Deinstitutionalisation (orphanages and children's institutions)
Encyclopedia
Africa
Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...
and Asia
Asia
Asia is the world's largest and most populous continent, located primarily in the eastern and northern hemispheres. It covers 8.7% of the Earth's total surface area and with approximately 3.879 billion people, it hosts 60% of the world's current human population...
although often at individual institutions rather than state wide. New systems generally cost less than those they replace as many more children are kept within their own family.
The Developed World
Deinstitutionalisation occurred in the US between 1941 and 1980. In the US it was a consequence of the 1935 Social Security Act which allowed Aid to Dependent Children (ADCAid to Families with Dependent Children
Aid to Families with Dependent Children was a federal assistance program in effect from 1935 to 1996, which was administered by the United States Department of Health and Human Services...
) to be passed and children could no longer be removed from their families due to poverty alone. It occurred over a similar period in Western European and some South American countries.
Eastern Europe
Deinstitutionalisation is currently most common in the former Soviet Bloc. Increasingly the institutions that remain in Eastern Europe are occupied by disabled children who can be harder to place in the community. Completing their closure and supporting the development of places they can be cared for in the community is seen as a priority by the EU and that has encouraged many countries wishing to accede to it including the Czech RepublicCzech Republic
The Czech Republic is a landlocked country in Central Europe. The country is bordered by Poland to the northeast, Slovakia to the east, Austria to the south, and Germany to the west and northwest....
, Romania
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...
, whose orphanages
Romanian orphans
The standard of living for Romanian orphans is still grave despite vast improvements since their conditions were leaked to the West after the fall of the Communist government in 1989...
are the most infamous in the world, and Bulgaria
Bulgaria
Bulgaria , officially the Republic of Bulgaria , is a parliamentary democracy within a unitary constitutional republic in Southeast Europe. The country borders Romania to the north, Serbia and Macedonia to the west, Greece and Turkey to the south, as well as the Black Sea to the east...
. It is also happening in Hungary
Hungary
Hungary , officially the Republic of Hungary , is a landlocked country in Central Europe. It is situated in the Carpathian Basin and is bordered by Slovakia to the north, Ukraine and Romania to the east, Serbia and Croatia to the south, Slovenia to the southwest and Austria to the west. The...
where no new children can be placed in orphanages, Moldova
Moldova
Moldova , officially the Republic of Moldova is a landlocked state in Eastern Europe, located between Romania to the West and Ukraine to the North, East and South. It declared itself an independent state with the same boundaries as the preceding Moldavian Soviet Socialist Republic in 1991, as part...
, Ukraine
Ukraine
Ukraine is a country in Eastern Europe. It has an area of 603,628 km², making it the second largest contiguous country on the European continent, after Russia...
, Belarus
Belarus
Belarus , officially the Republic of Belarus, is a landlocked country in Eastern Europe, bordered clockwise by Russia to the northeast, Ukraine to the south, Poland to the west, and Lithuania and Latvia to the northwest. Its capital is Minsk; other major cities include Brest, Grodno , Gomel ,...
and Bosnia. Azerbaijan
Azerbaijan
Azerbaijan , officially the Republic of Azerbaijan is the largest country in the Caucasus region of Eurasia. Located at the crossroads of Western Asia and Eastern Europe, it is bounded by the Caspian Sea to the east, Russia to the north, Georgia to the northwest, Armenia to the west, and Iran to...
has established a Department for De-institutionalisation and Child Protection. Russia is also recognising children should be brought up in families but is not yet closing institutions.
Africa
The majority of orphanages in Africa are funded by private donors and are often not part of a larger coherent child protection system. In Africa deinstitutionalisation has support from the Governments of RwandaRwanda
Rwanda or , officially the Republic of Rwanda , is a country in central and eastern Africa with a population of approximately 11.4 million . Rwanda is located a few degrees south of the Equator, and is bordered by Uganda, Tanzania, Burundi and the Democratic Republic of the Congo...
and Ghana
Ghana
Ghana , officially the Republic of Ghana, is a country located in West Africa. It is bordered by Côte d'Ivoire to the west, Burkina Faso to the north, Togo to the east, and the Gulf of Guinea to the south...
and Ethiopia
Ethiopia
Ethiopia , officially known as the Federal Democratic Republic of Ethiopia, is a country located in the Horn of Africa. It is the second-most populous nation in Africa, with over 82 million inhabitants, and the tenth-largest by area, occupying 1,100,000 km2...
however as the governments do not run the institutions the process can be more complex. Sudan
Sudan
Sudan , officially the Republic of the Sudan , is a country in North Africa, sometimes considered part of the Middle East politically. It is bordered by Egypt to the north, the Red Sea to the northeast, Eritrea and Ethiopia to the east, South Sudan to the south, the Central African Republic to the...
is also making moves towards deinstitutionalisation with the partial closure of Mygoma Orphanage and the setting up of foster placements for babies abandoned there consistent with the principle of Kafala.
Other
There are some small scale moves to increase the number of family based placements in ChinaChina
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
but this is not yet a large scale movement. It is now a priority of NGO's in Nepal
Nepal
Nepal , officially the Federal Democratic Republic of Nepal, is a landlocked sovereign state located in South Asia. It is located in the Himalayas and bordered to the north by the People's Republic of China, and to the south, east, and west by the Republic of India...
. In Haiti
Haiti
Haiti , officially the Republic of Haiti , is a Caribbean country. It occupies the western, smaller portion of the island of Hispaniola, in the Greater Antillean archipelago, which it shares with the Dominican Republic. Ayiti was the indigenous Taíno or Amerindian name for the island...
there are moves to move children out of orphanages and back to their families, but not as part of a wider deinstitutionalisation programme.
Why orphanages are being questioned
More than 4 out of 5 children living in institutions are not orphans. This amount rises to 98% in Eastern Europe. The nature of orphanages means that they often fail to provide the individual sustained attention and stimulation a child would get from growing up within a family. In many cases the children living in them are at risk of harm. There are also many reports of orphanages being abusive or having very high death rates.They are a particular issue for babies and children under three years old as they can stop them making the attachments
Attachment theory
Attachment theory describes the dynamics of long-term relationships between humans. Its most important tenet is that an infant needs to develop a relationship with at least one primary caregiver for social and emotional development to occur normally. Attachment theory is an interdisciplinary study...
that they should. These attachments can be broken by staff changing jobs and children moving to other rooms as they get older. In reality a very small proportion of AIDS orphans are in orphanages and there is no way orphanages could be a sustainable option for all AIDS orphans, even if it was desirable.
The Bucharest Early Intervention Programme
This was a scientific study that compared the development of children raised in institutions with children raised in birth families and foster care. The study took random samples of 208 children and followed their physical growth, cognitive, emotional and behavioural development over a number of years. The study found:- For every 2.6 months spent in a Romanian institutionRomanian orphansThe standard of living for Romanian orphans is still grave despite vast improvements since their conditions were leaked to the West after the fall of the Communist government in 1989...
a child falls behind one month of normal growth - Institutionalised children had significantly lower IQs and levels of brain activity than the other children, especially those who were institutionalised at a young age
- Children in institutions were far more likely to have social and behavioural abnormalities, including aggressive behaviour problems, attention problems and hyperactivity and a syndrome that mimics autismAutismAutism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
. - This syndrome and the behaviours disappear when the child is placed in a family.
Priorities for children living in institutions
It is considered important that all institution-to-home transitions must be accompanied by adequate preparation through individual and group counseling. The development of social work teams to manage fostering and adoption programs is also considered important.Reunification with family
When possible, children are reunited with their birth or extended family. This may require short term psychosocial or financial support but is generally seen as the ideal.Support to transition into independent living
Children transitioning out of care and into the community may need significant support as their life skills may be limited. Failure to prepare them can cause a significant number of them to return to institutions in later life or end up in crime or prostitution.Adoption
Domestic adoptionAdoption
Adoption is a process whereby a person assumes the parenting for another and, in so doing, permanently transfers all rights and responsibilities from the original parent or parents...
is adoption within the home country. Until a country's child protection system is well developed the adoption of children internationally
International adoption
International adoption is a type of adoption in which an individual or couple becomes the legal and permanent parents of a child that is a national of a different country...
is at risk of corruption.
Long term fostering
Long term fostering, defined as fostering for over a year, can often bridge the time between the closure of an institution and independent life.Small group homes
Small group homes or family type homes - ideally with 8 or less children - can provide life-time care for the most disabled children or act as a half way house where children leaving an institution can learn to live in a family.Longer term replacement services
The majority of orphans are absorbed within their own extended families. This is commonly known as alternative family care. Many efforts for the long term care of children without parental care have this at their heart. Successful deinstitutionalisation is accompanied by building the capacity of social services to run fostering and adoption services for new children at risk of separation. Other support structures for families at risk of separation can include facilities such as day care centres for disabled children or young babies. These can allow a mother to go to work so that she can earn a wage and support her family. After school clubs may also meet a similar need.Young mothers may be ostracized by their families. A mother and baby support arrangement can assist them in their early days together. This can be enhanced with counselling to the grandparents and extended family. This is a much shorter intervention which keeps families together at less cost and without harm to the child. Hasty deinstitutionalisation, closing the institution and reuniting the children, without properly thought out alternatives can be detrimental.
Setting up new services is not only considered better for the social, physical and cognitive
Cognitive development
Cognitive development is a field of study in neuroscience and psychology focusing on a child's development in terms of information processing, conceptual resources, perceptual skill, language learning, and other aspects of brain development and cognitive psychology compared to an adult's point of...
development of children but it's cost is up to six times lower once the transition has been funded.
External links
Organisations involved in Deinstitutionalisation- ARK
- Hope and Homes for Children
- Hope for Himalayan Kids
- Orphan Aid Africa
- Next Generation Nepal
- SERA France
- Chernobyl International
- Voluntas
- FARA
- TBACT
Resources for professionals