Woman and a young child

A summary of evidence on orphanage tourism

Whilst the true extent is unknown, it is estimated that as many as 8 million children across the world live in residential care institutions, also known as orphanages. UNICEF collated data from 140 countries showed that at least 2.7 million children were living in orphanages, however recognised this was only the ‘tip of the iceberg’ as large numbers of children in unregistered orphanages were not counted.1, 2  

Over 80% of children living in orphanages have at least one living parent, with poverty being the main underlying reason children are placed in care3, 4.  Other common reasons include, disability, access to education, abandonment and discrimination5. Children with disabilities are at high risk of being abandoned and placed in orphanages. 6,7 This is often due to stigma or because families do not have access to the social, health and educational services they need to support their children. 8,9  Children with disabilities are also more likely to experience violence or abuse in orphanages.

The United Nations Convention on the Rights of the Child and the Convention on the Rights of Persons with Disability make clear that children should grow up in a family environment and that priority should be given to support the child’s parents and extended family to enable them to care adequately and to prevent unnecessary separation. Poverty should never be the sole reason for removing a child from their family. 10,11

Orphanages are an inappropriate response to poverty.3  Caring for children in orphanages is between six and 10 times more expensive than hiring social workers to strengthen families and three to five times more expensive than foster care. 12,13  

Orphanages are ill-equipped to meet children’s needs and are known to negatively impact children’s cognitive, social, emotional and physical development. 3,14,15 They do not enable children to form a secure attachment with a primary caregiver and are associated with attachment disorders. 16 These impacts are more severe for younger children and increase with the time spent in care. 17,18   

Impacts of growing up in orphanages can continue to affect young people well into adulthood. They are more likely to experience mental health problems, struggle to form healthy relationships and adapt to the demands of independent living 14,19,20. A study which looked at outcomes for care leavers from Russian orphanages found that 20% had criminal record, 14% were in prostitution and 10% had committed suicide 21,22. Another study found that young people who left orphanages in Moldova were 10 times more likely to be trafficked. 23 

Children who live in orphanages were also found to be at increased risk of violence, abuse and neglect.7 A study conducted in five countries showed that 50.3% of children in orphanages had experienced physical or sexual abuse. 24 Another study found that 36% of children were emotionally abused and 57% emotionally neglected.25  

Orphanage voluntourism and foreign funding create a demand for children to be in orphanages 26. Some orphanages receive funding per child or depend on volunteer donations, which creates an incentive for them to recruit children into care. 27,28  Parents are offered money to give up their children or are coerced, enabling corrupt orphanages to profit through donations or child trafficking. 29  An analysis of the global volunteering market conducted in June 2018 identified the top 10 global orphanage voluntourism hot spots Nepal, Kenya, Ghana, Cambodia, Tanzania, Uganda, South Africa, India, Peru and Costa Rica. The USA, UK and Australia and are the top three countries sending volunteers to orphanages overseas. 30 


1.Pinheiro, P. S. (2006). World report on violence against children. Geneva: United Nations Secretary-General’s Study On Violence Against Children. https://www.unicef.org/violencestudy/
2. Petrowski, N., Cappa, C. & Gross, P. (2017). Estimating the number
of children in formal alternative care: Challenges and Results. Child Abuse and Neglect, 40, 388-398. https://doi.org/10.1016/j. chiabu.2016.11.026 (See also: https://www.unicef.org/media/ media_96099.html) 
3. Williamson, J. & Greenberg, A. (2010). Families, Not Orphanages. Working Paper, September 2010 https://bettercarenetwork.org/library/particular-threats-to-childrens-care-and-protection/effects-of-institutional-care/families-not-orphanages
4. CRS. (2017). Finding Families: The state of residential care for children and implications for human development. A research review. Catholic Relief Services. 
5. Csáky, C. (2009). Keeping children out of harmful institutions: Why
we should be investing in family-based care. London: Save
the Children. https://bettercarenetwork.org/library/particular-threats-to-childrens-care-and-protection/effects-of-institutional-care/keeping-children-out-of-harmful-institutions 
6. Better Care Network and EveryChild (2012). Enabling Reform: Why supporting children with disabilities must be at the heart of successful child care reform. https://bettercarenetwork.org/library/particular-threats-to-childrens-care-and-protection/children-with-disabilities/enabling-reform-why-supporting-children-with-disabilities-must-be-at-the-heart-of-successful-child
7. Sherr, L., Roberts, K. J., & Gandhi, N. (2017). Child violence experiences in institutionalised/orphanage care. Psychology, Health & Medicine, 22(sup1), 31-57. 
8. Browne K. D., Hamilton-Giacritsis C. E., Johnson, R., & Chou, S. (2005) Young children in institutional care in Europe. Early Childhood Matters, 105: 15–18. 
9. Mulheir. (2012.) Deinstitutionalisation. A human rights priority for children with disabilities. The Equal Rights Review.Vol. 9. 2012. Retrieved from. http://www.equalrightstrust.org/ertdocumentbank/err9_mulheir.pdf. Accessed Friday 9th November 2018. 
10. United Nations. (1989) Convention on the Rights of the Child. http://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx.  Accessed 4 April 2018
11. UN General Assembly, Convention on the Rights of Persons with Disabilities, 13 December 2006, A/RES/61/106, Annex I, available at: http://www.refworld.org/docid/4680cd212.html [accessed 8 October 2018]
12. Carter, R. Family matters: A study of institutional childcare in Central and Eastern Europe and the former Soviet Union, EveryChild, London, 2005. https://bettercarenetwork.org/toolkit/developing-an-informed-national-care-strategy/reducing-institutionsincreasing-community-based-care/family-matters-a-study-of-institutional-child-care-in-central-and-eastern-europe-and-the-former 
13. Gow, J. & Desmond, C.J. (2002) Impacts and interventions: the HIV/AIDS epidemic and the children of South Africa. In: Gow, J. & Desmond, C.J. <i>Impacts and interventions: the HIV/AIDS epidemic and the children of South Africa</i>. Pietermaritzburg: University of Natal Press. 111-143.
14. Berens, A. E., & Nelson, C. A. (2015). The science of early adversity: is there a role for large institutions in the care of vulnerable children? The Lancet, 386(9991), 388-398. 
15. Schoenmaker, C., Juffer, F., van IJzendoorn, M. H., & Bakermans- Kranenburg, M. J. (2014). Does family matter? The well-being of children growing up in institutions, foster care and adoption. In Handbook of child well-being (pp. 2197-2228). Springer Netherlands. 
16. Browne Kevin, Hamilton-Giachritsis Catherine, Johnson Rebecca, Ostergren Mikael (2006). Overuse of institutional care for children in Europe  BMJ 2006; 332 :485
17. Van Ijzendoorn, M. H., Luijk, M. P. C. M., & Juffer, F. (2008). IQ of children growing up in children’s homes: a meta-analysis on IQ delays in orphanages. Merrill-Palmer Quarterly, 54(3), 341–66. 
18. Merz, E. C., McCall, R. B., Wright, A. J., & Luna, B. (2013). Inhibitory control and working memory in post-institutionalized children. Journal of Abnormal Child Psychology, 41(6), 879-90. doi: 10.1007/s10802-013-9737-9. 
19. Rutter M, Colvert, E., Kreppner, J., Beckett, C., Castle, J., Groothues, C., Hawkins, A., O’Connor, T. G., Stevens, S. E., & Sonuka-Barke, E. J. S. (2007). Early adolescent outcomes for institutionally- deprived and non-deprived adoptees. I: disinhibited attachment. Journal of Child Psychology and Psychiatry, 48(1), 17–30. 
20. Pitula, C. E., Wenner, J. A., Gunnar, M. R., & Thomas, K. M. (2017).
To trust or not to trust: social decisionїmaking in postї institutionalized, internationally adopted youth. Developmental Science, 20(3). 
21. Pashkina (2001). Sotsial'noe obespechenie, 11:42–45. Cited in Holm-Hansen J, Kristofersen LB, Myrvold TM eds. Orphans in Russia. Oslo, Norwegian Institute for Urban and Regional Research (NIBR-rapport 2003:1). 
22. Holm-hansen, Kristoffersen & Myrvold. (2003). Orphans in Russia: Policies for family-like alternatives. Norwegian Institute for Urban and Regional Research
 23. ILO-IPEC. (2007). Trafficking and other Worst Forms of Child Labour in Central and Eastern Europe (Phase II), Technical Progress Report, Geneva, August 31, 2007, 5.
24. Gray, C. L., Pence, B. W., Ostermann, J., Whetten, R. A., O’Donnell, K., Thielman, N. M., & Whetten, K. (2015). Prevalence and incidence of traumatic experiences among orphans in institutional and family-fased settings in 5 low- and middle-income countries: A longitudinal study. Global Health: Science & Practice, 3, 395–404. doi:10.9745/GHSP-D-15-00093 
25. Pinto, R. J., & Maia, Â. C. (2013). Psychopathology, physical complaints and health risk behaviors among youths who were victims of childhood maltreatment: A comparison between home and institutional interventions. Children and Youth Services Review, 35, 603–610. 
26. Rotabi, K., Roby, J., & Bunkers, K. (2016). Altruistic exploitation: Orphan tourism and global social work. British Journal of Social Work. doi:10.1093/bjsw/bcv147 
27.  Martin and Sudrajat (2007). Someone that Matters, Save the Children, Ministry of Social Affairs of the Republic of Indonesia and UNICEF.
28. Better Care Network (2017). Violence Against Children and Care in Africa: A Discussion Paper. New York. https://bettercarenetwork.org/library/particular-threats-to-childrens-care-and-protection/child-abuse-and-neglect/violence-against-children-and-care-in-africa-a-discussion-paper
29. van Doore, K. E. (2016). Paper orphans: Exploring child trafficking for the purpose of orphanages. International Journal of Children's Rights, 24, 378-407.
30. Howe-Ely, M (2018) Informal research commissioned by the Better Care Network into the prevalence of the terms ‘orphan’ and ‘orphanage’ among international volunteer travel organizations.