User:KTilak02/Deinstitutionalisation (orphanages and children's institutions)

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Deinstitutionalisation is the process of reforming child care systems and closing down orphanages and children's institutions, finding new placements for children currently resident and setting up replacement services to support vulnerable families in non-institutional ways. It became common place in many developed countries in the post war period. It has been taking place in Eastern Europe since the fall of communism and is now encouraged by the EU for new entrants. In 2019 the UN General Assembly Resolution on the Promotion and Protection of the Rights of Children verified and urged all countries to put in place measure for children to be moved from institutions into family environments, or comparable alternatives and resources. It is also starting to take hold in Africa and Asia although often at individual institutions rather than statewide. New systems generally cost less than those they replace as many more children are kept within their own family.

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 Rwanda and Ghana and Ethiopia however as the governments do not run the institutions the process can be more complex. 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.

More recently many countries in Sub-Saharan Africa have begun to work on the transition from institutional to community-based care for children.

As a whole there is estimated to be about 52 million orphans in Africa, largely due to high mortality rates from various diseases within the continent (HIV/AIDS, malaria, tuberculosis), but also due to natural disasters, conflicts or other pregnancy and birth related reasons. In Malawi, some are simply abadoned due to financial of family reasons in orphanages. 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." In 2014, UNICEF started aiding the Malawi government to support the change from institutionalized care to a more family-centered care, following the global trend to do this across the world. As of 2018, 300 children had been transitioned throguh this standard.

Adding to The Lancet Commission
In 2020, the Lancet Journal published the findings of the Lancet Group Commission on institutionalisation and deinstitutionalisation of children, including a systematic and integrative review of evidence regarding effects on development. 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. Significant but smaller associations were found between institutionalisation and socioemotional development and mental health. Leaving institutions for foster or family care is associated with significant recovery from some developmental outcomes (eg. growth and cognition) but not for others (eg. attention). The length of time in institutions was associated with increased risk of adverse sequalae and diminished chance of recovery. The Commission concluded that reducing the number of children entering institutions and increasing the number leaving institutions is urgently needed. 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.

Some examples of this in action include the UK Aid Direct funding guidance from the UK Government's Department for International Development, which prevents private rather than governmental funding proposals from trying to form child institutions. Similarly, the US has the Advancing Protection and Care for Children in Adversity under it's government strategy from 2019-23, which states it's intentions to fund family-first in international development and funding. Additionally, part of the problem has also included volunteerism, and in response, foreign policy has been created to limit and properly address this. Of all the foreign legislation, Australia has the most comprehensive model on developing specific legislation on what volutneering in children's insitutions looks likes. Faith-based organisations, which often lead these efforts, engage in discussions of voluntourism and the negative consequences of supporting instutitions.

Priorities for children living in institutions[edit]
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.

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. Additionally, there is a focus that it is ethically done and effectively monitored and avaluated, and promotes access to programs and services that address and support the placement of children in families, as well as undergirds children who are at lisk for losing their family or without parental care.