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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Caminar a la velocidad de la confianza: El viaje emocional de la transición de un modelo de atención residencial a la atención basada en la familia y la comunidad

Changing the Way We Care, 15 Mar 2022

Este informe documenta las primeras etapas de un proceso de aprendizaje entre Cambiando la forma en que Cuidamos y la Congregación de las Hermanas de Nuestra Señora de la Caridad del Buen Pastor en México a medida que ellas avanzan en su proceso de transición. Este documento está dirigido a los profesionales, las organizaciones y los actores católicos interesados en apoyar o participar en un proceso de transición con las organizaciones católicas y también proporciona información útil para aquellos que participan en la transición con actores no religiosos. Esto incluye un importante aprendizaje relacionado con la forma de acompañar a las religiosas en el proceso de transición, comprendiendo los matices relacionados con el tiempo, el contenido y el enfoque. Y lo más importante es que explora el componente emocional que conlleva el hecho de que las religiosas, adapten el enfoque de su carisma a medida que se transforman, pasando de proporcionar atención residencial a una atención basada en la familia y la comunidad.

Insights Into the World of Privatized Faith-Based Residential Care Facilities in Myanmar

Better Care Network, Kinnected, ACC International Relief, 10 Mar 2022

The study was aimed at gaining insights into the operations of privately run, Christian faith-based residential care facilities (RCFs) in Myanmar. The outcomes of this analysis provide important insights to inform ongoing awareness raising, advocacy efforts, approaches to providing technical support and deinstitutionalization, and care reform strategies in Myanmar.

Practitioner's Perspective: Institutions and Reintegration

Alliance for Children Everywhere (ACE) Transition Partners, 02 Mar 2022

In this video Daisy Muzukutwa, Executive Director of ACE Zambia, addresses the following questions: financial viability of reintegration; future of institutional staff after the transition; and where to begin when considering a transition.

Practitioner Video Discussion Guide: Upendo Village, Kenya

Better Care Network, 15 Feb 2022

This video summary accompanies the Readjusting to Parenthood: Peer Support Groups for Grandparents Assuming Care for Orphaned Children (Upendo Village, Kenya) practitioner learning video which is part of the Kenya Practitioner Learning Video Series.

Care Reform in Zambia: Virtual Study Tour

Changing the Way We Care, UNICEF, Government of Zambia, 31 Jan 2022

This virtual study tour aims to provide you with an overview of care reform in Zambia from the comfort of your own home. Care reform relates to the care of children.

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Care Reform in Uganda: Virtual Study Tour

Changing the Way We Care, UNICEF, Government of Uganda, 31 Jan 2022

This virtual study tour aims to provide you with an overview of care reform in Uganda from the comfort of your own home. Care reform relates to the care of children.

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Care Reform in Kenya: Virtual Study Tour

Changing the Way We Care, UNICEF, Government of Kenya, 31 Jan 2022

This Changing the Way We Care virtual study tour aims to provide an overview of care reform in Kenya from the comfort of your own home. Care reform relates to the care of children. It refers to efforts to improve the legal and policy frameworks, structures, services, supports and resources that determine and deliver alternative care, prevent family separation and support families to care for children well.

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Individual-Inclusive Ecosystem Model of Rehabilitation for Inclusion of Children with Disabilities in Childcare Institutions

Josephine Anthony, 11 Jan 2022

In this best practice article, the challenges faced by these children with disabilities and the potential for inclusion within the CCI are discussed based on the field action project intervention of the Tata Institute of Social Sciences (TISS), Mumbai, with selected government CCIs. The article suggests a multi-pronged intervention approach for the Children with disability (CWD) at the levels of the individual CWD, peer group, CCI and the juvenile justice (JJ) System, which are together recognised as the stakeholders of an ‘inclusive ecosystem’. The article arrives at the ‘Inclusive Ecosystem Model of Rehabilitation’ by drawing from the individual–environment interaction model of disability.

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Emotional Psychological Impact of Institutionalization on Children and Early Adolescents

María del Carmen Manzo Chávez, 2022

The causes of institutionalization are multiple and the impact it causes is reflected in different areas such as the development of the child in general, such as mental, psychic structuring, health, and nutrition. Psychologically, children present alterations in their cognitive, emotional, sexual, and social domains with a high probability of developing several pathological conditions. This chapter presents an overview of this phenomenon based on several research investigations carried out in Spain, Latin America, and Mexico.

Child and Adolescent Development in Risky Adverse Contexts

Nutritional Status Assessment of Orphanage Children in Rawalpindi

Mehwish Riaz, Naila Azam, Humaira Mehmood, Raima Asif, Nazish Khan, Fatima Ali Raza Mughal, 31 Dec 2021

The objective of the study was to evaluate the health and nutritional status of four registered orphanages of Rawalpindi, to find frequency of nutritional deficiencies by physical examination findings and to assess their dietary intake and contrast it with individual recommended daily allowances.