Recent internationally endorsed guidance suggests that a range of alternative care options, primarily family-based, must exist in order to respond to children’s individual needs and circumstances. This continuum of care, including both prevention and response services, is at the core of any child welfare system. The process of decreasing reliance on orphanages, ensuring the quality of care, and providing a range of care options with an emphasis on family care, requires a significant investment of human and financial resources, and public support. This process requires time, and also conviction.
In summary, key points supported by the evidence include
The term “orphan” is often a misnomer. Most children who have lost a mother or father still have a living parent or other family members who are willing to care for them. However, many children have been separated or are at risk of being separated from family care for a range of reasons. Globally, it is estimated that well over 2 million children are living in orphanages.
Poverty is a primary reason that children are placed in orphanages. Too often, parents and relatives place children in orphanages in order to provide them with food, shelter, and an education. Other causes include lack of access to health care and/or social services; abandonment, abuse, and neglect; the loss of parents; and disability status. Each of these factors, when coupled with poverty, increases the risk of a child being placed in an orphanage.
Strengthening families and addressing children’s basic needs while enabling them to remain within family care is critical. Studies show that when parents and relatives are presented with the option of support or social services to avoid placing their children in an orphanage, most would unequivocally choose to keep their children at home. Supporting family-based options is also shown to be more cost-effective than orphanages.
A robust body of evidence over the last 30 years demonstrates that families provide the best environment for a child’s development. Children’s cognitive, social, and emotional development are supported when they are loved and protected, have a sense of belonging, and learn the life skills that are integral to growing up within a family.
Children living in orphanages are at greater risk for long-term negative impacts on their social, emotional, and cognitive development. This is especially true for children under three years of age and for children living in large institutions for long periods of time. While higher quality residential care (small numbers of children living “family-style” with consistent, well-trained caregivers) can help minimize these impacts, research shows that children growing up within families fare better in the long term than children raised in orphanages.
This facilitates the possibility of identifying the best care option to meet each child’s unique needs. The continuum of care includes prevention/family strengthening, family reunification, kinship care, adoption, and foster care, as well as smaller, “family-style” high-quality residential care.
“Whether in family care or in orphanages, all vulnerable children need to be protected from abuse, neglect, and the deprivation of their basic needs. While the evidence demonstrates that children are more likely to be abused or neglected in institutional care, it is important to support the well-being and protection of children in all settings.“
Ensuring that all children are well cared for, ideally within a family, takes the active involvement of and collaboration between government, non-governmental organizations, local communities, the faith-based community, families, and caregivers, as well as children and youth. There is a role for each of these groups and a need for collaboration and a shared understanding of what is best for children.