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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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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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.

Transitioning Residential Care Services Video Case Studies

Better Care Network in partnership with Kinnected, 14 Dec 2021

These video case studies were developed as a part of the Transitioning Models of Care Assessment Tool training pa

Making the Case for Transition - Kinnected Partner, India/Australia

Better Care Network in partnership with Kinnected, 14 Dec 2021

This video case study was developed as a part of the Transitioning Models of Care Assessment Tool training package. It is 1 of 8 video case studies exploring different aspects of learning on transitioning residential care services. To access the full set of case studies or the training package, visit the BCN Transition Hub.

Estudio de caso del proceso del cambio: Haciendo la Transición del Orfanato Firefly

Better Care Network and Kinnected, 01 Dec 2021

Este estudio de caso destaca algunas de las dinámicas clave que surgieron a lo largo del proceso de transición de sus servicios de la atención residencial a la programación no institucional de una organización y examina cómo esas dinámicas influyeron en la transición y determinaron el tipo de apoyo brindado, así como el más apropiado. estrategia de transición. El estudio de caso se organiza en torno a las distintas etapas de la transición y explora algunos de los temas clave descritos en la Herramienta de evaluación de modelos de atención en transición.

Versión inglesa

Más allá del cuidado institucional: Una hoja de ruta para la reforma del sistema de protección y cuidado infantil destinada a los Gobiernos de América Latina y el Caribe

Hope and Homes for Children, 01 Dec 2021

Más Allá del Cuidado Institucional proporciona un marco para que los gobiernos desarrollen su propia hoja de ruta para la reforma de sus sistemas de protección y cuidado infantil y la desinstitucionalización. Esperamos que esto inspire el diálogo, guíe las conversaciones entre grupos interministeriales y en la sociedad, oriente a grupos
multidisciplinarios de todos los niveles en la creación de su propia evaluación y ayude en la planificación de su propia hoja de ruta para el cambio.

Estudio de caso de una transición de alto riesgo: Lighthouse Children’s Village

Better Care Network and Kinnected, 01 Dec 2021

La Aldea Infantil Lighthouse se estableció en 2004 como una institución de atención residencial de gestión privada y financiada con fondos privados. En 2014, su donante principal desde hace mucho tiempo tomó la decisión de eliminar gradualmente la atención institucional de apoyo financiero. Este estudio de caso destaca algunas de las señales de advertencia tempranas y el posterior descubrimiento de comportamientos no éticos y delictivos que a veces se pueden observar en un proceso de transición.

Versión inglesa

Au-delà des soins en établissement: Feuille de route pour la réforme du système de protection et de prise en charge des enfants pour les gouvernements d’Amérique latine et des Caraïbes

Hope and Homes for Children, 01 Dec 2021

Au-delà des soins institutionnels fournit un cadre aux gouvernements pour développer leur propre feuille de route pour la réforme et la désinstitutionnalisation du système de protection et de garde des enfants. Nous espérons qu'il inspirera une conversation, guidera le dialogue interministériel et interprofessionnel, soutiendra les groupes multidisciplinaires à tous les niveaux pour encadrer leur propre évaluation et planifier leur propre feuille de route pour le changement.