Children's homes: The nanny state EVEN on a sunny day Sarata Noua is a gloomy place. From 1969 until it closed in 2012 this orphanage in rural Moldova housed up to 152 children at a time. Young people aged between seven and 22 slept ten to a room, sharing a weekly shower in a dark bathroom. Though murals of tropical lakes brighten the walls, it still feels much like a workhouse. Around the world about 2m children are thought to live in institutions like this. The true figure may be bigger. Some, as in Moldova, are left over from Soviet times, when governments took responsibility for children born with disabilities (occasionally against their families" wishes). Indian orphanages often cater to unwanted girls, many of whom leave only when they marry. In China around 800 state-run "social-welfare institutions" house abandoned children or those with mild disabilities. Charities in Africa run institutions for those whose families have died in genocides or from HIV/AIDs. But one cheerful fact unites these dreary places - big children's homes are falling out of fashion. In Romania, once notorious for its decrepit orphanages, the number of children living in institutions has dropped from more than 32,000 in 2004 to about 9,000 last year. In Moldova the total fell by 62% between 2007 and 2012, to 4,393. In Rwanda the number of orphanages has declined from over 400 five years ago to only 33 in 2012 and the government has promised to close them all by 2014. Georgia had 41 institutions ten years ago; now it has three. Slower-moving countries are starting to catch up. India's government is looking at alternatives, says Shireen Miller of Save the Children, a charity. International pressure is rising. In December the American government pledged to help children worldwide stay within families or family-like care. Reform is essential, for three reasons. First, big institutions are poisonous. John Williamson of the Better Care Network, a charity, and Aaron Greenberg of the UN argue that for every three months that a child stays in an institution he or she loses one month of development. Since 2000 American academics have kept track of 136 children from orphanages in Romania. They have found that the IQ levels of children who remain in big care homes are lower than those put in foster care. Both groups had lower scores than those who were not institutionalised at all. Even fairly modern institutions often continue controversial practices. The Chisinau Municipal Institution for Babies in the capital of Moldova is currently home to 44 children. It is clean, light and bustling with nurses. Yet when a child arrives he or she is placed in an "isolator" - a double-glazed glass booth containing one or two cots. Some with disabilities have been isolated for nearly a year. A nurse says this helps the children adjust to their new home. Others think it stunts development. Second, orphanages can prevent children living with what family they have. Most institutionalised children are not truly alone - up to 90% have living parents, says Georgette Mulheir of Lumos, a British campaign group. In Sri Lanka almost all children in care have one or both parents living, reckons Save the Children. In Rwanda over a third of children in institutions are in regular contact with relatives, says Hope and Homes for Children, a British charity. These places are a way of dealing with poverty, says Silvia Lupan, a child-protection officer for UNICEF in Moldova. Third, institutions are costly. They need staff to cook, clean and corral the children, and cash to warm and maintain big buildings. Studies from the World Bank and Save the Children say institutions cost between six and ten times as much as supporting a child within a family. Sarata Noua cost $300,000 per year to run, says Liliana Rotaru of CCF Moldova, a charity that helped close it down. Foster parents, by contrast, earn about $1,000 a year. A cottage industry In order to close institutions governments must bolster the alternatives. Small homes housing around 12 children are better than huge ones, at least for those with no living relatives or very severe disabilities. Long-term carers work in those places, not a large staff on shifts. Mother-and-baby groups and day centres for struggling parents reduce the likelihood that youngsters will need government protection. When it is unavoidable, foster and adoptive care are the healthiest ways to supply it. But that requires authorities to vet prospective parents, and to check up on them. This is difficult where social-care systems are poor. In countries such as the Czech Republic social workers are valued mainly for handing out benefit payments, rather than as mentors and monitors, says Ms Mulheir. Teachers and nurses who work in institutions sometimes resist reform. In a few places with a lot of institutions fractious and unstable governments are holding up change; in some of them running an orphanage can be a lucrative business for the corrupt. These challenges mean a handful of countries are bucking the global trend. Venezuela and Ecuador are building big new orphanages. Though Viktor Yanukovych, Ukraine's president, talks about closing such places, his government still spends 1% of its GDP on institutional care, says Mr Greenberg. In China small but entirely unregulated children's homes are taking in large numbers of abandoned youngsters. In Kenya many people are simply unaware of the alternatives, says Stephen Ucembe, a charity worker. That means a lot of work for organisations such as CCF Moldova, which has helped create a space at the Chisinau Municipal Institution for Babies where mothers can come to care for their children during the day. A new resource centre will soon provide parents with advice and medical assistance. Hope and Homes for Children is training 28 of the 60 social workers employed in Rwanda. Yet reforms have come very late for some. Nicolae, a 16-year-old boy with mild disabilities who was at Sarata Noua, is now at home with his mother nearby. He is catching up at the local school with the help of extra classes and wants to become a mechanic. At the institution other children bullied him; he is enjoying school more. Anna, a 14-year-old girl, now lives with a foster mother in a tidy house an hour away from the institution. She is learning how to cook and enjoying independence. But change is hard. "I miss my friends," she admits. Their government granted both children a poor upbringing. Others have a chance to be luckier.