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(Ivanhoe Newswire) Children in institutional orphanages in five Asian and African countries fared as well as or better than those who live in the community.
The findings from a Duke University study of more than 3,000 orphaned and abandoned children contrast sharply with research that associates institutional orphanages with poorer health and well-being, and call into question the policies adopted by many governments and international agencies.
"Our research is not saying that institutions are better. What we found is that institutions may be a viable option for some kids," study leader Kathryn Whetten, director of the Center for Health Policy at the Duke Global Health Institute, was quoted as saying. "As the number of orphans continues to rise worldwide, it is vital not to discount orphanages before assessing whether they are harmful to the millions of children for whom they care."
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Whetten's research team compared the physical health, cognitive functioning, emotion, behavior and growth of 3,000 orphaned or abandoned children aged 6 to 12, half of them living in institutions and the other half dwelling in the community. The study found that children in institutions in five countries reported significantly better health scores, lower prevalence of recent sickness and fewer emotional difficulties than children dwelling in the community.
The research team has been following the 3,000 orphans for three years, and they plan to continue tracking them into their late teens and early 20s to determine how their upbringing affects their life course.
Data were collected between May 2006 and February 2008 from children and their caregivers in 83 institutional care settings and 311 community clusters. The study assessed five culturally, politically and religiously distinct countries that face rising orphan populations. Sites included Cambodia, Ethiopia, Hyderabad and Nagaland in India, Kenya, and Tanzania.
Of the estimated 143 million orphans and abandoned children worldwide, roughly half reside in South and East Asia, according to UNICEF. An estimated 12 percent of all children in Africa will be orphaned by next year as a result of malaria, tuberculosis, pregnancy complications, HIV/AIDS and natural disasters, according to the World Health Organization.
"What people don't understand is that, in many cases, the institutions are the community's response to caring for orphaned and abandoned children," said Whetten. "These communities love kids and as parents die, children are left behind. So, the individuals who love children most and want to care for them build a building and that becomes an institution. These institutions do not look or feel like the images that many in this country have of eastern bloc orphanages; they are mostly places where kids are being loved and cared for and have stable environments."
The research findings run contrary to global policies held by organizations such as UNICEF and UNAIDS, which recommend institutions for orphaned and abandoned children only as a last resort, and urge that such children be moved as quickly as possible to a residential family setting.
"This is not the time to be creating policies that shut down good options for kids. We need to have as many options as possible," said Whetten. "Our research just says 'slow down and let's look at the facts.' It's assumed that the quality of care-giving is a function of being institutionalized, but you can change the care-giving without changing the physical building."
"Let's get beyond labeling an institution as good or bad," she said. "What is the quality of care inside that building, and how can we help the community identify cost-feasible solutions that can be delivered in small group homes, large group homes and family homes?"
SOURCE: PLoS ONE, December 18, 2009
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