Orphanhood in Romania became prevalent as a consequence of the Socialist Republic of Romania's natalist policy under Nicolae Ceaușescu. Its effectiveness led to an increase in birth rates at the expense of adequate family planning and reproductive rights. Its consequences were most felt with the collapse of the regime's social safety net during the 1980's Romanian austerity period, which led to widespread institutional neglect of the needs of orphans, with severe consequences in their health, including high rates of HIV infection in children, and well-being. A series of international and governmental interventions have taken place since the 1990s to improve the conditions in orphanages and reform the country's child protection system.