Yes. Over 100 years of research across neuroscience, psychology and public health consistently shows that orphanages harm children’s development, regardless of their funding level or quality of staff. The harm comes from the structure of orphanages themselves which cannot provide the stable, individual relationships children need to develop. Even well-run orphanages cause delays in brain development, attachment disruption, and long-term emotional and social harm.

No. Over 80% of children in orphanages have at least one living parent. The majority are separated not because of death, but because of poverty, disability, discrimination and the absence of adequate family support services. With the right help, most could be cared for by their families.

At least 5.4 million children are currently confined in orphanages around the world, though the true figure is likely higher as many are unregistered and unreported.

Children raised in orphanages are significantly more likely to experience cognitive and developmental delays, psychiatric disorders, difficulty forming relationships, social exclusion, and poor physical health. A systematic review drawing on more than 3.2 million people found that children with state care experience had more than double the mortality risk and more than three times the suicide risk in adulthood compared to those raised in families (Batty, Kivimäki and Frank, Lancet Public Health, 2022).

Families place children in orphanages primarily because of poverty and the absence of alternatives. They are often told an orphanage will give their child better food, education and healthcare, support that should have been provided to the family directly. The existence of orphanages removes pressure on governments to invest in the family support services that would keep children at home.

Children with disabilities are up to 17 times more likely to be placed in orphanages than their peers, rising to 30 times in Europe and Central Asia. Once placed, every harm described on this page is compounded. The UN Committee on the Rights of Persons with Disabilities made a formal legal determination that children with disabilities in Ukrainian orphanages face a disproportionate mortality risk. Children with disabilities need more individual responsive care than any orphanage can provide — not less.

Yes. Research shows significant recovery in cognitive development, emotional wellbeing and social functioning when children leave orphanages and enter family care. Children moved into family care show IQ scores averaging nine points above peers who stayed in orphanages sustained across 20 years of follow-up. Recovery is more complete the earlier it happens. Our own data from Rwanda, South Africa and Moldova confirms this recovery is achievable in practice.

The alternative is family-based care, whether with birth parents, extended family, foster carers or adoptive families, supported by strong community services that prevent unnecessary separation. Countries that have invested in family-based systems, including Bulgaria, Moldova, Romania and Rwanda, consistently achieve better outcomes for children at a fraction of the cost.

Yes, significantly. Orphanages are fixed locations that cannot evacuate quickly. In conflict, oversight collapses and children, already without a named adult to protect them, are acutely vulnerable to abduction, trafficking and forced recruitment. Research by Yale’s Humanitarian Research Lab found that the majority of an estimated 20,500 Ukrainian children forcibly transferred to Russia had been taken from orphanages. The same pattern is documented in Sierra Leone, the DRC and the Central African Republic.

Orphanages persist because they serve institutional and economic interests, not children’s interests. The voluntourism industry alone is estimated at US$2.6 billion per year. Many operate on business models dependent on donations and voluntourism, creating perverse incentives to maintain child separation rather than end it. Changing these systems requires sustained political will, investment in family-based alternatives, and the national reform programmes that Hope and Homes for Children supports worldwide.