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Orphanages Can Serve Children Well


There are an estimated 143 million orphans and abandoned children worldwide. World leaders are struggling with how to best serve these children. Currently, advocating that institution-living orphans and abandoned children (OAC) be moved to a residential family setting. Saving institutional orphanages as a last resort.

Dr. Kathryn Whetten, director of the Center for Health Policy at Duke University and the colleagues have published a new study on orphans in South Asia and Africa online in the journal PLoS One which challenges that widespread belief. The study found the care at orphanages is often at least as good as that given by families.

The Positive Outcomes for Orphans (POFO) study employed two-stage random sampling survey methodology in 6 sites across 5 countries (Cambodia, Ethiopia, India, Kenya and Tanzania) between May 2006 and February 2008. The researchers identified 1,357 institution-living and 1,480 community-living OAC ages 6–12. This included 658 children who were double-orphans or abandoned by both biological parents. The orphanages had, on average, 63 children each; 28 percent had 20 or fewer children, and 17 percent had 100 or more.

Survey analytic techniques were used to assess the children’s cognitive functioning, emotion, behavior, physical health, and growth.

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The study found the health, emotional and cognitive functioning, and physical growth of the children were no worse for institution-living than community-living OAC. Often it was better than for community-living OAC when the child was cared for by persons other than a biological parent.

The study notes that, on average, the institutions look quite different from institutions included in most of the previous studies that compared the outcomes of children in institutions and those in community settings. “Many institutions grew out of the community to meet the need of caring for the new wave of orphans and are a part of the community in a way that institutions in other regions and perhaps of the past were not. These institutions are not family-style/community care and they are not foster care, but they also do not look like institutions as we have come to think of them.”

The study suggests that researchers and policy makers need to: 1) gain a better understanding of these organic care structures and 2) ensure that they are not hindered by blanket policies about institutions.

“We’re not saying kids should be in institutions,” she emphasized. “We’re saying they’re not necessarily a bad option. We need to look at it as a feasible option for communities that are overwhelmed.”


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. doi:10.1371/journal.pone.0008169