At home or in a home?
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Powerpoint for the launch of "At home or in a home?" - June 2011
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At home or in a home?
- 1. At Home or in a Home? Formal care and adoption of children in Eastern Europe and Central Asia Presentation by: Jean Claude Legrand, Regional Advisor on Child Protection, UNICEF RO for CEECIS
- 3. Good news and bad news… two in one!
- 4. Economic growth, but no decrease in separation
- 5. Hidden increase in use of residential care
- 6. Gatekeeping: How do children leave the institutions?
- 7. Adoption is an option but only for some…
- 8. Adoption is an option but only for some…
- 9. Who are the children?
- 11. Proportion of children w. disabilities in residential care
- 12. Children under the age of three
- 13. Proportion of children under three in residential care out of all children in res care.
- 14. Rate of children under three in residential care
- 15. Disclaimer… Example of Serbia trends in formal care
- 16. Next step? A Call for Action!
Notes de l'éditeur
- The report At Home or in a Home? that I am here to present today documents the trends in formal care and adoption of children in the 22 countries that constitue the region of Eastern Europe and Central Asia. This report is based on data provided by national statistical offices from twenty countries in Central and Eastern Europe and the Commonwealth of Independent States (CEE/CIS), collected through the UNICEF regional monitoring project, MONEE, and also using research undertaken in the region. While the report document some failures – the reforms of child care and protection systems that countries are engaged in for more than 10 years remain incomplete and have so far not resulted in any impressive way to bring change to the lives of those children who grow up in residential institutional care across the region. At the same time, it must be acknowledged that there have been real changes in this system. What this report shows is just how difficult reform turned out to be and how slow and uneven progress has been. To be fair, we need to acknowledge as well that there are many committed staff who really care about the children. But this is not enough, because of the institution in itself – the way it is organized and the way it reduces a child to a number. It can never be what a family is and give those children the family love they so crave. So in summary, the report reveals how much the Soviet legacy system continues to dominate the child care system in most countries, of this region including in some EU member states. The role EU has been playing in pushing for further reforms has been crucial in some countries. However, it has to be done with a level of causion to not put children at further risk through a too rapid de-institutionalization process. I hope that we will have, following on to the presentation of this report and the one of OHCHR, a constructive and fruitful dialogue on how EU can further influence reforms of child care systems towards de-institutionalizaion and diversification of services closer to the community. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- In spite of on-going reforms, the number of children in residential care in the region is extraordinary – the highest in the world. Altogether there are some 1.3 million children in different forms of family substitute care across CEE/CIS region, illustrating a high level of separation of children from their biological families. More than 626,000 children reside in these institutions in the 22 countries or entities that make up Central and Eastern Europe and the Commonwealth of Independent States, CEE/CIS. The proportion of children living in residential institutions who have no living parent is between 2% and 5%. Most commonly, children are placed in care because of disability, family breakdown, violence in the home, lack of social support systems, and poor social and economic conditions, including poverty. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- This slide has one good news and one bad news... 1. The good news: If we look at the ratio at national level of children placed in residential care as compared to family based care there is an increasing share of children who need formal care services who are placed in new family based services . It is an indicator that provides a good picture of where the emphasis is in terms of services for children without parental care and it seems that reform have favoured the development of some new services, mainly such services that can serve as alternatives to institutional care. This is good news! 2. At the same time, some bad news, which is of great concern: One of the main findings of the report, is that there is an overall increase in separation of children from their families. This graph shows the the rate of children in formal care is increasing. Formal care refers to all children in residential care or family-based care. The data analysed confirms that despite reforms to the child care systems that have begun in all the countries in the region, there has been no significant reduction in the use of formal care services. Only one country (Azerbaijan) has a decreasing trend. . This is an important indicator of family vulnerability as it shows that families are increasingly using formal care services for their children. In conclusion: Since the overall rates of separation are still going up, efforts to develop family and child support services to prevent family separation and harm may have not been enough. It may also mean that development of new services – whatever they are may not really have targeted specifically those children who are already users of existing services. Also, the Report notes that the development of family based alternative care has been slow: While it is expanding residential care is not diminishing. The number of children living in family based care in CEE/CIS has gone up from 43 per cent of all children in formal care in 2000, to 51 per cent of all children in formal care in 2007. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- This slide is very similar to the one you just saw. It shows the overall rate of children in formal care in CEE/CIS region. However, here we combine it with the GDP trend for the same countries. Now, this graph has only data up until 2007, which was before the global economic crisis hit so hard on our region. However, it is still interesting to see that, during the years that are showed in this graph there was economic growth in these countries. However, economic growth or not, there continued to be an increasing trend of children who were placed in formal care services (institutional care but also new family based care). It means that economic growth in itself was not enough to impact on family vulnerability , but it is rather policy choices that matter. We are just getting the data for 2009 which is the first year we will probably see an impact also of the economic crisis. One clear message of the report “At Home or in a Home” is that, even if poverty is often reported as an important reason to why families hand over their children in formal care, it is not the only cause of separation. Single parenthood, migration, deprivation of parental rights, disability of the child are other factors which are often mentioned as causes. But behind these terms hide many different realities which often melt down to a general lack of access to free-of-charge social services. Often families are simply seeking day-care facilities to be able to work, or educational facilities in the localities where they live. When they find such services unavailable, or inaccessible, they resort to boarding schools or institutions instead. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- NB. Many countries report proudly on a decrease in numbers of children in formal care however, in the two previous slides we have used the rate of children in formal care. It is a safer indicator to measure trends over time because it also takes into account any potential decrease (or increase too for that matter) of the child population during the same time. This slide actually shows you the difference between the changes over time in numbers of children in residential care 8so in the type of care where we would like to see a decrease), as compared to the changes over time in the rate. It shows a hidden increase of residential care in most countries: An analysis of trends suggests that the total number of children in residential care in CEE/CIS has fallen between 2000 and 2007, from 757,000 to 626,000 children. However, as the birth rate in the region has also dropped dramatically, the numbers are less encouraging than they may seem. The rate of children in institutional care in CEE/CIS has on average been almost stagnant since 2000, following a longer-term upward trend since the early 1990s. We estimate that 859 children per 100,000 were living in residential care in 2007, which is about the same as the 2000 rate (861). This graph shows the regional average. I would like to note however, that it hides important differences between countries. A closer look reveals that in 12 countries the rate of children in institutional care increased between 2000 and 2007, while in 8 countries it decreased . This means that despite ongoing reforms, residential care is becoming more frequent in more than half the countries. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- Patterns of out-flow of children from residential care raise important questions about gate-keeping: Children are recorded as leaving institutions either because they have turned 18 years of age and enter the community as an independent adult, are reunited with their biological family, are adopted or benefit from family-based alternative care. However, some are transferred from one institution to another, and often these transfers are not registered in the statistics, thereby overestimating the true number of ‘leavers’. There are large variations between countries, but overall there is a concern that large proportions of children are entering or leaving institutions without such moves being made in the best interest of these children. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- This is the graph from At Home or in a Home… do you prefer this one? It shows: Domestic adoption is a new phenomenon in many countries of the region. In 2007, 28,000 children were adopted in CEE/CIS, about two thirds of whom were adopted within their own country and one third abroad. The numbers confirm what is already known, that domestic adoption needs further development in CEE/ CIS. The number of national prospective adoptive parents has been low in recent decades, especially during the transition in the early 1990s when many families were affected by increased poverty levels. Strong extended family ties have meant that children are often cared for by relatives (whether formalised or not) rather than adopted. Finally, there is still a stigma associated with bringing up children outside their birth families. MONEE data suggest that in the countries where domestic adoption has nevertheless been relatively common, rates display a longer-term downward trend. The findings suggest that domestic adoption is an increasingly underused alternative for children without parental care Adoption is an option but only for some: In 2007, 28,000 children were adopted in CEE/CIS, of which about 75 per cent were adopted within their own country (domestic adoption) and the remaining 25 per cent were adopted abroad (intercountry adoption). The findings suggest that additional efforts are required to establish transparent procedures for domestic adoption and to incorporate it within national social policies (child benefits), as is currently done in the Russian Federation. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- This is an alternative slide to the previous one – it has more recent data and includes the Eu memberstates which are part of MONEE. Domestic adoption is a new phenomenon in many countries of the region. In 2007, 28,000 children were adopted in CEE/CIS, about two thirds of whom were adopted within their own country and one third abroad. The numbers confirm what is already known, that domestic adoption needs further development in CEE/ CIS. The number of national prospective adoptive parents has been low in recent decades, especially during the transition in the early 1990s when many families were affected by increased poverty levels. Strong extended family ties have meant that children are often cared for by relatives (whether formalised or not) rather than adopted. Finally, there is still a stigma associated with bringing up children outside their birth families. MONEE data suggest that in the countries where domestic adoption has nevertheless been relatively common, rates display a longer-term downward trend. The findings suggest that domestic adoption is an increasingly underused alternative for children without parental care Adoption is an option but only for some: In 2007, 28,000 children were adopted in CEE/CIS, of which about 75 per cent were adopted within their own country (domestic adoption) and the remaining 25 per cent were adopted abroad (intercountry adoption). The findings suggest that additional efforts are required to establish transparent procedures for domestic adoption and to incorporate it within national social policies (child benefits), as is currently done in the Russian Federation. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- Children with disabilities represent a large proportion of all children in residential care: More than one third of all children in residential care are classified as having a ‘disability’. The number of children with disabilities in residential care has remained remarkably stable over the past 15 years, suggesting that little has been done to provide non-residential alternatives for them. Although there are differences in the diagnosis and classification of mental or physical disabilities between countries, as well as differences in the methodologies used for collecting statistics on disability, figures indicate that at least 230,000 children with disabilities or classified as such, were living in institutional care in CEE/CIS in 2007. This is equivalent to 315 per 100,000 children. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- This is an alternative slide to the previous one. It is not included in At Home or in a home. This shows the proportion of children with disabilities in residential care in 2009 out of the total number of children in residential care, in the countries we have complete data for (including the EU member countries that are part of MONEE). Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- Institutionalization of infants and young children is still too common: The institutionalization of infants is a serious concern because of the damaging effect it has on the young child’s health and development. Across the region, the loaded term ‘abandonment’ is often used to describe the reason these babies are in residential care. However, hidden behind many of the cases of ‘ abandonment’ are stories of mothers or parents whose decision to hand over their children was taken because they lacked support or advice. Sometimes they were even encouraged by the hospital staff to do so. Data analysed in this report show that in 2007, institutionalization rates of infants and young children were particularly high in 8 countries. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- This is an alternative slide to the previous one. It is not from At Home. This slide is based on data from 2009 and includes EU member states part of MONEE Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- This graph is not in At Home… It shows trends over time in the Rate of Children under three in residential care in selected countries (including the EU member states included in MONEE). Interesting to note: A sharp increase in some countries can be noted since 2008 – can be linked to the effect of global economic crisis? Countries concerened include: Bosnia and Herzegovina, FYR Macedonia and Taijikistan. Romania also has an increase but trend started earlier, in 2006. Please note the logarithmique scale of the graph (it was the only way to show all countries with such difference in value in one single graph) Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- We would like to bring to your attention that data presented in the report At Home or in a Home dates up until 2007. Therefore, all findings in this report do not take into account the effects of the global economic crisis and any recent progress which child care refroms may have contributed to. Also, any recent good progress which refroms of child care systems have contributed too, are not visible in the statistics I have just shared with you. In Serbia for example which is a very interesting case where the child care reform has acelerated in recent years with EU and UNICEF’s support, focused efforts to provide family based services to children with disabilities, to prevent abandonment in materntity wards and to de-institutionalize existing residential care institutions seem to have showed result. The graph above, which is not from At Home or in a Home, shows some of the results such work has lead to. There is an impressive trend of increasing use of family based care, and a simoultanous reduction in the use of residental care. In Serbia the number of children in institutions were 5,655 in 2007, however in December 2010, this number is 1,131. The reduction in the rate of children in residential care is also impressive, from 347 in 2007 to 73 in 2010! The new social welfare law adopted in April 2011 forbids the placement of children under three in residential care which is a measure that we think will drastically reduce the overall inflow of children into institutional care. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- It is time to reform the system now, once and for all The Way Forward: five core interventions • Legislative changes limiting to last resort, and setting strict conditions for, the placement into institutional care of children below three years; • Allocation of resources giving priority to the development of appropriate local services allowing alternative solutions for children below three with special attention to the needs of children with disabilities; • Proper budget allocations for supporting vulnerable families through the development of appropriate familybased responses and services; • Capacity-building and standards of practice for maternity ward and paediatric hospital staff to support parents of newborns with a disability and parents from most vulnerable groups, in order to discourage institutionalization; • Partnership with media and civil society to promote social inclusion of children deprived of parental care and children with disabilities. Child protection in CEE/CIS UNICEF Regional Office CEE/CIS
- Child protection in CEE/CIS UNICEF Regional Office CEE/CIS