‘Children in Exceptionally Difficult Circumstances’ (CEDC) are children whose basic needs for the necessities of life are not being met1. CEDC include children living in extreme poverty, orphans, child labourers, street children, children in institutions and child refugees2. CEDC have long been recognized by the United Nations International Children’s Emergency Fund (UNICEF) as a special public health concern1 probably because of their higher risk for physical and mental ill-health2. Nigeria is a country with a predominantly youthful population3. The majority of Nigeria’s youth live in an adverse social environment created by a combination of factors like extreme poverty, low literacy levels, high prevalence rates of HIV/AIDS, civil and religious conflicts, economic instability and poor social and welfare services. The combination of all these factors create a situation for a large number of Nigerian children to be described as ‘CEDC’4,5. Among the ‘CEDC’, children in institutions probably constitute a unique group because a probable outcome for most other categories of CEDC is the likelihood of ending up in institutions for care and protection. This is to be expected because most ‘CEDC’ experience a life of want, chaos, danger, instability, abuse and social isolation. These factors have been linked with a need for social interventions such as care and protection and associated delinquent behaviour,6,7,8 which are all important pathways to placement in institutions. Remand and borstal homes are the two