INSTITUTIONALIZED CHILD CARE IN URBAN SOUTH AFRICA

parental adult figures active in childrens’ lives who would be affected by a systematic
approach to child care. (Morgan, 2000) In some forms, aid and development bodies
sensed a need to adapt their language. UNICEF and USAID both moved from referring to
their target population as “children orphaned by AIDS” to “orphans and (other)
vulnerable children.” (UNAIDS, et. al., 2000)
The critique of institutions
Are institutions the best approach?
The discovery of the Romanian baby homes and their deplorable conditions has
had a tremendously negative effect on the public’s view of institutionalized child care.
This is reflected in much of the scholarship surrounding institutionalized child care across
international settings that aims to evaluate or critique the practice. The majority of studies
have covered populations of institutionalized children in search of malnutrition
indicators, psychological distress symptoms, or other signs of developmental challenges.
A good portion of these studies suggest inadequacy on the part of institutions through
statistical measures. The question of causality also remains in play. Most of the negative
factors often attributed to institutionalized child care are also linked with higher rates of
orphanhood.
It still remains that a large amount of literature surrounding institutionalized
children exists that describes poor psychological health and other undesirable outcomes.
Many negative effects have been seen in measures of child development. (MacLean,
2003; Smyke et. al., 2007) Many of the institutions that have been studied for food
security have revealed food shortages, a lack of quality nutrition, and malnourished
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