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Member Research & Reports

Member Research & Reports

UNC Research Finds Institutions No Less Safe for Orphans than Family Care

Orphans living in families are at least as vulnerable to sexual and physical abuse and other traumas as orphans living in institutions, a new study finds.

orphanage_Karim Childrens-Centre_Arusha, Tanzania_Chris Gansen
[Photo: Children in the Karim Children’s Centre orphanage in Arusha, Tanzania, pose for a visiting photographer. A new UNC study finds that institutionalized care for orphans in Cambodia, Ethiopia, India, Kenya and Tanzania is no less safe and viable for the children than is care in families. The research provides a counterpoint to a recent review in The Lancet, which advocated global deinstitutionalization to improve child protection. Photo by Chris Gansen]

Ms. Christine L. Gray, epidemiology doctoral student at the UNC Gillings School of Global Public Health, is lead author of the work, published online Aug. 26 in the journal Global Health: Science and Practice. Dr. Brian W. Pence, associate professor of epidemiology at the Gillings School, is a co-author.

The research, which analyzed longitudinal data from 2,235 orphans from five low- and middle-income countries participating in the Positive Outcomes for Orphans (POFO) study, challenges the commonly held perception that institutional care puts children at higher risk for experience of trauma than does family-based care.

The POFO study, based at Duke University’s Global Health Institute and carried out in Cambodia, Ethiopia, India, Kenya, and Tanzania, is led by principal investigator Dr. Kathryn Whetten, professor at Duke University’s Sanford School of Public Policy and director of the Center for Health Policy and Inequalities Research at the Duke Global Health Institute.

“We found that the incidence of traumatic events is high in both institutions and in families,” Ms. Gray said. “The most commonly experienced trauma was physical or sexual abuse – and that was higher among children placed in families.”

Annual incidence of physical or sexual abuse was 13 percent among orphans in institutional care, and 19 percent among orphans in families.

The new study provides a counterpoint to a recent review published by The Lancet which advocated global deinstitutionalization to improve child protection.

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