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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I Matter Campaign Briefing Paper 2: Preparation for Independent Living

SOS Children's Villages, 08 Jun 2010

The "I Matter Campaign" advocates for support for young people ageing out of care. The second edition of the "I Matter" briefing paper, published by SOS Children's Villages, focuses on young people's involvement in the campaign.

Improving Care Options for Children in Ethiopia through Understanding Institutional Child Care and Factors Driving Institutionalization

Family Health International , 01 Jun 2010

Findings and recommendations of the first national study of its kind in Ethiopia to study child care institutions, institutionalized children, and factors driving institutionalization.

Overlooked: Children with Disabilities in Residential Care

Alexandra L. Trout, Kathryn Casey, M. Beth Chmelka, Catherine DeSalvo, Robert Reid, and Michael H. Epstein, 13 May 2010

This study evaluated data of 123 children with and without disabilities in residential care to determine demographic, behavioral, mental health, and educational characteristics.

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Off the Backs of the Children: Forced Begging and Other Abuses against Talibés in Senegal

Human Rights Watch, 01 Apr 2010

This report is based on 11 weeks of field research in Senegal and Guinea-Bissau between November 2009 and February 2010.

Rightsizing Congregate Care: A Powerful First Step in Transforming Child Welfare Systems

Annie E. Casey Foundation, 01 Mar 2010

This new report from the Annie E. Casey Foundation outlines initiatives in four sites to help child welfare systems reduce institutional placements, improve outcomes, and support community services by changing the array of services, frontline practice, finances, performance management, and policy

Young Care Leavers and Social Inclusion: Matrix of Guidelines for Life after Institutional Care

Amici de Bambini, 01 Mar 2010

In response to the increased social exclusion affecting youth leaving care, Amici de Bambini developed Matrix of Guidelines for Life after Institutional Care, which can be used to increase the likelihood of social inclusion for young people who have been released from the child protection system.

Liberia: Regulations for the Appropriate Use and Conditions of Alternative Care for Children

Government of Liberia, Ministry of Health and Social Welfare , 01 Feb 2010

Regulations and tools designed to create the basis for reforming welfare institutions for the safe and appropriate administration of alternative care.

Bronfenbrenner’s Ecological System Theory and the Experience of Institutionalization of Romanian Children

Adrian V. Rus, Wesley C. Lee, Dafnne B. Bautista Salas, Sheri R. Parris, Rebecca D. Webster, Austin R. Lobo, Stativa Ecaterina, Cosmin Popa - Research, Education and Development: Symposium Proceedings, 2010

This article explores the experience of institutionalization of Romanian children and Bronfenbrenner’s Ecological System Theory.

Rapid assessment of residential child care institutions in the Republic of Armenia

Mira Antonyan, 2010

The study covers all residential child care institutions operating in Armenia, with the purpose of creating a basic baseline for further analysis required for the progressive reduction of placement of children and the development of alternative child care services. The aim of the assessment is to verify the situation of each child in relation to their families, and the respect of their entitlements related to their specific condition.

A Comparison of the Wellbeing of Orphans and Abandoned Children Ages 6–12 in Institutional and Community-Based Care Settings in 5 Less Wealthy Nations

Kathryn Whetten, Jan Ostermann, Lynne C. Messer, Rachel A. Whetten, Brian W. Pence, Karen O’Donnell, Nathan M. Thielman, The Positive Outcomes for Orphans (POFO) Research Team, 18 Dec 2009

Global policy makers are advocating that institution-living orphans and abandoned children (OAC) be moved as quickly as possible to a residential family setting and that institutional care be used as a last resort.