Institutionalized Care for Children

The textbook states, that often orphanages “ignore the power and presence of local
communities and extended families in caring for orphans. Not only that, but many times
exacerbate the challenges faced by orphans because they contribute to the cycle of
‘attachment and abandonment,’ owning to the short-term nature of these volunteer efforts”
(p. 191). Evaluate this statement given what you know about the well-being of children. In
what situations would orphanages or institutions for children be appropriate options and
at what ages? How would a country’s Department or Ministry of Health apply a Health in
All Policies approach to address the economic and social issues presented in this statement?

Institutionalized Care for Children

Indeed, the institutionalization of young children and infants in orphanages exposes them to
poorly suited environments and settings. Although the modal features of institutional care differ
from one setting to another, they are characterized by similar characteristics that include high
child to caregiver ratios. In most cases, the caregivers working in these orphanages and
institutional care settings have low wages and minimal to no training or education. Besides, their
activities are carried out in rotating shifts that are strictly-structured and generalized, which
hinders the provision of psychological support to the children (Dozier, Zeanah, Wallin, &
Shauffer, 2012). Consequently, the characteristics present significant challenges to the
development and general welfare of the children.

Despite the underlying challenges and shortcomings of orphanages, the various situations
in which institutional care would be an appropriate option for children and infants entail abusive
family settings, especially those with parents who engage in substance abuse. Additionally,
children abandoned by their parents or guardians, and do not have family ties or existing
relatives can be placed in orphanages. They may further be coupled with children from cultural
and social settings that increase their vulnerability to harmful eventualities. If such children lack
a guardian or an existing family member who can take care of them, they may be placed in foster
care or orphanages. As such, the Department or Ministry of Health within a country can apply a

Health in All Policies approach to address the economic and social issues presented in the
situation by considering the consequences of the decisions made (Dozier, Zeanah, Wallin, &
Shauffer, 2012). These may be coupled with the determination of suitable synergies that would
facilitate the avoidance of hazardous health effects and further focus on improving the children’s
well-being and ensuring equity and equality in the access to the resources available.



Dozier, M., Zeanah, C. H., Wallin, A. R., & Shauffer, C. (2012). Institutional care for young
children: Review of literature and policy implications. Social Issues and Policy
Review, 6(1), 1-25.