I haven't read this yet, but plan to soon.
are struggling to care for the estimated 143,000,000 orphans and
millions more abandoned children worldwide. Global policy makers are
advocating that institution-living orphans and abandoned children (OAC)
be moved as quickly as possible to a residential family setting and
that institutional care be used as a last resort. This analysis tests
the hypothesis that institutional care for OAC aged 6–12 is associated
with worse health and wellbeing than community residential care using
conservative two-tail tests.
Positive Outcomes for Orphans (POFO) study employed two-stage random
sampling survey methodology in 6 sites across 5 countries to identify
1,357 institution-living and 1,480 community-living OAC ages 6–12, 658
of whom were double-orphans or abandoned by both biological parents.
Survey analytic techniques were used to compare cognitive functioning,
emotion, behavior, physical health, and growth. Linear mixed-effects
models were used to estimate the proportion of variability in child
outcomes attributable to the study site, care setting, and child levels
and institutional versus community care settings. Conservative analyses
limited the community living children to double-orphans or abandoned
emotional and cognitive functioning, and physical growth were no worse
for institution-living than community-living OAC, and generally better
than for community-living OAC cared for by persons other than a
biological parent. Differences between study sites explained 2–23% of
the total variability in child outcomes, while differences between care
settings within sites explained 8–21%. Differences among children
within care settings explained 64–87%. After adjusting for sites, age,
and gender, institution vs. community-living explained only 0.3–7% of
the variability in child outcomes.
study does not support the hypothesis that institutional care is
systematically associated with poorer wellbeing than community care for
OAC aged 6–12 in those countries facing the greatest OAC burden. Much
greater variability among children within care settings was observed
than among care settings type. Methodologically rigorous studies must
be conducted in those countries facing the new OAC epidemic in order to
understand which characteristics of care promote child wellbeing. Such
characteristics may transcend the structural definitions of
institutions or family homes.
Citation: Whetten K, Ostermann J, Whetten RA, Pence
BW, O'Donnell K, et al. (2009) A Comparison of the Wellbeing of Orphans
and Abandoned Children Ages 6–12 in Institutional and Community-Based
Care Settings in 5 Less Wealthy Nations. PLoS ONE 4(12): e8169.
Here is a link to the abstract.