SummaryA country‐wide, cross‐sectional survey was conducted to determine the causes of institutionalization of Romanian children aged 0–3 years. A total of 628 children were sampled at random. Interviews were conducted with directors of institutions and records of each sampled child were reviewed. Each sampled child was given a brief medical and developmental evaluation.The children in Romanian institutions have one or more chronic health conditions. Their families have multiple, complex social problems. The referral to institutions usually involved a paediatrician (76% of children). Fifty‐four per cent of children were referred primarily from paediatric and maternity hospitals. The majority of children currently interned are likely to remain in institutional care. Implications for policy and re‐organization of health and social services are
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