Is there evidence that deinstitutionalisation (DI) works?

In the past, it was mostly institutions that looked after children. Today countries are moving in the direction of DI because it produces better outcomes. Countries in Eastern Europe, Africa, Indonesia, Cambodia, Myanmar, Vietnam and Thailand are reforming their childcare systems, implementing DI and working towards reintegrating children back into nurturing communities.

Implementing DI is challenging. Countries with vision embarked on the paradigm shift in public attitudes and committed resources to move children from an institutional to the family-based care system. Malaysia’s move to DI is evidence-based.

Family and community-based child care are more cost-effective and able to deliver better quality care to more children. Studies from Romania, Ukraine, Moldova and Russia show institutional care can be as much as six times more expensive than providing social services to vulnerable families. The same cost disparity occurs in many other parts of the world.

Source reference: The Risk of Harm, Lumos, 2014 cost

One study in Haiti estimated it costs US$1560 on average per year to support a family with a child, provide him or her with medical care, food and a place in school. It would cost US$6600 per year to keep that same child in an institution with much poorer quality care and exposed to the risk of serious harm. Four times more!

In Sudan and Cambodia family-based care costs just 10% of institutional placement.

Source reference: Ending the Institutionalisation of children in Malaysia, Lumos, 2014