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Orphanage
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Plaque where once stood the ruota ("the wheel"), the place to abandon children at the side of the Chiesa della Pietà, the church of an orphanage in Venice. The plaque cites on a Papal bull by Paul III dated 12 November 1548, threatens "excommunication and maledictions" for all those who – having the means to rear a child – choose to abandon him/her instead. Such ex-communication may not be canceled until the culprit refunds all freights incurred to raise the baby.
Former Jewish orphanage in Berlin-Pankow
Sofianlehto Orphanage from 1930 in Helsinki, Finland
St. Nicholas Orphanage in Novosibirsk, Russia

An orphanage is a residential institution, total institution or group home, devoted to the care of orphans and children who, for various reasons, cannot be cared for by their biological families. The parents may be deceased, absent, or abusive. There may be substance abuse or mental illness in the biological home, or the parent may simply be unwilling to care for the child. The legal responsibility for the support of abandoned children differs from country to country, and within countries. Government-run orphanages have been phased out in most developed countries during the latter half of the 20th century but continue to operate in many other regions internationally. It is now generally accepted that orphanages are detrimental to the emotional wellbeing of children, and government support goes instead towards supporting the family unit.

A few large international charities continue to fund orphanages, but most are still commonly founded by smaller charities and religious groups.[1] Especially in developing countries, orphanages may prey on vulnerable families at risk of breakdown and actively recruit children to ensure continued funding. Orphanages in developing countries are rarely run by the state.[1][2] However, not all orphanages that are state-run are less corrupted; the Romanian orphanages, like those in Bucharest, were founded due to the soaring population numbers catalyzed by dictator Nicolae Ceaușescu, who banned abortion and birth control and incentivized procreation in order to increase the Romanian workforce.[3]

Today's residential institutions for children, also described as congregate care, include group homes, residential child care communities, children's homes, refuges, rehabilitation centers, night shelters, and youth treatment centers.

History

[edit]
Caring for orphans, by Dutch artist Jan de Bray, 1663

The Romans formed their first orphanages around 400 AD. Jewish law prescribed care for the widow and the orphan, and Athenian law supported all orphans of those killed in military service until the age of eighteen. Plato (Laws, 927) says: "Orphans should be placed under the care of public guardians. Men should have a fear of the loneliness of orphans and of the souls of their departed parents. A man should love the unfortunate orphan of whom he is guardian as if he were his own child. He should be as careful and as diligent in the management of the orphan's property as of his own or even more careful still."[4] The care of orphans was referred to bishops and, during the Middle Ages, to monasteries. As soon as they were old enough, children were often given as apprentices to households to ensure their support and to learn an occupation.

In medieval Europe, care for orphans tended to reside with the Church. The Elizabethan Poor Laws were enacted at the time of the Reformation and placed public responsibility on individual parishes to care for the indigent poor.

Foundling Hospitals

[edit]
The Foundling Hospital. The building has been demolished.

The growth of sentimental philanthropy in the 18th century led to the establishment of the first charitable institutions that would cater to orphans. The Foundling Hospital was founded in 1741 by the philanthropic sea captain Thomas Coram in London, England, as a children's home for the "education and maintenance of exposed and deserted young children." The first children were admitted into a temporary house located in Hatton Garden. At first, no questions were asked about child or parent, but a distinguishing token was put on each child by the parent.[5]

On reception, children were sent to wet nurses in the countryside, where they stayed until they were about four or five years old. At sixteen, girls were generally apprenticed as servants for four years; at fourteen, boys were apprenticed into a variety of occupations, typically for seven years. There was a small benevolent fund for adults.

In 1756, the House of Commons resolved that all children offered should be received, that local receiving places should be appointed all over the country, and that the funds should be publicly guaranteed. A basket was accordingly hung outside the hospital; the maximum age for admission was raised from two months to twelve, and a flood of children poured in from country workhouses. Parliament soon came to the conclusion that the indiscriminate admission should be discontinued. The hospital adopted a system of receiving children only with considerable sums. This practice was finally stopped in 1801, and it henceforth became a fundamental rule that no money was to be received.[6]

Historical Development in the 18th and 19th century

[edit]
A group of orphans at Crumpsall Workhouse in the 19th century

United Kingdom

[edit]

By the early nineteenth century, the problem of abandoned children in urban areas, especially London, began to reach alarming proportions. The workhouse system, instituted in 1834, although often brutal, was an attempt at the time to house orphans as well as other vulnerable people in society who could not support themselves in exchange for work. Conditions, especially for the women and children, were so bad as to cause an outcry among the social reform–minded middle-class; some of Charles Dickens' most famous novels, including Oliver Twist, highlighted the plight of the vulnerable and the often abusive conditions that were prevalent in the London orphanages.

Clamour for change led to the birth of the orphanage movement. In England, the movement really took off in the mid-19th century although orphanages such as the Orphan Working Home in 1758 and the Bristol Asylum for Poor Orphan Girls in 1795, had been set up earlier. Private orphanages were founded by private benefactors; these often received royal patronage and government oversight.[7] Ragged schools, founded by John Pounds and the Lord Shaftesbury were also set up to provide pauper children with basic education.

Thomas John Barnardo, the founder of the Barnardos Home for orphaned children.

A very influential philanthropist of the era was Thomas John Barnardo, the founder of the charity Barnardos. Becoming aware of the great numbers of homeless and destitute children adrift in the cities of England and encouraged by the 7th Earl of Shaftesbury and the 1st Earl Cairns, he opened the first of the "Dr. Barnardo's Homes" in 1870. By his death in 1905, he had established 112 district homes, which searched for and received waifs and strays, to feed, clothe and educate them.[8] The system under which the institution was carried on is broad as follows: the infants and younger girls and boys were chiefly "boarded out" in rural districts; girls above fourteen years of age were sent to the industrial training homes, to be taught useful domestic occupations; boys above seventeen years of age were first tested in labor homes and then placed in employment at home, sent to sea, or emigrated; boys of between thirteen and seventeen years of age were trained for the various trades for which they might be mentally or physically fitted.[8]

United States

[edit]

In colonial and early America, orphanages that housed dependent children were rare but became increasingly popular between 1830 and 1860 following challenges associated with immigration, urban poverty, and public health crises like the cholera epidemic.[9] The earliest orphanages were private, religiously affiliated institutions that formed as a reaction to the harsh living conditions experienced by children in public poorhouses. In 1790, the Charleston Orphan House was institutionalized as the first public orphanage in the country. Other orphanages were also set up across the United States led by private or faith-based organizations that tend to screen the eligibility of children to be taken under its custody based on race, religious denomination, nationality, and ethnicity.[10] For example, in 1806, the first private orphanage in New York, then the Orphan Asylum Society, now Graham Windham, was co-founded by Elizabeth Schuyler Hamilton, Alexander Hamilton's widow.[11] In 1836, a group of Quaker women opened the first racially segregated orphanage, the Association for the Benefit of Colored Orphans (Colored Orphan Asylum). In 1836, the New York Catholic Protectory was established catering to a broad class of Catholic children, and a few years later, in 1860, a group of German Jews opened the Hebrew Orphan Asylum. These early historical developments paved the way for the extensive and continuing participation of religious groups in child welfare services in the United States today.[12]

After the Civil War, state and local governments became even more involved in regulating and founding orphanages across the country. The primary drivers of this increased involvement was the need to provide for war orphans, the growing opposition to placing children in poorhouses, and the development of new child abuse laws and enforcement machinery.[9] Under the influence of Charles Loring Brace, placing out children to homes instead of institutions popularized foster care as an alternative to caring for children in the mid-19th century.[13] Later, the Social Security Act of 1935 improved conditions by authorizing Aid to Families with Dependent Children as a form of social security.

Emperor Pedro I of Brazil and his wife Maria Leopoldina visiting the Casa dos Expostos orphanage in Rio de Janeiro, 1826.

Deinstitutionalization

[edit]

Evidence from a variety of studies supports the vital importance of attachment security and later development of children. Deinstitutionalization of orphanages and children's homes program in the United States began in the 1950s, after a series of scandals involving the coercion of birth parents and abuse of orphans (notably at Georgia Tann's Tennessee Children's Home Society). In Romania, a decree was established that aggressively promoted population growth, banning contraception and abortions for women with fewer than four children, despite the wretched poverty of most families. After Ceausescu was overthrown, he left a society unable and unwilling to take care of its children. Researchers conducted a study to see what the implications of this early childhood neglect were on development. Typically reared Romanian children showed high rates of secure attachment. Whereas the institutionally raised children showed huge rates of disorganized attachment.[14] Many countries accepted the need to de-institutionalize the care of vulnerable children—that is, close down orphanages in favor of foster care and accelerated adoption.

Foster care operates by taking in children from their homes due to the lack of care or abuse of their parents, where orphanages take in children with no parents or children whose parents have dropped them off for a better life, typically due to income. Major charities are increasingly focusing their efforts on the re-integration of orphans in order to keep them with their parents or extended family and communities. Orphanages are no longer common in the European Community, and Romania, in particular, has struggled greatly to reduce the visibility of its children's institutions to meet conditions of its entry into the European Union.

Some have stated it is important to understand the reasons for child abandonment, then set up targeted alternative services to support vulnerable families at risk of separation[15] such as mother and baby units and day care centres.[16]

Comparison to alternatives

[edit]

Research from the Bucharest Early Intervention Project (BEIP) is often cited as demonstrating that residential institutions negatively impact the wellbeing of children. The BEIP selected orphanages in Bucharest, Romania that raised abandoned children in socially and emotionally deprived environments in order to study the changes in development of infants and children after they had been placed with specially trained foster families in the local community.[17] This study demonstrated how the loving attention typically provided to children by their parents or caregivers is pivotal for optimal human development, specifically of the brain; adequate nutrition is not enough.[18] Further research of children who were adopted from institutions in Eastern European countries to the US demonstrated that for every 3.5 months that an infant spent in the institution, they lagged behind their peers in growth by 1 month.[19] Further, a meta-analysis of research on the IQs of children in orphanages found lower IQs among the children in many institutions, but this result was not found in the low-income country setting.[20] Worldwide, residential institutions like orphanages can often be detrimental to the psychological development of affected children. In countries where orphanages are no longer in use, the long-term care of unwarded children by the state has been transitioned to a domestic environment, with an emphasis on replicating a family home. Many of these countries, such as the United States, utilize a system of monetary stipends paid to foster parents to incentivize and subsidize the care of state wards in private homes. A distinction must be made between foster care and adoption, as adoption would remove the child from the care of the state and transfer the legal responsibility for that child's care to the adoptive parent completely and irrevocably, whereas, in the case of foster care, the child would remain a ward of the state with the foster parent acting only as a caregiver. Orphanages, especially larger ones, have had some well publicised examples of poor care.[21][22] In large institutions children, but particularly babies, may not receive enough eye contact, physical contact, and stimulation to promote proper physical, social or cognitive development.[23][24] In the worst cases, orphanages can be dangerous and unregulated places where children are subject to abuse and neglect.[21][25][26] Children living in orphanages for prolonged periods get behind in development goals, and have worse mental health. Orphanage children are not included in statistics making it easy to traffic them or abuse them in other ways.[citation needed] There are campaigns to include orphanage children and street children in progress statistics.[27]

Foster care

[edit]

The benefit of foster care over orphanages is disputed. One significant study carried out by Duke University concluded that institutional care in America in the 20th century produced the same health, emotional, intellectual, mental, and physical outcomes as care by relatives, and better than care in the homes of strangers.[28] One explanation for this is the prevalence of permanent temporary foster care. This is the name for a long string of short stays with different foster care families.[28] Permanent temporary foster care is highly disruptive to the child and prevents the child from developing a sense of security or belonging. Placement in the home of a relative maintains and usually improves the child's connection to family members.[28][29] Experts and child advocates maintain that orphanages are expensive and often harm children's development by separating them from their families and that it would be more effective and cheaper to aid close relatives who want to take in the orphans.[30]

Group homes

[edit]

Another alternative is group homes which are used for short-term placements. They may be residential treatment centers, and they frequently specialize in a particular population with psychiatric or behavioral problems, e.g., a group home for children and teens with autism, eating disorders, or substance abuse problems or child soldiers undergoing decommissioning.

Kinship care

[edit]

Most children who live in orphanages are not orphans; four out of five children in orphanages have at least one living parent and most having some extended family.[31] Developing countries and their governments rely on kinship care to aid in the orphan crisis because it is cheaper to financially help extended families in taking in an orphaned child than it is to institutionalize them.[32]

Commercial orphanages

[edit]

While many orphanages are run as not for profit institutions, some orphanages are run as for profit ventures. This has been criticized as incentivizing against the welfare of the orphans.

Most of the children living in institutions around the world have a surviving parent or close relative, and they most commonly entered orphanages because of poverty.[30] It is speculated that flush with money, orphanages are increasing and push for children to join even though demographic data show that even the poorest extended families usually take in children whose parents have died.[30] Visitors to developing countries can be taken in by orphanage scams, which can include orphanages set up as a front to get foreigners to pay school fees of orphanage directors' extended families.[33] Alternatively the children whose upkeep is being funded by foreigners may be sent to work, not to school, the exact opposite of what the donor is expecting.[34] The worst even sell children.[35][36] In Cambodia, from 2005 to 2017, the number of orphanages increased by 75%, with many of these orphanages renting children from poor families for $25/month. Families are promised that their children can get free education and food here, but what really happens is that they are used as props to garner donations.[37] Some are also bought from their parents for very little and passed on to westerners who pay a large fee to adopt them.[38] This also happens in China.[39] In Nepal, orphanages can be used as a way to remove a child from their parents before placing them for adoption overseas, which is equally lucrative to the owners who receive a number of official and unofficial payments and "donations".[40][41] In other countries, such as Indonesia, orphanages are run as businesses, which will attract donations and make the owners rich; often the conditions orphans are kept in will deliberately be poor to attract more donations.[42]

Worldwide

[edit]

Developing nations are lacking in child welfare and their well-being because of a lack of resources. Research that is being collected in the developing world shows that these countries focus purely on survival indicators instead of a combination of their survival and other positive indicators like a developed nation would do.[43]

Europe

[edit]

The orphanages and institutions remaining in Europe tend to be in Eastern Europe and Northern Europe and are generally state-funded.

Albania

[edit]

There are estimated to be about 31,000 orphans (0–14 years old) in Albanian orphanages. (2012 statistics) In most cases they were abandoned by their parents. At 14 they are required, by law, to leave their orphanage and live on their own.[44] There are approximately 10 small orphanages in Albania; each one having only 12-40 children residing there.[45] The larger ones would be state-run.

Bosnia and Herzegovina

[edit]

SOS Children's Villages gives support to 240 orphaned children.[46]

Bulgaria

[edit]

The Bulgarian government has shown interest in strengthening children's rights.

In 2010, Bulgaria adopted a national strategic plan for the period 2010–2025 to improve the living standards of the country's children. Bulgaria is working hard to get all institutions closed within the next few years and find alternative ways to take care of the children.

"Support is sporadically given to poor families and work during daytime; correspondingly, different kinds of day centers have started up, though the quality of care in these centers is poorly measured and difficult to monitor. A smaller number of children have also been able to be relocated into foster families".[47][48]

There are 7000[48] children living in Bulgarian orphanages wrongly classified as orphaned. Only 10 percent of these are orphans, with the rest of the children placed in orphanages for temporary periods when the family is in crisis.[49]

Estonia

[edit]

As of 2009, there are 35 different orphanages.[50][51]

Hungary

[edit]

A comprehensive national strategy for strengthening the rights of children was adopted by Parliament in 2007 and will run until 2032.

Child flow to orphanages has been stopped and children are now protected by social services. Violation of children's rights leads to litigation.[52]

Lithuania

[edit]

In Lithuania there are 105 institutions. 41 percent of the institutions each have more than 60 children. Lithuania has the highest number of orphaned children in Northern Europe.[53][54]

Poland

[edit]

Children's rights enjoy relatively strong protection in Poland. Orphaned children are now protected by social services.

Social Workers' opportunities have increased by establishing more foster homes and aggressive family members can now be forced away from home, instead of replacing the child/children.[55]

Moldova

[edit]

More than 8800 children are being raised in state institutions, but only three percent of them are orphans.[56]

Romania

[edit]

The Romanian child welfare system is in the process of being revised and has reduced the flow of infants into orphanages.[57]

According to Baroness Emma Nicholson, in some counties Romania now has "a completely new, world class, state of the art, child health development policy." Dickensian orphanages remain in Romania,[58] but Romania seeks to replace institutions by family care services, as children in need will be protected by social services.[59] As of 2018, there were 17,718 children in old-style residential centers,[60] a significant decrease from about 100,000 in 1990.[61]

Serbia

[edit]

There are many state orphanages "where several thousand children are kept and which are still part of an outdated child care system". The conditions for them are bad because the government does not pay enough attention in improving the living standards for disabled children in Serbia's orphanages and medical institutions.[62]

Slovakia

[edit]

The committee made recommendations, such as proposals for the adoption of a new "national 14" action plan for children for at least the next five years, and the creation of an independent institution for the protection of child rights.[63]

Sweden

[edit]

One of the first orphanages in Sweden was the Stora Barnhuset (1633-1922) in Stockholm,[64] which remained the biggest orphanage in Sweden for centuries. In 1785, however, a reform by Gustav III of Sweden stipulated that orphans should first and foremost always be placed in foster homes when that was possible.

In Sweden, there are 5,000 children in the care of the state. None of them are currently living in an orphanage, because there is a social service law which requires that the children reside in a family home.[citation needed]

United Kingdom

[edit]

During the Victorian era, child abandonment was rampant, and orphanages were set up to reduce infant mortality. Such places were often so full of children that nurses often administered Godfrey's Cordial, a special concoction of opium and treacle, to soothe baby colic.[65]

Orphaned children were placed in either prisons or the poorhouse/workhouse, as there were so few places in orphanages, or else they were left to fend for themselves on the street. Such openings in orphanages as were available could only be obtained by collecting votes for admission, placing them out of reach of poor families.

Known orphanages are:

Founded in Name Location Founder
1741 Foundling Hospital London Thomas Coram
1795 Bristol Asylum for Poor Orphan Girls (Blue Maids' Orphanage) nr Stokes Croft turnpike, Bristol
1800 St Elizabeth's Orphanage of Mercy Eastcombe, Glos
1813 London Asylum for Orphans
London Orphan Asylum
Hackney, London
Watford 1871
Cobham 1945
Rev Andrew Reed
1822 Female Orphan Asylum Brighton Francois de Rosaz
1827 Infant Orphan Asylum
Royal Infant Orphanage
Royal Wanstead School
Royal Wanstead Children's Foundation
Wanstead Rev Andrew Reed
1829 Sailor Orphan Girls School London
1831 Jews' Orphan Asylum
Norwood Jewish Orphanage 1928
Norwood Home for Jewish Children 1956
Goodman's Fields, Whitechapel, London 1831
West Norwood 1866
1836 Ashley Down orphanage Bristol George Müller
1844 Asylum for Fatherless Children
Reedham Orphanage
Richmond
Stoke Newington
Stamford Hill
Purley 1846
Rev Andrew Reed
1854 Wolverhampton Orphan Asylum Goldthorn Hill, Wolverhampton John Lees
1856 Wiltshire Reformatory[66] Warminster
1857 St. Mary's Orphanage for Boys Blackheath, London Rev. William Gowan Todd, D.D.
1860 Major Street Ragged Schools Liverpool Canon Thomas Major Lester
1861 St. Philip Neri's orphanage for boys Birmingham Oratorians
1861 Adult Orphan Institution St Andrew's Place, Regent's Park, London
1861 British Orphan Asylum Clapham, London
1861 Female Orphan Asylum Westminster Road, London
1861 Female Orphan Home Charlotte Row, St Peter Walworth, London
1861 Merchant Seamen's Orphan Asylum Bromley St Leonard, Bow, London
1861 Orphan Working School Haverstock Hill, Kentish Town, London
1861 Orphanage Eagle House, Hammersmith, London
1861 The Orphanage Asylum Christchurch, Marylebone, London's
1861 The Sailors' Orphan Girls' School & Home Hampstead, London
1861 Sunderland Orphan Asylum Sunderland
1862 Swansea Orphan Home for Girls Swansea
1863 British Seaman's Orphan Boys' Home Brixham William Gibbs
1865 The Boys' Home Regent's Park London
1866 Dr. Barnardo's various Dr. Barnardo
1866 National Industrial Home for Crippled Boys London
1867 Peckham Home for Little Girls London Maria Rye
1868 The Boys' Refuge Bisley
1868 Royal Albert Orphanage Worcester
1868 Worcester Orphan Asylum Worcester
1868 St Francis' Boy's Home Shefford, Bedfordshire
1869 Ely Deaconesses Orphanage Bedford Rev Thomas Bowman Stephenson
1869 Orphanage and Almshouses Erdington Josiah Mason
1869 The Neglected Children of Exeter Exeter
1869 Alexandra Orphanage for Infants Hornsey Rise, London
1869 Stockwell Orphanage London Charles Spurgeon
1869 New Orphan Asylum Upper Henwick, Worcs
1869 Wesleyan Methodist National Children's Homes
National Children's Homes
NCH Action for Children
Action for Children
various Rev Thomas Bowman Stephenson
1870 Fegans Homes London James William Condell Fegan
1870 Manchester and Salford Boys' and Girls' Refuge Manchester
1870 18 Stepney Causeway
The William Baker Memorial Technical School for Boys 1922
London
Goldings estate, Hertford 1922
Dr. Barnardo
1871 Wigmore West Bromwich and Walsall WJ Gilpin
1872 Middlemore Home Edgbaston Dr. John T. Middlemore
1872 St Theresa Roman Catholic Orphanage for Girls Plymouth Sisters of Charity
1873 The Orphan Homes Ryelands Road, Leominster Henry S. Newman[67][68]
1874 Cottage Homes for Children West Derby Mrs. Nassau Senior
1875 Aberlour Orphanage Aberlour, Scotland Rev Charles Jupp
1877 All Saints Boys' Orphanage Lewisham, London
1880 Birmingham Working Boy's Home (for boys over the age of 13) Birmingham Major Alfred V. Fordyce
1881 The Waifs and Strays' Society[69]
Church of England Incorporated Society for Providing Homes for Waifs and Strays 1893
Church of England Children's Society 1946
The Children's Society 1982
East Dulwich, London Edward de Montjoie Rudolf
1881 Catholic Children's Protection Society Liverpool James Nugent & Bishop Bernard O'Reilly
1881 Dorset County Boys Home Milborne St Andrew
1881 Brixton Orphanage Brixton Road, Lambeth, London
1881 Orphanage Infirmary West Square, London Road, Southwark, London
1881 Orphans' Home South Street. London Road, Southwark, London
1882 St Michael's Home for Friendless Girls Salisbury
1890 St Saviour's Home Shrewsbury
1890 Orphanage of Pity[66] Warminster
1890 Wolverhampton Union Cottage homes Wolverhampton
1892 Calthorpe Home For Girls Handsworth, Birmingham The Waifs and Strays' Society[70]
1899 Northern Police Orphanage
St George's House, Harrogate
Harrogate Catherine Gurney
1899 Inglewood Children's Home Otley, Leeds
1918 Painswick Orphanage Painswick
unknown Clio Boys' Home Liverpool
unknown St Philip's Orphanage, (RC Institution for Poor Orphan Children) Brompton, Kensington

Sub-Saharan Africa

[edit]
AIDS orphans in Malawi

Ethiopia

[edit]

"For example, in the Jerusalem Association Children's Home (JACH), only 160 children remain of the 785 who were in JACH's three orphanages." / "Attitudes regarding the institutional care of children have shifted dramatically in recent years in Ethiopia. There appears to be a general recognition by MOLSA and the NGOs with which Pact is working that such care is, at best, a last resort and that serious problems arise with the social reintegration of children who grow up in institutions, and deinstitutionalization through family reunification and independent living are being emphasized."[71]

Ghana

[edit]

A 2007 survey sponsored by Africa (previously Orphan Aid Africa) and carried out by the Department of Social Welfare came up with the figure of 4,800 children in institutional care in 148 orphanages.[72] The government is currently attempting to phase out the use of orphanages in favor of foster care placements and adoption. At least eighty-eight[73] homes have been closed since the passage of the National Plan of Action for Orphans and Vulnerable Children. The website www.ovcghana.org details these reforms.

Kenya

[edit]

A 1999 survey of 36,000 orphans found the following number in institutional care: 64 in registered institutions and 164 in unregistered institutions.[74]

Malawi

[edit]

There are about 101 orphanages in Malawi. There is a UNICEF/Government driven program on de-institutionalization, but few orphanages are yet involved in the program.[citation needed]

Rwanda

[edit]

Out of 400,000 orphans, 5,000 are living in orphanages.[75] The Government of Rwanda are working with Hope and Homes for Children to close the first institution and develop a model for community-based childcare which can be used across the country and ultimately Africa[76]

Tanzania

[edit]

"Currently, there are 52 orphanages in Tanzania caring for about 3,000 orphans and vulnerable children."[77] A world bank document on Tanzania showed it was six times more expensive to institutionalize a child there than to help the family become functional and support the child themselves.

Nigeria

[edit]
Nigerian orphanage in the late 1960s

In Nigeria, a rapid assessment of orphans and vulnerable children conducted in 2004 with UNICEF support revealed that there were about seven million orphans in 2003 and that 800,000 more orphans were added during that same year. Out of this total number, about 1.8  million are orphaned by HIV/AIDS. With the spread of HIV/AIDS, the number of orphans is expected to increase rapidly in the coming years to 8.2  million by 2010.[78]

South Africa

[edit]

Since 2000, South Africa does not license orphanages any more but they continue to be set up unregulated and potentially more harmful. Theoretically, the policy supports community-based family homes but this is not always the case. One example is the homes operated by Thokomala.[79]

Zambia

[edit]

Zimbabwe

[edit]
Mother of Peace AIDS orphanage, Zimbabwe, 2005

There are 39 privately run children's charity homes, or orphanages, in the country, and the government operates eight of its own. Privately run Orphanages can accommodate an average of 2000 children, though some are very small and located in very remote areas, hence can take in less than 150 children. Statistics on the total number of children in orphanages nationwide are unavailable, but caregivers say their facilities were becoming unmanageably overwhelmed almost on a daily basis. Between 1994 and 1998, the number of orphans in Zimbabwe more than doubled from 200,000 to 543,000, and in five years, the number is expected to reach 900,000. (Unfortunately, there is no room for these children.)[80]

Togo

[edit]

In Togo, there were an estimated 280,000 orphans under 18 years of age in 2005, 88,000 of them orphaned by AIDS.[81] Ninety-six thousand orphans in Togo attend school.[81]

Sierra Leone

[edit]

[82]

  • Children (0–17 years) orphaned by AIDS, 2005, estimate 31,000[83]
  • Children (0–17 years) orphaned due to all causes, 2005, estimate 340,000[83]
  • Orphan school attendance ratio, 1999–2005 71,000[83]

Senegal

[edit]
  • Children (0–17 years) orphaned by AIDS, 2005, estimate 25,000[84]
  • Children (0–17 years) orphaned due to all causes, 2005, estimate 560,000[84]
  • Orphan school attendance ratio, 1999–2005 74,000[84]

South Asia

[edit]

Nepal

[edit]

There are at least 602 child care homes housing 15,095 children in Nepal[85] "Orphanages have turned into a Nepalese industry there is rampant abuse and a great need for intervention."[36][86] Many do not require adequate checks of their volunteers, leaving children open to abuse.[85]

Afghanistan

[edit]
PRT donates clothing, blankets to Khowst orphanage in Afghanistan

"At Kabul's two main orphanages, Alauddin and Tahia Maskan, the number of children enrolled has increased almost 80 percent since last January[when?], from 700 to over 1,200 children. Almost half of these come from families who have at least one parent, but who can't support their children."[87] The non-governmental organisation Mahboba's promise assists orphans in contemporary Afghanistan.[88] Nowadays the number of orphanages had changed. There are approximately 19 orphanages only in Kabul.[89]

Bangladesh

[edit]

"There are no statistics regarding the actual number of children in welfare institutions in Bangladesh. The Department of Social Services, under the Ministry of Social Welfare, has a major program named Child Welfare and Child Development in order to provide access to food, shelter, basic education, health services and other basic opportunities for hapless children." (The following numbers mention capacity only, not actual numbers of orphans at present.)

9,500 – State institutions 250 – babies in three available "baby homes" 400 – Destitute Children's Rehabilitation Centre 100 – Vocational Training Centre for Orphans and Destitute Children 1,400 -Sixty-five Welfare and Rehabilitation Programmes for Children with Disability

The private welfare institutions are mostly known as orphanages and madrassahs. The authorities of most of these orphanages put more emphasis on religion and religious studies. One example follows: 400 – Approximately – Nawab Sir Salimullah Muslim Orphanage.[90]

Maldives

[edit]

The 2010 estimate for the number of children (0–17 years) orphaned due to all causes is 51.[91]

India

[edit]
Tirurangadi Orphanage, India.

India is in the top 10 and also has a very large number of orphans as well as a destitute child population. Orphanages operated by the state are generally known as juvenile homes. In addition, there is a vast number of privately run orphanages running into thousands spread across the country. These are run by various trusts, religious groups, individual citizens, citizens groups, NGO's, etc.

While some of these places endeavor to place the children for adoption a vast majority just care and educate them till they are of legal majority age and help place them back on their feet. Prominent organizations in this field include BOYS TOWN, SOS children's villages, etc.

There have been scandals especially with regard to adoption. Since government rules restrict funds unless there are a certain number of residents, some orphanages make sure the resident numbers remain high at the cost of adoption.

Pakistan

[edit]

According to a UNICEF report in 2016, there are around 4.2 million orphaned children in Pakistan.[92] Pakistan has had sizable economic growth from 1950 to 1999 yet they aren't performing well in multiple social indicators like education and health, and this is mainly due to the corrupt and unstable government.[93] Pakistan heavily relies on the nonprofit sector and zakat to finance social issues such as aid for orphans. Zakat is a financial obligation on Muslims which requires one to donate 2.5% of the family's income to charity, and it is specifically mentioned in the Quran to take care of orphans.[94] With the new use of zakat money from donations to investments it has a lot of potential in benefiting the development as well as the ultimate goal of poverty alleviation.[citation needed] The Pakistan government relies on this public sector on taking care of local issues so that they do not have the burden. Furthermore, only 6 percent of cash revenues are contributed to non-profits in Pakistan, and they are heavily favored by the government because it saves them money as non-profits are taking care of issues such as orphan care.[95]

East and Southeast Asia

[edit]

Taiwan

[edit]

The number of orphanages and orphans drastically dropped from 15 institutions and 2,216 persons in 1971 to 9 institutions and 638 persons by the end of 2001.[citation needed]

Thailand

[edit]

There are still a substantial number of NGOs and informal Orphanages in Thailand, particularly in Northern Thailand near the borders of Laos and Myanmar, e.g. around Chiang Rai. Very few of the children in these establishments are orphans, most have living parents. They attract funding from well-meaning tourists. Often protecting the children from trafficking/abuse is cited but the names and photographs of the children are published in marketing material to attract more funding.[96] The reality is that the safest environment for these children is almost always with their parents or in their villages with familial connections where strangers are rarely seen and immediately recognized. A very few of these orphanages, go so far as to abduct or forcibly remove children from their homes, often across the border in Myanmar. The parents in local hill tribes may be encouraged to "buy a place" in the orphanage for vast sums, being told their child will have a better future.[citation needed] Some children's homes claim to always try to repatriate children with their families, but the local managers & director of the homes know of no such procedures or processes.[97]

Vietnam

[edit]

There are approximately 2 million highly vulnerable children in Vietnam with an estimated 500,000 orphaned or abandoned children.[98] There are a number of orphanages present in the country including the Vinh Son Montagnard Orphanage, however these are generally privately funded. There are very few government run institutions.[99]

South Korea

[edit]

According to the Los Angeles Times, "There are now 17,000 children in public orphanages throughout the country and untold numbers at private institutions."[100]

Japan

[edit]

Approximately 39,000 children live in orphanages in Japan out of the 45,000 (2018 statistics) who are not able to live with their birth parents.[101]

However, as of 2016, Japanese orphanages are severely underfunded, relying heavily on volunteer work. There are 602 foster homes across Japan, each with 30 to 100 children. A large portion of children in these orphanages are not actually orphans but victims of domestic abuse or neglect.[102]

Cambodia

[edit]

As of 2010, 11,945 children lived in 269 residential care facilities in Cambodia. About 44% were placed there by a parent. However it is estimated that there are 553,000 orphans in the country. Most of these children are cared for by their extended family or community.[103][104]

China

[edit]

There are currently over 600,000 abandoned orphans living in China (some would put the figure as high as 1 million[105]). Of these, 98% have special needs.[106]

Laos

[edit]

"It is stated that there are 20,000 orphaned children in Laos."[citation needed] However the figure generally remains unknown as about 30% of children are never registered with the government and remain invisible. In Laos nearly 50 per cent of the population lives below the poverty line and many children are involved in child labor. There are six orphanages that are run by SOS Children's Village that help with this problem.[107]

Middle East and North Africa

[edit]
Orphan girls at the Aleppo Armenian orphanage, 1923

Egypt

[edit]

"The [Mosques of Charity] orphanage houses about 120 children in Giza, Menoufiya and Qalyubiya." "We [Dar Al-Iwaa] provide free education and accommodation for over 200 girls and boys." "Dar Al-Mu'assassa Al-Iwaa'iya (Shelter Association), a government association affiliated with the Ministry of Social Affairs, was established in 1992. It houses about 44 children." There are also 192 children at The Awlady, 30 at Sayeda Zeinab orphanage, and 300 at My Children Orphanage.

Note: There are about 185 orphanages in Egypt. The above information was taken from the following articles: "Other families" by Amany Abdel-Moneim. Al-Ahram Weekly (5/1999). "Ramadan brings a charity to Egypt's orphans". Shanghai Star (13 December 2001). "A Child by Any Other Name" by Réhab El-Bakry. Egypt Today (11/2001).

Sudan

[edit]

There is still at least one orphanage in Sudan although the conditions there have been reported as very poor.[108]

South Sudan

[edit]

The number of orphans is expected to be 5,000 in 2023 in South Sudan. And in 2018, the UN Children Fund (UNICEF) reported that about 15,000 children in South Sudan had become separated from their families or were missing due to conflict.[109]

Bahrain

[edit]

The "Royal Charity Organization"[110] is a Bahraini governmental charity organization founded in 2001 by King Hamad ibn Isa Al Khalifah to sponsor all helpless Bahraini orphans and widows. Since then almost 7,000 Bahraini families are granted monthly payments, annual school bags, and a number of university scholarships. Graduation ceremonies, various social and educational activities, and occasional contests are held each year by the organization for the benefit of orphans and widows sponsored by the organization.

Iraq

[edit]

UNICEF maintains the same number at present. "While the number of state homes for orphans in the whole of Iraq was 25 in 1990 (serving 1,190 children); both the number of homes and the number of beneficiaries has declined. The quality of services has also declined."

A 1999 study by UNICEF "recommended the rebuilding of national capacity for the rehabilitation of orphans." The new project "will benefit all the 1,190 children placed in orphanages."

Israel

[edit]

"In 1999, the number of children living in orphanages witnessed a considerable drop as compared to 1998. The number dropped from 1,980 to 1,714 orphans. This is due to the policy of child re-integration in their household adopted by the Ministry of Social Affairs."

Former Soviet Union

[edit]
The Moscow Orphanage (founded in 1763, constructed in the 1770s)

In the post-Soviet countries, orphanages are better known as "children's homes" (Детскиe домa). After reaching school age, all children enroll at internats (Школа-интернат) (boarding schools).

Russia

[edit]

In 2021 it was recorded that there were 406,138 orphans living in orphan homes and families in Russia.[111] UNICEF estimates that 95% of these children are "social orphans", meaning that they have at least one living parent who has given them up to the state.[112][113][114][115] In 2011 Russian authorities registered 88,522 children who became orphans that year (down from 114,715 in 2009).[116]

There are few webpages for Russian orphanages in English. "Of a total of more than 600,000 children classified as being 'without parental care' (most of them live with other relatives and fosters), as many as one-third reside in institutions."[117]

In 2011, there were 1344 institutions for orphans in Russia,[118] including 1094 orphanages ("children's homes")[119] and 207 special ("corrective") orphanages for children with serious health issues.[120]

Azerbaijan

[edit]

It is estimated that more than 10,000 children are living in 44 orphanages.[121] In general, "many children are abandoned due to extreme poverty and harsh living conditions. Some may be raised by family members or neighbors but the majority live in crowded orphanages until the age of fifteen when they are sent into the community to make a living for themselves."[122]

Belarus

[edit]

Approximate total – 1,773 (1993 statistics for "all types of orphanages")

Kyrgyzstan

[edit]
Belovodski Preschool Orphanage in Karabalta, Kyrgyzstan

Partial information: 85 – Ivanovka Orphanage[123]

Tajikistan

[edit]

There are 4 orphanages in the major cities and 64 boarding schools in Tajikistan, where 8275 children are being educated. Those four orphanages raise 185 children up to 3 years old. In total there are 160 orphans. This small number is likely due to the popularity of adopting. [124]

Ukraine

[edit]
Orphanage in Ukraine

Before the Russian invasion of 2022, there were an estimated 100,000 orphans in Ukraine's state-run facilities.[125] Of this number about 80 percent are described as "social orphans", because the parents are either financially destitute, abusive, or addicted to drugs or alcohol and thus are unable to raise them.[126] Due to a lack of funding and overcrowding the conditions at these orphanages are often poor, especially for disabled children.[127][128][129]

Since 2012 the number of children adopted by foreigners has gradually been reducing. By 2016, the number of children adopted by foreigners had been reduced to around 200 from about 2,000 in 2012.[130] A bit more than a thousand children were adopted by Ukrainians in 2016.[130] During 2019 1,419 children were adopted.[131] In 2020 2,047 children were adopted, in 1,890 cases the adoption was carried out by citizens of Ukraine.[131]

Other information:

Oceania

[edit]

Australia

[edit]

Orphanages in Australia mostly closed after World War II. Instead, children are mainly put in either Kinship, Residential or Foster care. Notable former orphanages include the Melbourne Orphanage and the St. John's Orphanage in Goulburn, New South Wales.[135]

Indonesia

[edit]

No verifiable information for the number of children actually in orphanages. The number of orphaned and abandoned children is approximately 500,000.[136]

Fiji

[edit]

Orphans, children (0–17 years) orphaned due to all causes, 2005, estimate 25,000[137]

North America and Caribbean

[edit]

Haiti

[edit]

Haitians and expatriate childcare professionals are careful to make it clear that Haitian orphanages and children's homes are not orphanages in the North American sense, but instead shelters for vulnerable children, often housing children whose parent(s) are poor as well as those who are abandoned, neglected or abused by family guardians. Neither the number of children or the number of institutions is officially known, but Chambre de L'Enfance Necessiteusse Haitienne (CENH) indicated that it has received requests for assistance from nearly 200 orphanages from around the country for more than 200,000 children. Although not all are orphans, many are vulnerable or originate in vulnerable families that "hoped to increase their children's opportunities by sending them to orphanages. Catholic Relief Services provides assistance to 120 orphanages with 9,000 children in the Ouest, Sud, Sud-Est and Grand'Anse, but these include only orphanages that meet their criteria. They estimate receiving ten requests per week for assistance from additional orphanages and children's homes, but some of these are repeat requests."[138]

In 2007, UNICEF estimated there were 380,000 orphans in Haiti, which has a population of just over 9 million, according to the CIA World Factbook. However, since the January 2010 earthquake, the number of orphans has skyrocketed, and the living conditions for orphans have seriously deteriorated. Official numbers are hard to find due to the general state of chaos in the country.[citation needed]

Jamaica

[edit]

A large amount of children on the island of Jamaica grow up without a parental relationship as a result of their parents' death.[139] An example of places for these lone children to go to are SOS children's villages, The Maxfield Park Children's Home[140] and the Missionaries of the Poor facilities.

Mexico

[edit]

There are over 700 public and privates orphanages in Mexico which house over 30,000 children. In 2018 it was estimated that 400,000 children lacked parents. Of these 100,000 are thought to be homeless.[141]

Some notable orphanages include:

  • Casa Hogar Jeruel Orphanage in Chihuahua City, Mexico[142]
  • Casa Hogar Alegría[143]

United States

[edit]
St. Elizabeth's orphanage in New Orleans, 1940

While the term "orphanage" is no longer typically used in the United States, nearly every US state continues to operate residential group homes for children in need of a safe place to live and in which to be supported in their educational and life-skills pursuits. Homes like the Milton Hershey School[144] in Pennsylvania, Mooseheart[145] in Illinois and the Crossnore School and Children's Home[146] in North Carolina continue to provide care and support for children in need. While a place like the Milton Hershey School houses nearly 2,000 children, each child lives in a small group-home environment with "house parents"[147] who often live many years in that home. Children who grow up in these residential homes have higher rates of high school and college graduation than those who spend equivalent numbers of years in the US Foster Care system, wherein only 44 to 66 percent of children graduate from high school.[148][149]

Some private orphanages still exist in the United States apart from governmental child protective services processes.[150][151] Following World War II, most orphanages in the U.S. began closing or converting to boarding schools or different kinds of group homes. Also, the term "children's home" became more common for those still existing. Over the past few decades,[when?] orphanages in the U.S. have been replaced with smaller institutions that try to provide a group home or boarding school environment. Most children who would have been in orphanages are in these residential treatment centers (RTC), residential child care communities, or with foster families. Adopting from RTCs, group homes, or foster families does not require working with an adoption agency, and in many areas, fostering to adopt is highly encouraged.[152][153]

Central and South America

[edit]
In a Colombian orphanage, a nurse takes care of three children.

Guatemala

[edit]

"...currently there are about 200,000 children in orphanages."[154]

Peru

[edit]

It is estimated that 550,000 children grow up without parents in Peru. Many of the children in orphanages are considered "social orphans". [155]

Significant charities that help orphans

[edit]

Prior to the establishment of state care for orphans in First World countries, private charities existed to take care of destitute orphans, over time other charities have found other ways to care for children.

  • The Orphaned Starfish Foundation[156] is a non-profit organisation based in New York City that focuses on developing vocational schools for orphans, victims of abuse and at-risk youth. It runs fifty computer centers in twenty-five countries, serving over 10,000 children worldwide
  • Lumos works to replace institutions with community-based services that provide children with access to health, education, and social care tailored to their individual needs.
  • Hope and Homes for Children are working with governments to deinstitutionalize their child care systems.
  • Stockwell Home and later Birchington, started by Charles H Spurgeon, is now Spurgeons after the last orphanage closed in 1979. Spurgeons Children's Charity provides support to vulnerable and disadvantaged children and families across England.
  • SOS Children's Villages is the world's largest non-governmental, non-denominational child welfare organization that provides loving family homes for orphaned and abandoned children.
  • Dr. Barnardo's Homes are now simply Barnardo's after closing their last orphanage in 1989.
  • OAfrica, previously OrphanAid Africa, has been working in Ghana since 2002, to get children out of orphanages and into families, in partnership with the government and as the only private implementing partner of the National Plan of Action.[157]
  • Joint Council on International Children's Services is a nonprofit child advocacy organization based in Alexandria, Virginia. It is the largest association of international adoption agencies in America, and in addition to working in 51 countries, advocates for ethical practices in American adoption agencies

See also

[edit]

References

[edit]
[edit]
Revisions and contributorsEdit on WikipediaRead on Wikipedia
from Grokipedia
An orphanage is a residential dedicated to housing and caring for whose biological parents are deceased, absent, or unable to provide adequate care due to factors such as , illness, or abandonment. These facilities emerged prominently in the amid , wars, and epidemics, serving as a response to widespread vulnerability in and , though earlier forms existed in ancient and medieval societies. Orphanages have historically provided basic shelter, food, and , often under religious or charitable auspices, but from longitudinal studies reveals substantial risks associated with institutional care, including delays in cognitive, social-emotional, and physical development due to structural , inadequate caregiver-child ratios, and limited individualized attention. Children in such settings frequently exhibit attachment disorders, behavioral problems, and heightened vulnerability to , with effects persisting into adulthood even after deinstitutionalization. While short-term institutionalization may offer immediate protection, causal analyses underscore that family-based alternatives like or kinship arrangements yield superior outcomes by fostering stable relationships essential for human development. Despite these findings, orphanages persist in regions with limited resources or ongoing crises, prompting global efforts to phase them out in favor of community-integrated care models.

Definition and Core Features

Defining Orphanages and Their Purpose

An orphanage is a residential established to house and care for deprived of parental guardianship, encompassing cases where parents are deceased, absent due to abandonment, or incapacitated by , illness, or other factors rendering them unable to provide adequate support. This definition extends beyond strictly parentless to include those from disrupted family units, reflecting the practical scope of such facilities in addressing vulnerability rather than literal orphanhood. The etymological root traces to the mid-16th century, deriving from "" (from Greek orphanos, meaning "bereft of parents") combined with the "-age," initially denoting the condition of orphanhood before evolving to signify an institutional collective for such children. Legally, orphanages function as custodial entities under varying national frameworks, often regulated to ensure minimum standards of safety and welfare, though enforcement differs widely; for instance, , they historically operated as charitable or state-supervised homes for indigent youth. The core purpose of orphanages is to deliver structured, communal care that fulfills basic survival and developmental requirements—namely , , , medical attention, and rudimentary —while protecting residents from immediate perils like , exposure, or predation until restoration, , or independent adulthood becomes viable. This institutional model arose from pragmatic necessity in eras of high mortality and social upheaval, prioritizing collective over individualized placements, though empirical outcomes have varied, with some studies indicating potential deficits in emotional attachment compared to familial environments. In resource-scarce settings, orphanages have served as stopgap measures against child labor exploitation or , but their efficacy hinges on operational quality rather than inherent design. Orphanages provide congregate care in a centralized facility for children lacking parental guardianship or whose families cannot provide adequate support, distinguishing them from , which places children in vetted private households to simulate family environments with individualized attention from foster parents. This institutional model in orphanages relies on professional staff managing groups of children, often 20 or more per site, whereas emphasizes temporary, decentralized placements licensed by child welfare agencies, with oversight focused on family integration rather than dormitory-style operations. In the United States, for instance, orphanages were largely supplanted by foster systems post-1940s, reflecting a policy shift toward family-based alternatives amid evidence of better developmental outcomes in home settings. Residential care facilities, including children's homes and group homes, overlap terminologically with orphanages but differ in scale and target demographics; group homes typically accommodate 4-12 older youth or those with behavioral challenges in smaller, semi-independent units mimicking household dynamics, contrasting with the larger, more regimented structures of traditional orphanages housing dozens under centralized authority. Children's homes may serve broader vulnerable populations beyond orphans, such as or abuse victims, and increasingly incorporate therapeutic programming, whereas classic orphanages prioritize basic shelter and sustenance for abandoned infants and young children without specialized interventions. These distinctions persist globally, with estimating that while 80% of non-parentally cared-for children remain in family arrangements, institutional variants like orphanages endure in regions lacking robust foster infrastructure. Historically, orphanages diverge from workhouses, which emerged under frameworks like Britain's 1834 Poor Law Amendment Act to enforce labor among the able-bodied poor in exchange for minimal provisions, encompassing mixed-age paupers including families and vagrants rather than isolating child-specific care. Workhouses imposed punitive regimens—such as segregated genders, uniform labor tasks, and austere diets—to deter , often commingling orphans with adults in environments prioritizing cost-efficiency over nurturing, unlike orphanages founded by charities like those in 18th-century for exclusive child rearing and moral instruction. By 1900, British workhouses held over 200,000 inmates, with children comprising about 15-20% but subjected to adult oversight and vocational drudgery, whereas dedicated orphanages, such as those run by Dr. Barnardo's from 1867, emphasized and emigration over deterrence. This separation underscores orphanages' child-centric ethos against workhouses' broader anti-pauperism mandate.

Variations in Scale and Population Served

Orphanages exhibit significant variations in the populations they serve, encompassing not only children who have lost both parents—true double orphans—but predominantly those classified as social orphans, who have at least one living parent unable to provide care due to factors such as , parental illness, , incarceration, or abandonment. Globally, estimates that the majority of the 5.4 million children in residential institutions are not orphans in the literal sense, with 80-90 percent having living family members, often in developing countries where economic hardship or crises like epidemics drive family separations. In , for instance, while AIDS has created millions of single or double orphans—contributing to 43.4 million orphans overall—many institutionalized children stem from overload rather than total parental loss, highlighting institutional care's role in addressing broader vulnerability rather than orphanhood alone. Scale varies widely by region, institutional type, and historical context, ranging from small, family-like group homes accommodating 5-20 children to large state-run facilities housing hundreds or more, particularly in , , and parts of where resource constraints limit alternatives. In countries like and , pre-deinstitutionalization eras saw mega-orphanages with capacities exceeding 500 residents, often resulting from policy-driven placements or post-conflict surges, though global estimates place average institutional populations lower in reformed systems favoring smaller units under 25 children to mimic environments. Developing nations tend toward larger scales due to higher demand—e.g., hosts 87.6 million orphans, many in underfunded institutions—while Western countries have shifted to minimal large-scale orphanages, prioritizing for populations under 100,000 institutionalized children continent-wide. These differences reflect causal factors like funding availability, governmental capacity, and cultural preferences for communal versus kin-based care, with larger scales correlating to higher risks of inadequate individualized attention but enabling in resource-poor settings. Population demographics within orphanages also diverge: infant foundlings and abandoned babies predominate in urban foundling wheels or modern equivalents in places like and , while older children from conflict zones—such as Syrian or Ukrainian war-displaced—enter en masse, often comprising mixed-age groups up to . Faith-based and NGO-run facilities may prioritize specific subgroups, like girls in gender-selective societies or HIV-affected youth, whereas state systems serve broader at-risk cohorts including runaways or those removed from abusive homes, with double orphans representing only about 11 percent of the global orphan total of 140 million. This heterogeneity underscores orphanages' adaptation to local causal pressures, from demographic policies (e.g., China's former one-child rule inflating girl placements) to disasters, rather than uniform orphan care.

Historical Development

Ancient Origins and Early Charitable Efforts

In , care for orphans in Greek and Roman societies primarily fell to extended family members or appointed guardians under legal frameworks, rather than dedicated public institutions. , for instance, emphasized patria potestas, where surviving relatives or tutors managed the orphan's property and upbringing, with the state intervening only in cases of disputed guardianship. This familial approach stemmed from the absence of centralized welfare systems, leaving orphans without kin vulnerable to enslavement, , or death. Infanticide and infant exposure were widespread practices in these civilizations, often targeting potentially burdensome children, including those at risk of orphanhood due to parental death during childbirth or war. In ancient Greece, fathers decided within days of birth whether to rear or expose the infant, with deformed or female children frequently abandoned; archaeological evidence from sites like the Athenian Agora reveals deposits of infant remains consistent with such exposures dating to the 5th century BCE. Roman custom similarly permitted exposure on dung heaps or at temples, though by the 1st century CE, some philosophical critiques, such as those from Seneca, questioned the morality without altering legal norms. These methods reflected pragmatic population control amid high infant mortality rates, estimated at 25-30% in the first year of life, rather than charitable intervention. The institutional origins of orphanages emerged in the late with the , marking a shift toward organized . Early Christian communities, influenced by scriptural mandates to "defend orphans" (James 1:27), established rudimentary care systems contrasting Greco-Roman norms; bishops were tasked with oversight, as noted in the 3rd-century . The first documented facilities appeared in the 4th century in , including the Orphanotropheion associated with Saint Zoticus (Zotikos), a who founded a leprosarium that expanded to house orphans, earning him the title Orphanotrophos ("cherisher of orphans"). By the 5th century, Byzantine emperors formalized these efforts, with Emperor Leo I's novel of 469 CE recognizing the orphanotrophos role and supporting institutions like the Great Orphanotropheion, which provided , , and vocational to hundreds of children annually. This model integrated state patronage with ecclesiastical administration, prioritizing orphans of Christian families and distinguishing it from earlier ad hoc family-based systems; records indicate the orphanage operated until the 13th century, influencing later European developments.

19th-Century Institutionalization and Foundling Systems

The 19th century witnessed a marked expansion of institutional care for orphans and abandoned children in Europe and North America, driven by industrialization, urbanization, and social upheavals such as wars and epidemics that orphaned large numbers of youth. In the United States, religious organizations and charities established orphanages in response to these pressures, including the aftermath of the Civil War, which left thousands of children without parents; by mid-century, private institutions proliferated to house dependent youth previously reliant on apprenticeships or almshouses. Similarly, in England, the 1834 Poor Law Amendment Act centralized poor relief in workhouses, where orphans comprised a significant portion of inmates, often subjected to regimented labor and minimal education until reforms in the 1870s introduced district schools for pauper children. Foundling systems, inherited from earlier centuries, persisted amid rising infant abandonment rates fueled by illegitimacy stigma and , with institutions admitting vast numbers despite chronic underfunding and overcrowding. In , foundling homes received approximately 40,000 annually by the mid-19th century, though mortality often exceeded 50% due to infectious diseases, , and inadequate wet-nursing practices; reforms like the abolition of anonymous deposition wheels in around 1875 aimed to reduce abandonment but correlated with sustained high death rates until legislative mandates for better in the lowered from over 60% to around 40% by 1900. European foundling hospitals generally reported infant survival rates below 50%, with rural wet-nursing contracts failing to mitigate institutional risks like from disrupted bonding. In response to urban orphan crises, innovative programs like the U.S. orphan trains, operated by the Children's Aid Society from 1854 to 1929, relocated over 200,000 children—many not true orphans but street urchins or from broken families—from eastern cities to Midwestern farms, emphasizing placement in rural households over institutional confinement to promote self-sufficiency. This shift reflected growing critiques of asylum-style orphanages, which critics argued fostered dependency and poor health outcomes compared to family-based care, though placements sometimes resulted in exploitation akin to . By century's end, while institutionalization provided structured shelter for hundreds of thousands, empirical records indicated persistent challenges, including elevated mortality and developmental delays, underscoring the limitations of large-scale facilities without individualized attention.

20th-Century Expansion Amid Wars and Social Changes

World War I generated widespread orphanhood in , prompting expansions in institutional care to address the surge in parentless children. Relief organizations estimated up to 200,000 children orphaned or left with one surviving parent in alone prior to U.S. entry in 1917. American humanitarian campaigns sponsored over 60,000 French war orphans by summer 1918, channeling funds to orphanages and similar facilities across the continent. In Eastern Europe, post-armistice chaos fueled , with more than 50,000 reported in by 1920-1921, necessitating scaled-up orphanage operations. The interwar period's economic turmoil, culminating in the , further accelerated orphanage growth, particularly in the United States where placements often involved children from impoverished but intact families. By the 1930s, U.S. orphanages housed around 144,000 children at their peak, reflecting heightened family separations due to and . Institutions in industrial centers like expanded facilities and admissions despite funding shortages, maintaining their role in child welfare amid fiscal strain. Social Security provisions from 1935 offered some family aid, yet institutional reliance persisted as overwhelmed household capacities. World War II dwarfed prior crises, displacing over 11 million people in by war's end, many children among them rendered orphans by combat, , and . In the U.S., orphanage enrollments exceeded 1909 benchmarks by 1944, driven by indirect war effects and ongoing social disruptions. Rapid industrialization and urbanization throughout the century compounded these pressures, increasing accident rates and family instability that funneled more children into care systems. Orphanages thus served as critical buffers during these upheavals, absorbing surges until post-war policy shifts began favoring alternatives.

Post-1980s Deinstitutionalization Push and Backlash

The deinstitutionalization movement gained momentum in the late 1980s and 1990s, driven by revelations of severe neglect in Romania's state orphanages following the 1989 revolution, where over 170,000 children were institutionalized under Ceaușescu's policies, leading to widespread developmental deficits including stunted growth and IQ reductions of up to 20 points compared to family-reared peers. The Bucharest Early Intervention Project, initiated in 2000, provided empirical evidence that randomized transfers from institutions to improved cognitive and social outcomes, with institutionalized children showing persistent deficits in EEG patterns, attachment, and rates exceeding 50% in some cohorts. International organizations, including , formalized opposition to institutional care in the 2009 UN Guidelines for the Alternative Care of Children, prioritizing family-based options like kinship or as superior for , citing meta-analyses of over 3,800 children across 19 countries demonstrating lower and higher abuse risks in institutions. By the , this led to policy shifts in and , where nearly 500,000 children resided in residential facilities as of 2024, prompting UNICEF-backed reforms to reduce reliance on such care through family strengthening programs. Proponents argued that institutions inherently disrupt attachment formation due to frequent caregiver turnover and lack of individualized , with longitudinal from Romanian studies showing lasting neural alterations in areas like the and among those remaining institutionalized beyond age two. , where orphanages had already declined to negligible levels by amid a post-World War II shift to , federal policies like the Adoption Assistance and Child Welfare Act of reinforced reunification preferences, reducing institutional placements further. Globally, NGOs and governments in regions like targeted orphanage closures, with estimating that 80-90% of institutionalized children worldwide have living parents, often placed due to rather than true orphanhood, advocating prevention over alternative care. Critics of rapid deinstitutionalization, particularly in low-resource settings, highlighted implementation failures where orphanage closures without robust family-based alternatives resulted in increased street children, trafficking, or return to abusive homes, as documented in Kenya's 2019 reforms that disrupted stable institutional education for thousands without adequate foster systems. Empirical reviews noted that while neglectful institutions harm development, high-quality facilities with low child-to-caregiver ratios—such as small-group homes—can yield outcomes comparable to or better than overburdened foster care in developing countries, where foster systems often lack oversight and resources, leading to higher instability and abuse rates. A 2023 analysis underscored divisive debates, arguing that blanket policies ignore contextual factors like HIV/AIDS epidemics creating 52 million African orphans, where institutions provide essential medical and educational stability absent in informal family placements. Studies from diverse contexts, including post-deinstitutionalization evaluations, revealed that foster care advantages diminish or reverse in underfunded systems, with some children experiencing multiple placements exacerbating trauma akin to institutional disruptions. This backlash prompted calls for hybrid models, emphasizing quality institutional care as a temporary bridge rather than prohibiting it outright.

Operational Structures and Quality Indicators

Types of Orphanages: State, Private, and Faith-Based

State-run orphanages, also known as government-operated facilities, are funded and managed by national or local authorities, often in countries with centralized welfare systems such as and . In , approximately 370,000 children resided in state institutions as of recent estimates, representing a significant portion of the country's orphaned or vulnerable child population, with around 15,000 aging out annually and facing high risks of (up to 5,000 cases yearly) and (10% rate among leavers). These institutions typically feature large-scale operations with standardized protocols but have been criticized for bureaucratic inefficiencies and neglect, as documented in reports on understaffing and inadequate medical care. In , over 1,000 state-run orphanages cared for about 59,000 registered orphans in 2022, though many more children remain outside formal systems amid reports of systemic issues like and limited emotional support in the 1990s and early . State models prioritize scale and public accountability but often struggle with resource constraints in transitioning economies, leading to variable child outcomes influenced by enforcement. Private orphanages, operated by non-governmental organizations (NGOs) or independent charities, rely on donations, grants, and sometimes fees, filling gaps where state capacity is limited, particularly in low- and middle-income countries. In , private facilities, often unregistered, house an estimated 58,000 children, clustered in certain regions and varying widely in oversight and resources. Examples include NGO-run homes in and , where quality ranges from adequate basic provision to risks of exploitation via voluntourism, with studies indicating that well-resourced private institutions can match or exceed in caregiving consistency when staff training is prioritized. However, decentralized private operations frequently lack regulation, contributing to inconsistent outcomes such as emotional isolation or poor long-term adjustment, as evidenced in East African institutional settings where maltreatment persists despite NGO involvement. Private models offer flexibility in programming, such as targeted or interventions, but their dependence on external can lead to instability, with empirical reviews showing better results in facilities emphasizing individualized care over sheer volume. Faith-based orphanages, managed by religious organizations or foundations, integrate spiritual education and moral guidance into care, drawing on community networks for volunteers and resources; these often overlap with private models but emphasize doctrinal principles like charity in or zakat in . Historically, Christian groups established segregated orphanages in 19th-century and the U.S., while in the Islamic world, they include waqf-run (religious endowment) facilities alongside state and individual ones, providing and religious upbringing to foster resilience. In , faith-affiliated private homes outnumbered state ones in 2009, caring for over 12,000 children with programs blending care and faith instruction. Outcomes research suggests potential benefits in prosocial behaviors, with religious schooling linked to enhanced and , though institutional faith-based care still risks attachment disruptions if not family-oriented. These institutions leverage congregational support for sustainability, as seen in U.S. faith agencies recruiting more foster parents, but face scrutiny over selectivity in placements. Across types, quality hinges on staffing ratios, oversight, and funding stability rather than alone, with global data indicating private and faith-based prevalence in regions underserved by states.

Essential Components for Effective Care

Effective care in orphanages hinges on elements that foster individualized and developmental , countering the inherent risks of group settings such as indiscriminate attachment and delayed cognitive growth. indicates that modifying institutions to reduce group sizes and implement consistent, responsive caregiving yields measurable improvements in outcomes, though such reforms remain insufficient compared to family-based alternatives. Staffing and Caregiver Consistency: Low staff-to-child ratios, ideally approaching 1:5 in smaller units, enable sustained relationships essential for secure attachments; higher ratios correlate with , emotional withdrawal, and poorer neurodevelopment, as evidenced in longitudinal studies of institutionalized children. Caregivers must be stable, with frequent turnover exacerbating instability akin to repeated losses. Training in Responsive Practices: Caregivers require specialized training in child psychology, , and techniques like language enrichment and routine enforcement; the Bucharest Early Intervention Project demonstrated that trained personnel in reformed institutions improved attachment security from 17% to higher rates, though still lagging behind foster placements at 49%. Multidisciplinary teams, including those versed in evidence-based models such as the Teaching Family Model, enhance therapeutic milieus by prioritizing skill-building and emotional regulation. Health and Nutrition Protocols: Routine medical screenings and balanced feeding programs are critical, given systematic reviews revealing stunting and deficiencies in up to 50% of institutionalized children due to inadequate practices; evidence-based for staff has increased dietary diversity and reduced undernutrition in vulnerable populations. Educational and Stimulatory Interventions: Structured access to , play, and cognitive activities mitigates IQ deficits observed in large-scale institutions; programs incorporating trauma-focused therapies and behavioral tools like the PAX Good Behavior Game support academic progress and self-regulation. Small-scale, family-like operations—limiting residents to 20-25 per unit—facilitate these components, with data from modified institutions showing gains in physical growth and when combined with family reintegration planning. Overall, while no institutional model fully replicates familial bonds, prioritizing these evidence-derived elements minimizes harm and promotes resilience.

Metrics for Assessing Institutional Quality

Key metrics for evaluating orphanage quality emphasize structural factors, such as and facilities, and process-oriented elements, including daily caregiving interactions and child protections, which empirical studies link to improved health and development within institutional settings. Structural indicators include child-to-caregiver ratios, with indicating that ratios above 1:4 for infants and 1:6 for toddlers correlate with reduced individualized and heightened risks of developmental delays, whereas lower ratios (e.g., 1:3 for young children) facilitate better attachment and responsiveness. Staff qualifications and training represent another core metric, as caregivers with specialized in and low turnover rates (below 20% annually) enhance care consistency; untrained or overburdened staff, common in under-resourced facilities, contribute to . Facility conditions, assessed via standards, , and safe sleeping arrangements, are critical, with accredited institutions demonstrating superior compliance in preventing infections and ensuring nutritional adequacy. Process metrics focus on caregiving practices and child safeguards, often measured through tools like the Child Status Index (CSI), which evaluates domains such as food/nutrition security (e.g., balanced meals meeting caloric needs), shelter quality (adequate space and safety), health access (regular medical checkups and immunizations), protection from harm (abuse reporting protocols and incident rates below 5%), psychosocial support (emotional responsiveness and play opportunities), and educational engagement (access to age-appropriate learning). High-quality institutions exhibit low abuse clearance rates, developmentally appropriate activities, and family involvement where possible, with inspections verifying compliance; UNICEF guidelines stress regular monitoring to enforce these, noting non-compliance in uninspected facilities elevates risks. Accreditation status serves as an overarching indicator, with peer-reviewed evidence showing accredited orphanages outperform non-accredited ones in (e.g., 90% compliance vs. 60%), standards, and healthcare delivery, though alone does not guarantee outcomes without ongoing enforcement. Additional indicators include group sizes limited to 8-10 children per unit to minimize regimentation, provision of play materials fostering cognitive growth, and economic safeguards like to prevent shortages. These metrics, when tracked longitudinally, reveal institutional pathologies like high staff rotation (over 30%) or inadequate oversight, which systemic reviews associate with persistent vulnerabilities despite formal standards.

Empirical Evidence on Child Outcomes

Neurodevelopmental and Attachment Effects

Children raised in orphanages exhibit elevated rates of attachment disruptions compared to family-reared peers, primarily due to inconsistent caregiving and lack of responsive, one-on-one interactions essential for secure bond formation. A meta-analysis of 10 studies involving attachment assessments in institutionalized children found that they display significantly higher proportions of disorganized attachment (effect size d=1.20) and lower secure attachments, correlating with emotional dysregulation and social deficits. The Bucharest Early Intervention Project (BEIP), a randomized controlled trial of 136 Romanian orphans, demonstrated that children remaining in institutions at age 54 months showed 65% prevalence of disinhibited social engagement disorder—a form of reactive attachment disorder characterized by indiscriminate friendliness toward strangers—versus 18% in those transitioned to foster care before 24 months. These patterns arise causally from prolonged deprivation of individualized attention, as evidenced by the trial's assignment to institutional versus foster conditions, with partial recovery in foster care indicating sensitive periods in early infancy for attachment plasticity. Neurodevelopmentally, institutionalization impairs growth and function through chronic psychosocial deprivation, independent of nutritional deficits in many cases. Longitudinal from the BEIP revealed that ever-institutionalized children had reduced gray matter volume in cortical regions linked to executive function and emotion regulation, with EEG studies showing persistent abnormalities in neural synchrony up to . A review of neurobiological consequences documented smaller head circumferences (up to 1 standard deviation below norms) and stunted physical growth in institutionalized infants, attributable to elevated disrupting hypothalamic-pituitary-adrenal axis development. Meta-analytic confirms average IQ deficits of 20 points (84 versus 104 in settings) among orphanage-reared children, with in motor, language, and cognitive milestones persisting even after or foster placement if exposure exceeds 6-24 months. These effects endure into adulthood, with a 15-year BEIP follow-up indicating heightened risks for internalizing disorders ( 2.5) and cognitive stagnancy in institutionalized groups, underscoring that institutional models fail to replicate the causal mechanisms of familial care—namely, contingent responsiveness—for normative and behavioral maturation. While some recovery occurs post-removal, particularly before age 2, full normalization is rare, highlighting the non-equivalence of group care to dyadic in fostering causal pathways for healthy development.

Cognitive and Educational Achievements

Children raised in institutional care environments, such as orphanages, consistently demonstrate lower cognitive performance, including reduced IQ scores, compared to peers in -based settings. A of studies involving children in orphanages found an IQ of 84 for those remaining institutionalized, versus 104 for those reared in foster or care, attributing the gap to insufficient individualized and responsive caregiving. Similarly, a broader review of over 75 studies encompassing more than 3,800 children across 19 countries reported an IQ deficit of 20 points for orphanage-raised children relative to non-institutionalized peers. These deficits persist into and adulthood, with prolonged institutionalization linked to ongoing impairments in executive function and problem-solving abilities. The Bucharest Early Intervention Project (BEIP), a involving 136 Romanian orphans, provides causal evidence of these effects. Children assigned to high-quality before age 2 showed significant IQ gains—averaging 9 points higher at age 18—over those remaining in institutions, with institutional group scores reflecting severe early deprivation's lasting impact on neural development and . By , participants outperformed institutionalized peers on full-scale IQ measures, underscoring the benefits of timely transition from group care. However, even early-adopted children from institutions exhibit residual cognitive lags if deprivation occurred in the first years, highlighting sensitive periods for brain development. Educational achievements mirror these cognitive patterns, with institutionalized children showing poorer academic outcomes across reading, math, and overall performance. A study of 1,200 children in reported significantly lower grades and higher dropout risks compared to non-institutionalized counterparts, with effect sizes indicating moderate to large disparities (η² = 0.174). Factors exacerbating these include limited one-on-one and emotional support, though high-quality institutions with structured education can mitigate some gaps; in resource-poor contexts, orphanages occasionally outperform placements in basic completion. Long-term, adults with orphanage histories face reduced postsecondary attainment, tied to foundational cognitive delays rather than socioeconomic factors alone.

Behavioral and Long-Term Socioeconomic Results

Children reared in orphanages exhibit elevated rates of behavioral difficulties, including disinhibited social engagement and reactive attachment disorders, which persist into adolescence and early adulthood compared to those in family-based care. In the Bucharest Early Intervention Project (BEIP), a randomized controlled trial involving institutionalized Romanian children, those remaining in institutions showed significantly higher symptoms of disinhibited social engagement (β = -0.35 effect size reduction with foster care intervention) and reactive attachment disorder (β = -0.61) relative to the foster care group, with limited recovery even after early intervention. Similarly, the English and Romanian Adoptees (ERA) study found that early institutional deprivation was associated with persistent emotional difficulties and conduct problems in adoptees assessed up to age 11, with a notable increase in emotional issues from age 6 onward in the Romanian cohort. 30045-4/fulltext) These patterns stem from prolonged deprivation of individualized caregiving, leading to deficits in social reciprocity and emotional regulation, as evidenced by higher quasi-autism traits and ADHD prevalence in ERA participants into early adulthood.30045-4/fulltext) Externalizing behaviors, such as and conduct disorders, also show adverse effects from institutionalization, though recovery varies. BEIP data indicated no overall significant reduction in with (β = -0.15 in ), suggesting persistent challenges in impulse control and peer interactions for many ever-institutionalized children. Longitudinal tracking in BEIP further revealed stagnancy or widening deficits in executive functioning domains like and spatial by age 16 in institutionally reared groups versus never-institutionalized peers, correlating with heightened risk for antisocial behaviors. In contexts of severe deprivation, such as post-communist , these outcomes align with causal mechanisms of disrupted neural development from lack of responsive attachment, rather than solely genetic or socioeconomic confounders. Long-term socioeconomic results for orphanage alumni are generally poorer, marked by reduced educational attainment and employment stability. Orphanhood, particularly when involving institutional care, correlates with approximately one year less schooling and diminished human capital accumulation, as observed in longitudinal data from northwestern Tanzania where maternal orphans faced persistent deficits in education and health outcomes into adulthood. Institutionalized children experience lower high school graduation rates and stable housing, contributing to higher reliance on public assistance and unemployment; for instance, global analyses indicate institutionalized youth have markedly reduced employment prospects compared to family-reared peers due to cascading effects from early cognitive and behavioral impairments. BEIP and ERA findings indirectly support this through unremedied executive function gaps, which hinder workforce integration, though direct employment data from these cohorts remain limited. 30045-4/fulltext) Evidence on wage differentials is mixed, with some studies showing no significant orphan wage penalty after controlling for education, but overall patterns point to heightened vulnerability in low-resource settings where institutional care predominates. These disparities underscore the causal role of early institutional environments in perpetuating intergenerational socioeconomic disadvantage, beyond baseline orphanhood risks.

Comparisons to Non-Institutional Alternatives

Evidence from Foster Care Studies

The Bucharest Early Intervention Project (BEIP), a initiated in 2000 involving 136 Romanian children institutionalized before 31 months of age, demonstrated that assignment to high-quality yielded significant cognitive benefits compared to continued institutional care. By age 8, children in the foster care group exhibited IQ scores approximately 9 points higher than those remaining in institutions, with gains persisting into despite early deprivation. (EEG) assessments in the same cohort revealed enhanced brain activity patterns, including steeper event-related potentials indicative of improved attentional processing, in foster care children versus institutionalized peers, underscoring neurodevelopmental advantages from family-based placements. Meta-analyses of longitudinal studies further corroborate these findings, synthesizing data from multiple cohorts to compare residential (institutional) care with family . Across 36 studies involving over 13,000 children, foster care placements were associated with lower rates of internalizing problems ( d = -0.20), externalizing behaviors (d = -0.17), and foster care re-entry (d = -0.22), indicating reduced emotional and behavioral disturbances relative to institutional settings. These differences held after controlling for baseline deprivation severity, suggesting causal benefits from individualized family environments over group-based institutional routines, though effect sizes were modest and varied by placement duration. However, foster care outcomes are not uniformly superior without qualifiers; placement instability, documented in meta-analyses of over 50 studies, correlates with heightened risks of issues, with instability rates averaging 20-30% annually and linked to poorer long-term adjustment. In contexts of low-resource settings, such as post-institutional transitions in , foster care's advantages diminish if not supported by rigorous screening and training, as evidenced by subgroup analyses in BEIP where delayed foster placement (after 24 months) yielded minimal gains over institutions. Nonetheless, when implemented with oversight, foster care consistently outperforms institutional care in fostering secure attachments and adaptive functioning, per randomized evidence from high-deprivation populations.

Kinship Care and Extended Family Placements

involves the out-of-home placement of children with relatives or extended family members, serving as a primary non-institutional alternative to orphanages and emphasizing continuity of familial bonds over stranger-based . This arrangement leverages existing relationships to mitigate the disruptions inherent in institutional settings, where high child-to-caregiver ratios and staff turnover impair attachment formation. Empirical studies demonstrate that children in experience fewer behavioral problems and mental health disorders than those in non-kin , with systematic reviews of over 100 quasi-experimental studies confirming reduced placement disruptions and improved overall . Institutional care, by contrast, yields markedly worse outcomes, including disorganized attachments in 65% of children versus 15% in family-reared peers, indiscriminate sociability in 44% versus 18%, and average IQ deficits approaching 50 points. Randomized trials like the Early Intervention Project further substantiate that transitioning from orphanages to family-based care, akin to kinship placements, yields gains in cognitive and emotional development, underscoring the causal role of consistent caregiving in averting neurodevelopmental harm. Placement stability represents a key advantage, as kinship arrangements exhibit lower re-entry rates into care and fewer breakdowns compared to group homes or orphanages, where children report negative perceptions and face elevated risks of emotional and behavioral escalation. Meta-analyses indicate preserves greater connectedness to birth family and culture, correlating with long-term socioeconomic benefits like higher , though caregivers often contend with and limited formal supports. In low-resource contexts, placements naturally absorb orphans—many of whom retain living parents—reducing orphanage dependency while aligning with cultural norms, though outcomes hinge on supplemental resources to address caregiver strains. Despite these challenges, child-centered metrics consistently favor over institutionalization, prioritizing relational continuity to foster resilience.

Adoption Outcomes Versus Prolonged Institutionalization

Children removed from institutional care and placed into adoptive families exhibit substantial improvements in cognitive, emotional, and physical development compared to those remaining in prolonged institutionalization, with outcomes influenced by the duration of early deprivation. Longitudinal data from the Bucharest Early Intervention Project (BEIP), a involving 136 Romanian children institutionalized before age 2, demonstrate that randomization to —a family-based alternative akin to —yielded higher IQ scores at age 12 (mean IQ of 81.9 for foster care group versus 74.3 for institutionalized group, d=0.35) and reduced rates of . These gains persisted into , with foster care participants showing better physical growth, fewer psychiatric disorders (e.g., 18% lower prevalence of internalizing problems), and improved brain electrical activity patterns indicative of enhanced neural maturation, though institutional rearing led to enduring deficits in domains like executive function and . Meta-analytic reviews corroborate these findings, indicating that adoption from institutions facilitates catch-up growth in linear height and weight, closing approximately 46% of initial deficits within the first years post-placement, alongside cognitive rebounds to near-normal IQ levels (average 104) typically within . In contrast, prolonged institutionalization beyond 24-27 months correlates with exacerbated risks, including larger volumes linked to heightened anxiety, lower , and stagnant developmental trajectories in adaptive skills, as evidenced by comparisons of post-institutionalized adoptees versus never-institutionalized peers. Earlier age at adoption amplifies benefits; children adopted before 12 months show minimal long-term impairments, while those adopted after 18 months retain vulnerabilities in attachment security and behavioral regulation, underscoring sensitive periods for neural plasticity. Long-term socioeconomic markers further favor adoption, with adoptees demonstrating superior school performance and reduced psychopathology into adulthood relative to institutionally reared counterparts, who face elevated odds of unemployment and relational instability. These patterns hold across international adoption cohorts, where family environments post-adoption mitigate early deprivation effects more effectively than continued institutional settings, which often lack individualized caregiving and stimulation essential for causal developmental cascades. However, outcomes vary by institutional quality and adoptive family resources, with suboptimal foster or adoptive placements occasionally yielding intermediate results between high-quality institutions and prolonged neglect.

Controversies and Systemic Critiques

Risks of Abuse, Neglect, and Institutional Pathology

Children in orphanages face heightened risks of neglect due to structural features such as high child-to-caregiver ratios and insufficient individualized attention, which impair emotional bonding and physical care. A systematic review of reviews on severe neglect in under-resourced childcare institutions documented consistent associations with deficits in brain development, attachment formation, and cognitive growth, attributing these to chronic deprivation of responsive interactions. In Romania's state-run orphanages during the 1980s and early 1990s, policies under Nicolae Ceaușescu led to over 100,000 children in institutional care, where neglect manifested in widespread malnutrition, untreated illnesses, and minimal stimulation; post-1989 inspections revealed facilities with children restrained to beds for hours and ratios exceeding 20:1 in some units. Physical and emotional by staff is prevalent in many institutional settings, often normalized as disciplinary measures amid resource constraints and poor . A of experiences in institutionalized care found that up to 70% of ren in sampled orphanages reported physical from caregivers, with emotional including verbal degradation and isolation tactics. Sexual , though less systematically tracked, emerges in survivor accounts and investigations, linked to unchecked authority dynamics; for instance, a review of institutional maltreatment identified failures in reporting and intervention as exacerbating factors, with long-term sequelae including post-traumatic stress and relational distrust. Empirical data from Romanian placement centers in the 1990s indicated severe staff punishments, such as beatings and food deprivation, predicted by institutional overcrowding rather than -specific traits. Institutional pathology encompasses broader systemic dysfunctions, including dehumanizing routines and oversight lapses that foster maltreatment cultures. The Early Intervention Project, a randomized study of 136 Romanian orphanage children initiated in 2000, causally linked prolonged institutional rearing to elevated rates of disinhibited (affecting 45% versus 22% in family-reared controls) and internalizing disorders, evidencing how group-based care erodes normative attachment and self-regulation. Cross-national evidence reinforces that without family-like contingencies, institutions promote apathy among staff and developmental stagnation, as seen in persistent delays even after resource improvements; one analysis noted that caregiver training interventions rarely address violence prevention, perpetuating cycles of . These pathologies are not universal but arise predictably from scaling care beyond intimate, responsive models, with sub-Saharan studies showing institutionalized orphans experiencing comparable or higher institutional despite similar baselines.

Orphanage Trafficking and Exploitation of Donors

Orphanage trafficking entails the recruitment, transportation, and harboring of children—often from intact but impoverished families—into facilities under of orphanhood, primarily to generate revenue from international donors, volunteers, and tourists. This form of exploitation leverages the global demand for charitable giving, with operators fabricating documentation to portray children as orphans eligible for institutionalization. An estimated 5.4 million children live in such institutions worldwide, yet over 80 percent have at least one living , indicating systemic rather than genuine need for orphan care. The mechanism exploits economic vulnerabilities: parents, enticed by promises of education, healthcare, or remittances, relinquish children who then perform for visitors—singing, begging, or posing for photos—to solicit funds. Donations, including an annual $3.3 billion from U.S. Christian organizations to , often fail to reach children, instead sustaining operators' profits and incentivizing further . Voluntourism exacerbates this, as short-term volunteers pay fees for "hands-on" experiences, creating a market that outstrips the supply of true orphans and perpetuates separations without addressing root . In , where orphanage numbers surged post-Khmer Rouge, 406 facilities housed over 16,000 children as of 2019, but only 20 percent were genuine orphans; the remainder, including many with living parents nearby, generated income through tourist interactions and souvenir sales, with children earning minimal wages like $10–20 monthly funneled partly to families. The government, aided by inspections, closed 11 institutions in by 2018, reintegrating 644 children into communities. Similarly, in , where 80 percent of institutionalized children have families, post-2015 earthquake aid inflows fueled fake orphanages, with thousands of children coerced into posing as orphans to attract Western donations amid lax oversight. These practices yield cascading harms: children endure , , and heightened risks of or labor exploitation, while donors' goodwill subsidizes a cycle detached from family-based solutions. Reports from organizations like , drawing on UN data, highlight how unregulated funding parallels create exploitation hubs, though such analyses warrant scrutiny for potential advocacy biases favoring deinstitutionalization over context-specific reforms. Nepal stands as an , explicitly criminalizing orphanage trafficking in 2018 by recognizing child movement for institutional profit as a trafficking offense.

Commercialization Versus Altruistic Models

Commercial orphanages, often structured as for-profit entities or quasi-businesses reliant on voluntourism, sponsorships, and international donations, prioritize generation over child welfare, leading to systemic of non-orphans from intact families to sustain operations. In regions like , this model has proliferated since the 2000s, with orphanages actively soliciting children from poor families under of or support, only to exploit them for that benefits operators rather than residents. Such incentivizes prolonged institutionalization to maximize donor appeal, as evidenced by cases where 80-90% of children in these facilities have living parents, separated solely to meet funding demands. Altruistic models, typically non-profit or government-funded with mandates for transparency and family reintegration, emphasize evidence-based care without financial extraction from children's presence, resulting in lower incentives for unnecessary placements. For instance, rigorously monitored charitable programs in select Eastern European countries post-2000s reforms have shown improved outcomes in and development when profit motives are absent, focusing resources on short-term intervention and kinship alternatives rather than perpetual occupancy. However, even altruistic setups can falter due to underfunding or oversight gaps, though they lack the commercial drive to fabricate orphan status for profit, as documented in global reviews of institutional care. Empirical comparisons reveal heightened risks in commercial variants, including and exploitation; in the UK, for-profit residential care providers contracted by local authorities since the 2010s have correlated with reduced placement stability and increased incidents of restraint and , with data from 2017-2022 indicating 20-30% higher disruption rates compared to non-profit equivalents. Orphanage trafficking studies further quantify commercialization's harms, estimating that donor-funded institutions in and generate millions annually while subjecting children to labor, , or sexual exploitation to cut costs and inflate perceived need. Altruistic frameworks, by contrast, align more closely with standards, such as those from evaluations showing better adherence to reintegration protocols when operations are not donor-dependent for survival.
AspectCommercial ModelsAltruistic Models
Incentive StructureRevenue from voluntourism and donations drives child recruitment and retentionFocus on welfare metrics like reunification rates, with funding tied to outcomes
Placement RisksHigh unnecessary separations (e.g., 85% non-orphans in Cambodian cases)Prioritizes preservation, reducing institutionalization by 40-60% in reformed systems
Abuse IncidenceElevated due to cost-cutting; for-profits report 25% more concernsLower, with oversight emphasizing care quality over profitability
Long-Term EffectsPerpetuates dependency cycles, hindering socioeconomic reintegrationSupports transitions to , correlating with improved developmental trajectories
These patterns underscore causal links between profit motives and institutional , where commercialization distorts caregiving into a supply-demand economy fueled by external , whereas altruistic intent, when paired with , mitigates such distortions.

Global Patterns and Contextual Adaptations

Orphanages in Developed Economies

In developed economies, large-scale orphanages of the 19th and early 20th centuries have been largely supplanted by family-based care systems, driven by that institutional environments often impair through disrupted attachments and limited individualized attention. This shift accelerated post-World War II, with policies favoring and over congregate settings; for instance, the U.S. Children's Bureau promoted foster placements from 1912 onward, reducing reliance on orphanages by the mid-20th century. By the 1980s, federal legislation like the Adoption Assistance and Child Welfare Act emphasized family preservation and permanency, further diminishing institutional options to short-term or specialized residential facilities for children with acute needs, such as severe behavioral disorders or medical conditions. Contemporary institutional care in these economies typically manifests as small group homes or therapeutic residential programs rather than traditional orphanages, serving a minority of children in out-of-home placements. , approximately 343,000 children were in as of 2023, with residential or settings accounting for roughly 10-15% of placements—estimated at 30,000 to 50,000 children—primarily for those unsuitable for family due to aggression or trauma histories. , the pattern varies but shows higher use; Western European countries reported 294 children per 100,000 in in 2024, totaling over 450,000 across and , though EU-wide figures for stood at about 303,000 in 2021, often in smaller facilities amid ongoing deinstitutionalization efforts. , for example, had around 123,000 youth in residential homes in 2021, reflecting a regulated model focused on transition to independence. These facilities prioritize rehabilitation over long-term housing, with outcomes improving in high-resource settings through professional staffing and oversight, though empirical data indicate persistent risks of poorer cognitive and emotional development compared to family placements unless interventions are intensive. Deinstitutionalization policies, influenced by organizations like , have reduced institutional populations but face critique for overburdening foster systems, where placement instability can mirror institutional harms; in some cases, quality group homes yield comparable or better short-term stability for high-needs youth. Despite advocacy for near-elimination of , developed economies maintain these options for the 5-20% of cases where family alternatives fail, balancing evidence of institutional drawbacks against pragmatic necessities.

Institutional Care in Low-Resource Developing Nations

In low-resource developing nations, particularly in and , orphanages serve as a common repository for children separated from families due to , epidemics like , and conflict, with global estimates indicating approximately 2.7 million children reside in facilities as of 2018, many in under-resourced settings. In , alone orphaned over 11 million children by the early 2000s, straining institutional systems where up to 80-90% of residents often have at least one living unable to provide support amid economic desperation. These institutions frequently house children not as true orphans but as temporary placements, yet chronic underfunding perpetuates cycles of overcrowding and minimal standards. Operational conditions in such facilities typically feature high caregiver-to-child ratios, averaging 1:10 and reaching extremes of 1:23 in Tanzanian orphanages, which hampers consistent emotional bonding and responsive caregiving essential for early development. Inadequate staffing, compounded by low salaries and high turnover, results in "structural ," characterized by unstable routines, limited physical resources, and insufficient , elevating risks of infectious diseases and chronic health issues. Nutrition deficits are prevalent, with institutionalized children displaying atypically and higher stunting rates linked to inconsistent feeding and deficiencies, outcomes mirroring broader patterns of undernutrition in low-income contexts but amplified by institutional constraints. Developmental impacts from prolonged institutionalization include impaired cognitive function, with studies documenting lower IQ scores and among residents compared to family-based peers, alongside socio-emotional deficits such as attachment disorders and behavioral dysregulation. Physical growth lags persist, with resident children evidencing poorer height-for-age metrics, though partial catch-up can occur following or reintegration into family environments. Peer-reviewed evidence from low-income settings underscores these risks, attributing them to the absence of individualized care rather than inherent child vulnerabilities, with resilience factors like early intervention mitigating some effects. Comparative analyses favor family-based alternatives, such as or , for fostering superior physical, cognitive, and emotional outcomes, as institutional models in resource-poor areas often fail to replicate familial stability despite providing basic shelter. However, implementing deinstitutionalization faces barriers including weak social welfare and cultural preferences for absorption, which buckles under pressures, necessitating targeted investments in prevention and community support to avert unnecessary placements. While some institutions deliver and access unavailable in destitute households, empirical data consistently highlight the superiority of non-institutional options when viable, informing global policy shifts toward reintegration.

Regional Case Studies of Successes and Failures

In post-communist , institutional care exemplified systemic failure, with orphanages housing over 100,000 children by 1990 amid severe neglect, leading to stunted physical growth, cognitive delays, and neurological impairments such as reduced volume and altered activity patterns observable into . Longitudinal data from the Bucharest Early Intervention Project, tracking children institutionalized before age 2, revealed that those remaining in facilities through age 16 had IQ deficits, elevated ADHD prevalence (around 20%), and higher rates compared to non-institutionalized peers, attributable to prolonged deprivation rather than genetic factors. Reforms emphasizing early foster placement yielded partial successes, boosting IQ by 7-9 points, improving attachment security, and normalizing development when implemented before 24 months, though unstable placements diminished gains and highlighted the limits of post-institutional recovery. Post-war Bosnia and Herzegovina illustrated institutional pathologies amid political fragmentation, where an estimated 2,000 children occupied 24 orphanages by 2010, plagued by inadequate oversight, reports of (including and forced sedation), substandard , and restricted recreation due to the Dayton Accords' decentralized . State failure to unify monitoring or prosecute violations exacerbated vulnerabilities, with alternatives underdeveloped—only about 12 families available in —and a 2008 deinstitutionalization plan stalled by funding shortages and legal ambiguities, leaving orphans at risk of prolonged isolation and unaddressed trauma. In , orphanage-based care for orphans and other vulnerable children correlated with heightened behavioral and emotional disturbances, affecting 16.78% of residents in a 2018 Visakhapatnam study of 292 children, with conduct disorders predominant at 34.9%, followed by peer problems (15.8%) and emotional issues (14.7%), exacerbated by late admission, abandonment as entry reason, and extended stays. These patterns disrupted daily functioning, impairing classroom performance (88.8% impacted) and social bonds (64.4% affected), underscoring institutional settings' inadequacy in replicating familial support amid resource constraints. Sub-Saharan African contexts revealed mixed outcomes, where poorly resourced orphanages often mirrored global institutional risks like and abuse, yet select regulated facilities in countries including and achieved viable results. A 2009 Duke University analysis of over 3,000 children across five African and Asian nations found that high-quality orphanages provided equivalent or better physical health, cognitive gains, and lower abuse incidence than in kinship-heavy, low-support environments, particularly for short-term placements. NGO models, such as in , demonstrated successes in and self-sufficiency, with like former resident Sam Mbugua advancing to leadership roles in African development by 2020, though scalability remained limited by donor dependency and local capacity gaps.

Effects of Conflicts, Pandemics, and Migration

Armed conflicts surge the demand for orphanage care by orphaning children through direct violence, parental deaths, and family separations, often straining or destroying institutional . In , Russia's starting February 24, 2022, resulted in 1,969 children losing by October 2024 due to war-related deaths, disappearances, or displacements, prompting evacuations of over 100,000 children from institutions and efforts to reintegrate 95,700 into families, as most have at least one surviving parent. In Syria's civil war from 2011 onward, the Assad regime abducted and hid over 300 children in orphanages, particularly under Air Force Intelligence, separating them from families for or control, with many remaining untraced post-regime fall in December 2024. Globally, conflicts now affect nearly 19% of children, up from 10% in the 1990s, with over 150,000 separated from parents in 2024 alone, heightening institutionalization risks amid disrupted services. Pandemics exacerbate orphanhood through caregiver deaths, overwhelming orphanages with influxes and resource shortages, while increasing vulnerability to in underfunded systems. The crisis in orphaned approximately 10 million children by the early 2000s, with 13.8 million (range 10.9-17.7 million) worldwide as of 2024, driving reliance on institutions where extended families collapse under economic burdens. caused over 1.1 million children to lose a primary in its first 14 months (March 2020-April 2021), rising to 5.2 million by October 2021, correlating with heightened institutionalization, poverty, and developmental delays as families fracture.01253-8/fulltext) These events compound institutional pathologies, as evidenced by elevated abuse rates in crisis-hit facilities, though short-term placements may avert immediate perils absent family alternatives. Migration and refugee flows, often tied to conflicts, amplify orphanage admissions via parental losses en route, border separations, and asylum seekers' inability to care for children amid instability. Over half of global migrants and refugees are children, facing traumas that predispose them to institutional care, with family separations in crises like Ukraine's displacement of millions leading to temporary orphanage surges before family reunifications. In broader refugee contexts, unaccompanied minors—exceeding 150,000 in recent war zones—enter institutions at higher rates, incurring lifelong risks of emotional neglect and cognitive stunting from depersonalized environments, as longitudinal studies affirm family-based care's superiority for attachment formation. Such placements, while providing shelter, often perpetuate cycles of vulnerability without addressing root causes like poverty or legal barriers to reunification.

International Guidelines and Reform Initiatives

The Guidelines for the Alternative Care of Children, developed through consultations by , the UN High Commissioner for Human Rights, and other entities and endorsed by the UN General Assembly via resolution A/RES/64/142 on February 24, 2010, establish principles to guide policies on children separated from parental care. These guidelines prioritize maintaining children in their environment as the default, invoking a "necessity principle" that alternative care—such as institutional placement—should only occur when it is impossible to provide suitable family-based options like or foster placement, and when such care demonstrably serves the child's . They further mandate suitability assessments, periodic reviews of placements, and preparation for , drawing on empirical evidence of developmental harms associated with prolonged institutionalization, including attachment disorders and cognitive delays observed in longitudinal studies of institutionalized children. Complementing the 1989 UN Convention on the Rights of the Child (Article 20), which requires states to provide special protection for children without family environments, the guidelines advocate for deinstitutionalization by redirecting resources toward prevention of family separation, such as alleviation and support services. Implementation has influenced national reforms, as seen in over 20 countries adopting family-based care targets by , though progress remains uneven due to resource constraints and varying interpretations of evidence on institutional versus family outcomes in low-income contexts. Reform initiatives include the Better Care Network's ReThink Orphanages campaign, launched in the early 2010s and expanded globally, which collaborates with donors and governments to halt funding for new orphanages and phase out existing ones in favor of strengthening, citing data that 80-90% of children in institutions worldwide have living parents and enter due to rather than true orphanhood. This effort has prompted policy shifts in countries like and , where post-2010 moratoriums on orphanage construction reduced institutional populations by 20-30% in targeted regions through reintegration programs. Similarly, the 2025 Global Charter on Children's Care Reform, endorsed by organizations including and the government, urges 50 countries by 2030 to commit to closing large-scale institutions and scaling up foster and systems, with technical assistance for monitoring outcomes via indicators like child well-being metrics. The Commission on deinstitutionalization, published in 2020, synthesizes evidence from randomized trials and cohort studies showing family-based care yields better emotional and educational outcomes, informing initiatives like UNICEF's regional programs in and , where deinstitutionalization efforts since 2010 have transitioned over 100,000 children to settings with reported reductions in rates. However, these reforms face challenges, including insufficient gatekeeping to prevent unnecessary placements and reliance on under-evidenced models in resource-scarce areas, as noted in critiques of rapid closures without adequate support infrastructure. Ongoing monitoring by bodies like the Better Care Network emphasizes data-driven adjustments, prioritizing empirical evaluations over uniform deinstitutionalization mandates.

Empirical Debates on Prioritizing Institutions Over Deinstitutionalization

A growing body of challenges the universal prioritization of deinstitutionalization, particularly in low- and middle-income countries where family-based alternatives may falter due to , overburdened networks, and limited support systems. While care is often associated with improved socio-emotional development in resourced settings, studies indicate that well-managed institutions can deliver comparable or superior outcomes in physical health, , and access to when contrasted with informal foster arrangements in resource-scarce environments. For instance, a 2014 randomized evaluation across five countries found that children in institutional care exhibited higher physical health scores and lower rates of recent illness compared to those in , attributing this to institutions' ability to consistently meet like food and medical attention. Further evidence from a analysis of orphaned children in low- and middle-income settings revealed no significant differences in cognitive, physical, or outcomes between (institutional) placements and , suggesting that high-quality institutions serve as viable alternatives where family reintegration risks exploitation or neglect. In such contexts, placements frequently result in child labor or inadequate provisioning, as documented in comparative reviews highlighting equivalent or higher rates in impoverished households versus regulated facilities. Critics of rapid deinstitutionalization argue that these policies, often driven by Western NGOs, overlook causal factors like endemic , where institutions provide structured environments preventing worse deprivations; for example, modern orphanages in regions like have demonstrated better school attendance and nutritional status than dispersed burdened by economic strain. The debate underscores contextual contingencies: while early institutionalization poses risks like attachment disruptions in any setting, longitudinal data from resource-limited areas indicate that prioritizing institutions over unprepared family transitions can mitigate broader harms, such as increased vulnerability to trafficking or post-deinstitutionalization. Proponents of selective institutional retention emphasize that evidence-based reforms—enhancing institutional quality rather than wholesale closure—yield net benefits, as hasty shifts to family care in under-resourced nations have correlated with elevated dropout rates and health deteriorations in affected cohorts. This perspective gains traction amid critiques of overgeneralized deinstitutionalization agendas, which may undervalue institutions' role in scaling interventions like drives and vocational training unavailable in fragmented family systems.

References

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