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Why Institutions Matter: Empirical Data from Five Low- and Middle-Income Countries Indicate the Critical Role of Institutions for Orphans

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Book cover Child Maltreatment in Residential Care

Abstract

Millions of children orphaned by or separated from their parents are particularly vulnerable to maltreatment. Preventing and mitigating the effects of maltreatment requires understanding the context in which maltreatment occurs. A vastly disproportionate number of the world’s orphans live in South Asia and sub-Saharan Africa, where poverty, civil unrest, and economic insecurity compromise the capacity of family-based care. While studies of children in select destitute orphanages have demonstrated the effects of severe early deprivation, they do not represent the heterogeneity of institution-based care in general or the heterogeneity of institution-based care in low- and middle-income countries (LMICs) specifically. Furthermore, the only large-scale, multi-country study designed to compare average experiences in both institution-based and family-based care indicates the prevalence, and incidence of maltreatment is similar in both types of care. Increasing advocacy for global deinstitutionalization is inconsistent with emerging evidence about institution-based care as compared to family-based care. Furthermore, such sweeping action would remove a critical safety net for many orphans. Long-term positive outcomes are much more likely to come from improved understanding of the essential elements of quality caregiving in all settings, caregiver training and support, and innovative models of orphan care.

There is nothing so expensive, really, as a big, well-developed, full-bodied preconception.

– EB White (1944).

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Authors and Affiliations

  1. Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599-7435, USA

    Christine L. Gray & Brian W. Pence

  2. Duke Global Health Institute, Duke University, Durham, NC, USA

    Sumedha Ariely & Kathryn Whetten

  3. Public Policy and Global Health, Duke University, Durham, NC, USA

    Kathryn Whetten

Authors
  1. Christine L. Gray
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  2. Sumedha Ariely
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  3. Brian W. Pence
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  4. Kathryn Whetten
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Correspondence to Christine L. Gray .

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Editors and Affiliations

  1. Department of Social and Behavioral Science, Southwestern Christian University, Bethany, Oklahoma, USA

    Adrian V. Rus

  2. Texas Christian University, Fort Worth, Texas, USA

    Sheri R. Parris

  3. Social Pediatrics and Obstetrics Research Department, National Institute for Mother and Child Health “Alessandrescu-Rusescu”, Bucuresti, Romania

    Ecaterina Stativa

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Gray, C.L., Ariely, S., Pence, B.W., Whetten, K. (2017). Why Institutions Matter: Empirical Data from Five Low- and Middle-Income Countries Indicate the Critical Role of Institutions for Orphans. In: Rus, A., Parris, S., Stativa, E. (eds) Child Maltreatment in Residential Care. Springer, Cham. https://doi.org/10.1007/978-3-319-57990-0_18

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