Deinstitutionalisation (orphanages and children's institutions)
[8] 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 Republic,[9] Romania, whose orphanages are the most infamous in the world,[10][11][12] and Bulgaria.
[17] Moldova[18] has made considerable progress, where investment in inclusive education means many children with disabilities can live at home with their families, reducing the need for institutional placements.
[20][21] The majority of orphanages in Africa are funded by private donors and are often not part of a larger coherent child protection system.
[27] Sudan 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.
[28] More recently many countries in Sub-Saharan Africa have begun to work on the transition from institutional to community-based care for children.
In 1997 the Chikondri Centre opened, and the founder, Mussa, found that many ended up in "special need’s schools, vocational training, starting small businesses, getting jobs and living independently."
[30] The Maghreb region in North Africa has some of the highest rates of child institutionalisation in the world: Algeria 550,000, Libya 80–145,000, Mauritania 45,850, Morocco 471,006, and Tunisia 140,000.
[36] 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.
[42] The study took random samples of 208 children and followed their physical growth, cognitive, emotional and behavioral development over a number of years.
The study found that the institutionalised children were severely impaired in IQ and manifested a variety of social and emotional disorders, as well as changes in brain development.
[44] This meta-analysis of 308 studies found strong negative associations between institutional care and children's development, especially in relation to physical growth, cognition and attention.
Leaving institutions for foster or family care is associated with significant recovery from some developmental outcomes (e.g. growth and cognition) but not for others (e.g. attention).
[45] Universal Health Coverage 2030 has an aim for these to include "advocacy, accountability, knowledge exchange and learning, and civil society engagement" supported multilaterally by UNESCO, the World Bank, and UNICEF under the Global Partnership for Education to focus on accomplishing this by strengthening the education systems in low-income countries.
The focus and guidelines for international policies is to transform care systems based on the idea that children thrive and are supported the best in a family-based environment.
Additionally, part of the problem has also included volunteerism, and in response, foreign policy has been created to limit and properly address this.
[49] The goal for national plans revolved around informed international experience and guidelines, working and partnering with other countries and organizations to ensure that the process, timing and phasing are done realistically, with a proper focus on children with their families, and adequately provide for a variety of needs, from early intervention to alternative care.
Other support structures for families at risk of separation can include facilities such as day care centres for disabled children[16] or young babies.
