Noting the growing global consensus on the need to promote family-based alternatives to institutional care for children and adolescents, this report examines efforts to prevent the institutionalization of children in Argentina, Chile, Uruguay, Italy, and Spain, focusing on both public and private initiatives, as well as local and national policies. Following introductory remarks concerning deinstitutionalization as an integral part of a collective process of cultural transformation, the chapters are: (1) "Beyond the Orphanage: The Process of Deinstitutionalizating Children in Italy. Post-War Developments"; (2) "The Process of Deinstitutionalization in Spain"; (3) "Protection of Children's Rights at the Local Level in Argentina. The Case of Guaymallen: A Model under Construction"; (4) "Chile: The Use of Residential Institutions as a Form of Child Protection"; and (5) "Establishing a New Institutional Framework in Uruguay: The Community Level, Neighbourhoods and Social Assets." Each chapter gives an account of child institutionalization policies in the respective countries and shows that in order to reform policies and institutions, it is essential to strengthen policies and programs of inclusion and integration, tailored to suit the specific situations of the country concerned. The report asserts that the decentralization of social services in Spain and Italy has provided a structure for movement toward an approach based on the promotion of rights and protection. Residential institutions in Argentina, Chile, and Uruguay continue operation because of weaknesses in policies and the existence of complex institutionalizing circuits still embedded throughout the social system. The report maintains that reform involves using the local setting to establish a new approach to organizing and combining services to promote the community welfare. (KB)