Global Deinstitutionalization of Children 

She was two years old when her mother placed her in an orphanage in South Korea. Her mother’s intentions were not to relinquish parental rights, but simply to keep her daughter safe while she tried to find an income and stable housing. She was three years old when her mother came to the orphanage, only to learn that her daughter had been adopted internationally just a few days before. Though the context of this story is in South Korea, similar situations happen to children in institutions around the globe.

Currently, 8 million children live in orphanages (LUMOS, 2019). Within this group,  80% have at least one living parent (LUMOS, 2019). Poverty is the leading reason parents place their children in institutions with the ability to receive an education as an additional influential factor (Bilson & Cox, 2007; UNICEF, 2008). This indicates that, contrary to popular belief, the vast majority of children in institutions are not parentless and in need of adoption. Rather, they need community supports that allow them to remain in their families.

Institutions not only fail to serve the original purpose for which they were created, they harm children’s immediate and future development. Orphanages provide limited stimulation, verbal interactions, and time for play (Dalen & Theie, 2014). The effects of institutionalization can be seen in toddlers who lag behind their noninstitutionalized peers in both motor and communication skills. In early childhood, residual effects of institutionalization are shorter attention spans and lower levels of sensory processing and executive function (Jacobs et al., 2009). Additionally, children and adults who have been institutionalized are more likely to exhibit atypical attachment styles with their caregivers and partners (Roberson, 2006).

Recognizing the lifelong consequences of institutionalization, the United Nations General Assembly in New York reached a landmark decision on December 18, 2019, in which all 193 UN member states unanimously adopted the Resolution on the Rights of the Child. This resolution urges states to “adopt and enforce policies, services, and programs and direct budget towards supporting families,” prioritize “quality alternative care options over institutionalization” and “progressively replac[e] institutionalizations with quality alternative care, including, inter alia, family and community-based care and, where relevant, redirecting resources to family and community-based care services (UN General Assembly, 2019, p. 14).”

A few states, including Bulgaria, Romania, and Cambodia have begun the process of deinstitutionalization. In Bulgaria, it has been shown that institutionalization of children can be avoided when adequate support is given to families (Bilson & Cox, 2007). Unfortunately, prevention services have not been emphasized enough, and the number of children in care are on the rise again in Bulgaria (LUMOS, 2017). Romania’s deinstitutionalization was aided by legislative reform, professional training of child protection workers and officials directly involved in implementation, and the creation of a continuum of services including daycare and maternal centers and counseling services (Wehrmann, 2005). Despite some successes, challenges to deinstitutionalization in Romania include a struggling economy, poor funding, communication issues, lack of commitment from stakeholders, and a long-held belief that the state should be the caregiver for children whose parents are unable to fill that role. Though similar methods and subsequent obstacles have been seen in some of the states attempting deinstitutionalization, no evidence-based procedures or policies have yet emerged (Forber-Pratt, 2019).

The world may not be ready to implement deinstitutionalization on a global scale, but the philosophy and policies around child protection are quickly shifting. We must examine the successes and the challenges of countries that have already begun this work. Stakeholders in child welfare owe it to these already vulnerable children to make the transition from institutionalization to deinstitutionalization a successful one. Our children’s lives depend on it.




Bilson, A., & Cox, P. (2007). Caring about poverty: alternatives to institutional care for children in poverty Journal of children and poverty, 13(1), 37-55. DOI: 10.1080/10796120601171294

Dalen, M., & Theie, S. (2014). Similarities and differences between internationally adopted and nonadopted children in their toddler years: Outcomes from a longitudinal study. American journal of orthopsychiatry, 84(4), 397-408. Retrieved from

Forber-Pratt, I. (2019). A ten countries review of the literature on deinstitutionalization and child protection system reform. Unpublished paper.

Hope and Homes for Children. (2019). Landmark moment as the UN calls for the end of orphanages. Retrieved from

Jacobs, E., Miller, L. C., & Tirella, L. G. (2010). Developmental and behavioral performance of internationally adopted preschoolers: A pilot study. Child Psychiatry & Human Development, 41(1), 15-29. DOI 10.1007/s10578-009-0149-6

Jo, S. (2015). Ghost of Sangju: a memoir of reconciliation. Minneapolis, MN: CQT Media and Publishing.

Lizarazu, P.M. (2018). The deinstitutionalization of children in Cambodia: intended and unintended consequences. (Masters Dissertation). Graduate Institute of Geneva. Retrieved from

LUMOS. (2019). Home page. Retrieved from

LUMOS. (2017). Ending institutionalization: an analysis of the financing of the deinstitutionalization process in Bulgaria. Retrieved from

Roberson, K. C. (2006). Attachment and caregiving behavioral systems in intercountry adoption: A literature review. Children and Youth Services Review, 28(7), 727-740. Retrieved from

United Nations General Assembly. (2019) Protection and promotion of the rights of the child. Retrieved from

Wehrmann, K. C. (2005). An Exploratory Study on Child Welfare Reform in Post-Revolutionary Romania. Journal of Social Work Research and Evaluation, 6(1), 87-99. Retrieved from






One response to “Global Deinstitutionalization of Children 

  1. Pingback: Myka Stauffer: An Adoption Fantasy Unraveled | Red Thread Broken·

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