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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Violence Against Children Affected by HIV/AIDS: A Case Study of Uganda

World Vision, 2005

Report documenting participatory research conducted on violence against children affected by HIV/AIDS in Uganda. Particular focus on the stigmatisation and discrimination.

Family Matters: A Study of Institutional Child Care in Central and Eastern Europe and the Former Soviet Union (Shorter Version)

Richard Carter - Every Child, 2005

This report reviews the faltering progress made in childcare reform across Central and Eastern Europe and the former Soviet Union over the 15 years since the ‘orphanages’ of Romania were revealed to the world.

Research on Institutional Care of Vulnerable Children

North American Council on Adoptable Children, 2005

A brief literature review of the key findings of academic research into the effects of institutional care for vulnerable children. Contains information on the negative effects of institutional care.

Children and Disability in Transition CEE/CIS and Baltic States

UNICEF Innocenti Research Centre, 2005

Report presents and analyzes new research and data around children with disabilities in the region, the effects of institutional care, and the need for family support services.

Study of Children in Children's Homes in Nepal: Volume 1: Main Text

Rabi Bhawan, 2005

Reports on the status of children living in residential facilities in Nepal. Includes detailed survey instruments in appendicies.

Protecting the Rights of Children in Residential Care: Uncovering a Culture of Abuse

Jacqueline Ramdatt, 2005

Describes and analyses abuse in institutional care using a case study of a home for girls in the developed world.

A European survey of the number and characteristics of children less than three years old in residential care at risk of harm

Kevin Browne , 2005

This report presents the survey Kevin Browne and colleagues conducted in 33 European countries to identify the number and characteristics of children less than three placed in residential care without their parents for more than three months during the year ending December 31, 2003. The purpose was to assess the rate and cost of residential care as a response to children in adversity.

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Children in Institutional Care: The Status of their Rights and Protection in Sri Lanka

Save the Children Sri Lanka and Save the Children Canada, 31 Dec 2004

A situation analysis of children in institutional care that includes policy implications and key recommendations.

Attachment in Institutionalized and Community Children in Romania

Charles H. Zeanah, Anna T. Smyke, Sebastian F. Koga, Elizabeth Carlson, 31 Dec 2004

This study examined attachment in institutionalized and community children 12 – 31 months of age in Bucharest, Romania.

Children in Residential Care: The Zimbabwean Experience

G. Powell, T. Chinake, D. Mudzinge, W. Maambira, and S. Mukutiri, 2004

Analyzes the state of institutional care in Zimbabwe against the national child protection policy. Focuses on the role of donors in the proliferation of institutional care and strategies to better regulate the development and provision of child protection services.