Ending Child Institutionalization

The detrimental effects of institutionalization on a child’s well-being are widely documented. Family based care alternatives such as kinship or foster care, are much more effective in providing care and protection for a child, and are sustainable options until family reunification can take place. The use of residential care should be strictly limited to specific cases where it may be necessary to provide temporary, specialized, quality care in a small group setting organized around the rights and needs of the child in a setting as close as possible to a family, and for the shortest possible period of time. The objective of such placement should be to contribute actively to the child’s reintegration with his/her family or, where this is not possible or in the best interests of the child, to secure his/her safe, stable, and nurturing care in an alternative family setting or supported independent living as young people transition to adulthood.

Countries which have traditionally relied on residential care are now undergoing major transformations to their child care and social welfare policies, in order to move towards family and community based care options. Such transformations are rooted in the research-based evidence of the impact of institutionalization on a child’s development, vulnerability to abuse within residential care settings, and the institution's high operational costs. It is therefore of great concern that the use of residential care is increasing in developing countries with high rates of HIV/AIDS. Such projects are typically funded by foreign donors to the detriment of the local population, and pressure should be placed on the host governments to pursue policies of family based care rather than residential care.

The use of residential care should be strictly limited to specific cases where it may be necessary to provide temporary, specialized, quality care in a small group setting organized around the rights and needs of the child in a setting as close as possible to a family, and for the shortest possible period of time. The objective of such placement should be to contribute actively to the child’s reintegration with his/her family or, where this is not possible or in the best interests of the child, to secure his/her safe, stable, and nurturing care in an alternative family setting or supported independent living as young people transition to adulthood.

Where the separation of parents and child is long-term, the alternative care arrangement should be family based to give the child a sense of security, continuity, stability and belonging by providing certainty on where the child will live for the rest of childhood and who the child’s parents or legal guardians will be. Keeping siblings, cousins and close friends together should be an important consideration in placement decisions. Adolescents, who may find integration into a new family difficult, may benefit from placement in supported independent living arrangements. These arrangements should be fully integrated in the community to which the children belong, with a comparable standard of living.

Any child in a residential care setting must have their needs assessed and planned for, to enable them to return to their families as soon as possible. If a child has become separated from her family in an emergency, documentation, tracing and reunification activities should begin urgently. If a child has been removed from parental care for her safety, support services should be provided to the parents in order to facilitate the return of the child. Children must be kept fully informed and involved in any plans for their care, and encouraged to maintain contact with known relatives where possible.

Residential care services must adhere to stringent standards of documentation and care and be regularly monitored by protection workers to ensure the children have their safety, health, psychosocial, and educational needs met.

The literature in this section deals with examples of countries which are working to develop their child care policies away from using residential care to alternative family care options such as kinship care, fostering, and adoption.

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La historia de la evolución y transformación de Casa Eudes, dirigido por las Hermanas de Nuestra Señora de la Caridad del Buen Pastor, en Tijuana, México

Changing the Way We Care, 07 Oct 2022

Este estudio de caso destaca la transición de servicios de cuidado residencial a los basados en la familia y comunidad, realizado por las Hermanas de Nuestra Señora de la Caridad del Buen Pastor, en Tijuana B.C., México.

The Transformation Process of Casa Eudes of the Congregation of Our Lady of Charity of the Good Shepherd in Ciudad Juarez, Mexico

Changing the Way We Care, 07 Oct 2022

This case study highlights the transition of the Sisters of Our Lady of Charity of the Good Shepherd in Ciudad Juarez. It is an honest look at the emotional, logistical, and practical elements involved in transitioning from a residential care model which existed for more than 100 years to a provider of community-based and family-centered services.

Case Studies: Stories of Transformation and Transition in Juarez and Tijuana, Mexico

Changing the Way We Care, 07 Oct 2022

The Transformation Process of Casa Eudes of the Congregation of Our Lady of Charity of the Good Shepherd in Ciudad Juarez, Mexico

La historia del proceso de transformación de Casa Eudes, a cargo de la Congregación de Nuestra Señora de la Caridad del Buen Pastor en Ciudad Juárez, México

Changing the Way We Care, 07 Oct 2022

Este estudio de caso destaca la transición de servicios de cuidado residencial a los basados en la familia y comunidad las realizado por las Hermanas de Nuestra Señora de la Caridad del Buen Pastor, en Ciudad Juárez, México.

Child’s i Foundation Case Study: Tororo District Transformation

Child's i Foundation, Better Care Network, 06 Oct 2022

Based in Uganda, Child’s i Foundation successfully transitioned their residential programs before deciding to expand their vision and seek to bring about care reform to the entire district of Tororo. Partnering with the district level government and several CCIs, Child’s i Foundation carried out an extensive analysis and assessment of the Tororo region which provided information to guide the ensuing transitions of CCIs throughout the region.

Transition Case Study: Alliance For Children Everywhere Zambia

Better Care Network, Alliance for Children Everywhere, 06 Oct 2022

Alliance for Children Everywhere (ACE) Zambia is a US-funded organization that transitioned from providing residential care in Zambia to pioneering family-based care, including foster care, and supporting other residential care service providers to transition. With important links to the Zambian government, ACE Zambia has been a key actor in supporting the development of policies, programs and guidelines that are now utilized across the country.

Pasos y recursos para acompañar a organizaciones en el proceso de transformación

Changing the Way We Care, 26 Sep 2022

Este documento está diseñado para orientar a las personas u organizaciones que están apoyando un proceso de transición para pasar de proporcionar atención residencial a un modelo que promueva la atención familiar y comunitaria. El documento está diseñado en torno a las Fases de la Transición de Better Care Network. Se basa en el trabajo que Changing the Way We Care ha realizado en los últimos años para apoyar a diferentes proveedores de atención residencial, tanto religiosos como laicos, en su propio proceso de transición. Hay ejemplos y enlaces a herramientas relevantes, mensajes y actividades sugeridas que pueden utilizarse para apoyar las diferentes fases del proceso.

Case Story of Transition: Story International

Changing the Way We Care, Story International, 19 Sep 2022

This case story is meant to illustrate transition, the actors involved, the challenges and the success factors; recognizing that each transition is an individual process with different starting points, different dynamics and different evolutions. Story International’s transition example demonstrates the ups and downs of divesting from the orphanage model.

Case Story of Transition: Journey of Change and Safe Closure

Changing the Way We Care, 09 Sep 2022

The Journey of Change and Safe Closure case story demonstrates the process of early engagement and awareness to supporting the long-term reintegration of children in families.

An Introduction to Care Reform

Emily Delap - Regional Learning Platform on Care Reform, UNICEF, Changing the Way We Care , 01 Sep 2022

Although care reform is well established in some parts of the Eastern and Southern Africa, many countries in the region are just beginning their care reform journey. This short paper is aimed at these contexts. It explains what care reform is, the different components of care reform, why care reform is important and how to start a care reform process.

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