It is estimated that about 2 million children around the world are living in institutions, though the true figure may be higher. Conditions in these facilities are often poor and the effects of institutionalization on children are usually detrimental. Some institutions are intended to provide care for children born with disabilities (occasionally against their families’ wishes), others often cater to unwanted girls, some house abandoned children or those with mild disabilities, and certain institutions, especially those in Africa, serve as residential facilities for those whose families have died in genocides or from HIV/AIDs. There are a host of reasons that children around the world may be placed in institutions and the institutions may serve different purposes. However, according to this article, there is a commonality: the number of institutions globally is in decline. In Romania, the number of children living in institutions has dropped from more than 32,000 in 2004 to about 9,000 in 2012. In Rwanda, the number of orphanages has declined from over 400 in 2008 to only 33 in 2012 and the government has promised to close them all by 2014. And Georgia has also seen a decline in orphanages. In 2003 it had 41 institutions; now it has three. Additionally, other countries and governments are beginning to look into alternatives to institutionalization. For instance, the US government has pledged to help children worldwide stay within families or family-like care.
The article states that institutional reform is essential for three reasons: (1) institutionalization is detrimental to children’s development, (2) orphanages often prevent efforts to keep children in family care - up to 90% of children in orphanages have living parents, says Georgette Mulheir of Lumos, a British campaign group - and, (3), institutions are economically costly. The article offers some solutions and alternatives to institutionalization, such as offering more parental support and, for those who truly have no available family or those with severe disabilities, creating smaller group homes of no more than 12 children with long-term staff who provide more individualized care. The article also provides some examples of the challenges to systemic reform. For instance, institutions may be a lucrative business for some who will not want to see them shut down, and offering foster care and adoption as alternatives to orphanages requires governments to properly vet prospective carers and parents. In some countries, these challenges lead to an increase in, or a continued commitment to, institutionalization. However, many more are moving towards deinstitutionalization, which the author believes is a positive step.