Transitioning institutional care of children to family-based care, fostering and adoption


Worldwide, millions of children live in child care institutions (CCIs)/orphanages, yet 80% of these children have at least one living parent. Abuse, poverty, exploitation, conflict, displacement and lack of awareness of the value of family contribute to children being separated from their families.

People with a desire to meet children’s needs have responded to children separated from their families by establishing CCIs. Whilst a good institution can provide children with food, safety, education and community, there are limits to this care. In a home such as an orphanage, with many children to look after, holistic emotional care is just not possible for every child. Research shows that there are detrimental effects of institutional care on children’s brain activity, social and emotional development. Furthermore, when children grow too old for the home, many do not have the support they need when forging a life into the future.

It is well-known that the best environment for a child to thrive physically, emotionally, spiritually and developmentally is within a safe and loving family. There is a growing body of opinion, supported by international standards that recognises that the best way to provide care for children is to support them in their families and if they lose parents or become separated, that they are reunited quickly with family members or provided with an alternative family environment.

Our approach

The Child Reintegration programme seeks to reduce the number of children growing up in institutional care and to change the attitudes and policies of children’s homes and local and national actors and policy-makers. Families are also supported to be able to provide for their reintegrated child’s health, education and nutritional needs.

The Child Reintegration programme partners with children’s homes which are set up for caring for children in a permanent residential care setting to see children placed back into families. It builds the capacity of the partnering children’s homes to operate their own reintegration projects, which should become self-sustaining. 

Network staff work with Board members, senior staff, social workers and caregivers from the member organisations to help them restructure the way they provide care for children. They commit to a mutual process of learning where they are helped to design a reintegration programme for children and to establish gatekeeping policies where children are not taken into the residential home in the first place if they could instead be supported to remain within their families and with their communities. 

At the same time, the network works with the governmental duty bearers to ensure that the direction in policy and implementation is to deinstitutionalise children in the country and promote family care instead. 

The key response areas are:

1. Equipping Children’s Homes to develop Reintegration Programmes

Initially, the network must identify children’s homes in the network to partner with in this programme. Programme leaders will then work with the orphanages to:

  • Train staff, and assist in the identification of children who are candidates for reintegration.
  • Develop a gatekeeping programme, which includes criteria for the intake of children into the home. 
  • Initiate policies regarding exit strategies and reintegration procedures, documenting rescues, the rehabilitation and reintegration process. 
  • Develop follow-up programmes to ensure that children who are reintegrated have the support required to succeed in their families and communities.

2. Reintegrating Children

The networks work with the children’s homes to identify children to be reintegrated. These children are 0-14 years in age and have some family (aunt, uncle, parent, sibling, grandparent) willing for them to return home.

In order for children to return home, assessment of needs and capacity and support for the families are vital.

3. Alternative family-based care

When families cannot be located or have passed away, we believe that where possible, alternative family-based care is best for a child, rather than in institutions. Whilst we advocate for family-based care for children, it is vital that this process is not rushed. With hundreds of thousands of children currently living in institutions, a mass exodus towards family-based care could mean that children are re-housed without due process, potentially putting them at risk. Being Family ( ) is a resource developed to explain the changing trends in global discourse and safe and sustainable process to rehouse children to ensure that they are holistically cared for in transition and beyond.

4. Advocacy on the national and local level to ensure children are living in family-based environments to the fullest extent possible 

Networks facilitate monthly meetings for participating children’s homes, as well as childcare forums to provide support and feedback regarding reintegration. 

The network is encouraged to form and strengthen relationships with relevant government and NGO actors. We offer advocacy workshops for children’s homes to share experiences and be more inspired to work on reintegration projects. Through national and city advocacy, other faith-based organisations are given an increased level of awareness of the importance of community-based care and child reintegration.

Case studies

Our partner network, CRANE, is coordinating a city-wide response to reintegrate children into families in Kampala, Uganda. Over the past five years, CRANE has reunited 1,016 children with their families. As well as working with local community, the network is engaging with city and national authorities to form a consortium that will tackle the need for children to be in families throughout the city.

CRANE and Viva have created training programmes to teach network member staff about the methodology of family reintegration, so that resettlement is successful for both family and child. Staff learn how to trace a family, provide counselling and to ensure the home situation is safe and suitable for long-term care.

Other useful resources