Moving from Institutions to Families

CARE REFORM - 23 December 2025

Global Childcare Reform: Moving from Institutions to Families

For decades, large residential institutions were seen as a solution for children who couldn't remain with their families. Today, with more insight, many are re-examining this idea. Across regions, governments, NGOs, and international agencies are shifting from institutional care to family- and community-based models.

They're driven by mounting evidence, evolving policy frameworks, and a growing consensus on what children need to thrive: family.

This worldwide change was at the center of recent discussions among child protection leaders, policymakers, and practitioners from Africa, Europe, Asia, and Latin America at the Global Multi-Stakeholder Workshop on Child Care Reforms in Kigali, Rwanda, from December 17 - 19. Organized by SOS Children's Villages, the workshop reviewed the work completed by the Global Expert Group on Child Care Reform (GEGCCR) and strengthened SOS Children's Villages International's leadership in promoting childcare reform in the best interests of children.

The message was clear: childcare reform is no longer an abstract debate about best practice. It's an urgent, system-wide transformation already underway in many countries, with others now working to catch up.

Why institutional care is being phased out

Evidence against institutional care isn't new, but it's now overwhelming. Research from across disciplines shows that children raised in institutions face higher risks of developmental delays, mental health challenges, and safeguarding failures, particularly in closed systems with limited oversight.

"Institutionalization is one of the most researched topics in our sector," said Eyob Berhanu, Lead Global Expert on Child Care Reform at SOS Children's Villages. "There is an enormous amount of evidence that institutionalization poses risk and harm to children's safeguarding, development, and overall wellbeing."

As a result, global frameworks such as the UN Guidelines for the Alternative Care of Children emphasize that children should grow up in families whenever possible. There's now broad agreement that children under the age of three should never be placed in institutional care, and that preventing family separation must be the priority of any child protection system.

What is replacing institutions

While institutional care is being phased out, reform doesn't point to a single replacement model. Instead, it promotes a spectrum of family-based and community-based care options tailored to local contexts.

Family-based care includes foster care, kinship care, kafala, guardianship, and other arrangements in which children are raised in real, existing families rather than in families created solely for care. Reform also prioritizes services that support families before separation happens, including social protection, mental health support, and community-based services.

"Before we even talk about alternative care," Berhanu noted, "the goal of care reform is preventing the separation of children from their families in the first place."

Across countries, successful reform efforts share several common elements: strong gatekeeping mechanisms to ensure that children are separated from their families only as a last resort, investments in social work capacity, and sustained funding for community services. Without these, experts warn, children risk being moved out of institutions only to face instability elsewhere.

A global movement, unfolding unevenly

Although the direction of childcare reform is global, the pace and pathways vary widely. In parts of Europe, deinstitutionalization has been underway for more than two decades. In Africa, Asia, and Latin America, reform has gained momentum in recent years, driven by national policy shifts and evolving donor expectations.

In Rwanda, for example, SOS Children's Villages has shifted from village-based residential care to a mix of foster care, kinship care, small group homes, and short-term community-based services, working in close partnership with the government to reintegrate children into families.

In Nigeria, Botswana, Kenya and many more MAs, the SOS Childre's Villages' national association has begun relocating its families into surrounding communities, supporting foster and kinship placements, facilitating responsible reintegration of children to their families of origin and repurposing former residential facilities into services such as early childhood centres and family support programs.

Similar transitions are underway across the SOS Children's Villages federation, with national associations in countries including Colombia and North Macedonia closing or transforming residential villages while expanding family-based and prevention-focused models.

The challenges beneath the consensus

While there's growing agreement that institutional care is harmful, there's less agreement on how quickly it should be dismantled. Some advocates call for the rapid closure of all institutions; others argue for a phased transition to avoid placing children at risk before alternative systems are ready.

Funding remains one of the biggest obstacles. Too often, experts note, money allocated to institutions disappears when facilities close rather than being redirected to foster families, social workers, and community services. Workforce shortages, particularly trained social workers and foster caregivers, also slow reform.

There's also resistance rooted in history and emotion. Many caregivers, staff, and communities remain deeply attached to institutions that once symbolized safety and stability.

"The biggest challenge," said Lanna Idriss, CEO of SOS Children's Villages Worldwide, "has been convincing people who truly believed in the old model. People are usually risk-averse and want to stick with what they know."

Where childcare reform is headed

Globally, the direction of childcare reform is now clear, even if the road ahead is uneven. The conversation has moved beyond whether institutions should be replaced to how systems can transition responsibly and sustainably.

The childcare reform workshop concluded with the adoption of the Kigali Declaration on Child Care Reform, through which SOS Children's Villages national associations, partners, and others committed to accelerating care reform. The declaration emphasizes family strengthening, separation prevention, gatekeeping, safeguarding, and the responsible transition away from institutional care, aligning the sector around shared standards and accountability.

"There are different perspectives of childcare reform," Berhanu said. "If we want care reform to be holistic and systemic, we should engage with those actors who are supporting it, and those who've resisted it. And in this process, we need to make use of evidence available to inform our decisions, and to inform care reform planning and implementation."

For policymakers and partners, the message is that meaningful reform requires time, investment, and political will, but it also offers a chance to build systems that put children at the center.

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