, trends, conceptual analyses, hypotheses, and speculations regarding some fundamental issues of research, practice, and policy that are largely unsettled or controversial, regarding children without permanent parental care.

The Rights of Vulnerable Children Under the Age of Three: Ending their placement in institutional care

Dainius Puras - The Regional Office for Europe of the Office of the United Nations High Commissioner for Human Rights (ROE OHCHR), 2011

This document was commissioned by the Regional Office for Europe of the Office of the United Nations High Commissioner for Human Rights (ROE OHCHR). One of its aims was to stimulate discussion at the Sub-Regional Workshop on the Rights of Vulnerable Children Aged 0 to 3 Years in Prague on 22 November 2011.