Chris Gray, Brian Pence, and POFO team featured in UNC News

New research finds institutions are 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.

Christine GrayDr. Brian Pence


Christine L. Gray, MPH, 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. Brian W. Pence, PhD, 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.

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

“Our findings suggest that eliminating institutional care may be removing a viable – and in some cases protective – placement option for vulnerable children,” Whetten said. “We need to use all of the available evidence to identify support services and appropriate care for children, rather than applying sweeping policies that may have unintended consequences, including a rise in street children and child-headed households.”

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