Prolonged institutional care is consistently associated with cognitive, socioemotional, behavioural, and neurobiological deficits in children. Family-based alternatives such as foster and kinship care demonstrate restorative potential, yet policy translation remains uneven in low- and middle-income contexts. A narrative synthesis guided by the PRISMA framework was conducted. Peer-reviewed English-language studies published between 2009 and 2025 were systematically searched in SCOPUS, PubMed, and Google Scholar. From 603 records, 94 studies met inclusion criteria and were thematically analysed. Evidence from randomized controlled trials (e.g., Bucharest Early Intervention Project), longitudinal cohorts, and implementation studies shows that institutional rearing impairs developmental outcomes, while early and stable family placements promote recovery. Moderators of recovery include caregiving quality, placement stability, and timing of transition. Programmatic evidence highlights the importance of caregiver training, monitoring systems, and culturally adapted implementation models. For Ogun State, Nigeria, three priorities are recommended: (1) strengthening gatekeeping to reduce institutional exposure, (2) investing in recruitment, training, and sustained support for foster and kinship carers, and (3) embedding developmental screening, mental health integration, and monitoring within phased deinstitutionalisation strategies. A strategic transition toward evidence-informed foster care reform offers a sustainable pathway to improved child outcomes.
