Government vision and leadership in reducing the number of children in institutions, including children with disabilities – lessons learned and next steps. From 4th Child Protection Forum in Tajikistan, 2013.

1. Government Vision and Leadership in Reducing the
Number of Children in Institutions, including
Children with Disabilities – Lessons Learned and
Next Steps
George Kakachia
Head of Social Protection Department,
Ministry of Labour, Health and Social Affairs of Georgia
Dushanbe, 2013

2. • Total population - 4.2 million
• Child population - 979.500
• Children with disabilities- 9000
• Internally displaced persons – 300.000 (28% 0-18)
• Children not registered at birth – 8%
• Extreme child poverty (below 1 USD) -12 %
• Official child poverty – 28%
• Official poverty – 26%
Country Profile

3. Children were Overwhelmingly Institutionalized Because of
Poverty and Disability - 90% had a Living Parent

4. Deinstitutionalization and child care system reform launched in 2005
Several major steps have been taken under the framework of the Reform:
 Development and improvement of relevant legislation to reduce administrative
barriers for child’s reintegration into biological family, adoption and placement in foster
care;
 Defining of central responsible agency for child care and guardianship;
 Establishment of regional guardianship and care panels;
 Development of social workers profession and strengthening their role;
 Adoption of the child protection and deinstitutionalization action plan by the
Government of Georgia
Overview of the Reform

5.  Reduction of the number of orphanages from 47 to 3 and the
number of their beneficiaries from 5200 to 122
 Opening 44 small group homes (for 6-18 year olds)
throughout the country
 Financing prevention and reintegration programs
 Provision of free health care for children 0-5 years, and for disabled
children
0-18 years from 2012 and universal health insurance from 2013
 Strengthening alternative services: Foster care (emergency,
regular, specialized)
Overview of the Reform (Cont.)

6. THERE ARE THREE MAIN PRIORITIES OF THE REFORM:
 Reintegration of children living in the institutions into biological
families
 Provision of various social benefits as a preventive measures
against child abandonment
 Substitution of orphanages with alternative-family based services
like small group homes and foster care
Overview of Reform (cont.)

7. CHILDREN RETURNED TO FAMILY ENVIRONMENT
 77 children adopted
 1055 children placed in foster care
 353 children reintegrated to biological families
 44 small group homes with 329 children
 Number of social workers - 239
 The reintegrated families and children in foster care are
provided with health insurance
Results of the reform for 2013
(January-June)

8. Changes in Country’s Child Care Profile
Children in 2 Large Institutions (6-18)
(children with disabilities)
52
Children in 1 Infant Home (0-5)
Those with Disability
70 (total)
59
Children in 44 Small Group Homes 329
Children in Foster Care
(Including 104 Children with Disabilities)
1055
Children in Church Run Institutions
Approximatel
y 1000
2005 2013
Children in 45 Large Institutions (6-18)
4900
Children in 2 Infant Homes (0-5) 220
Children in Small Group Homes 0
Children in Foster Care 100
Children in Church Run Institutions
Approximately
1000

9. Children Living in Institutions Compared to Alternatives over
a 5-Year Period

10. New Frontier of Family Support Services for Children Supported by
the State
Early Intervention service for children
with disabilities
0
Foster care for children with
disabilities
20
prevention, food vouchers
200
Mother/baby shelters (places)
30
Social work services (basic)
80
Early Intervention service for children
with disabilities
150
Foster care for children with disabilities
100
prevention, food vouchers
450
Mother/baby shelters (places)
50
Social work services (basic)
240
2005 2013

11. Challenges and Plans Placement of Children in
Institutional Care
• Need for more preventive/family strengthening programs
• Lack of specialized foster care families for children with severe
disabilities and health needs
• Early identification and timely intervention for disabled children
• Identification and provision of services for disabled children based on
their individual needs
• Monitoring of the alternative services and ensuring of child care
standards
• Disability stigma

12. Next Notable Steps
towards the Reform in 2014

13. -Recommendations of the Committee on the Rights of the Child (from
2008) – still valid for children with disabilities:
1)Ensuring children with disabilities have equal access to education;
2) Making the necessary human and financial resources available;
3) Expanding community based programmes, including parent support
groups;
4) Undertake awareness raising campaigns;
5) and improving data collection.
Future Plans and Challenges - Focus on Disability

14. •Convention on Rights of Persons with Disabilities - already adopted; will
be ratified soon
•Reforming of the disability assessment system and replacement of
the ,,medical” model by the ,,social” model. Social approach is based
on assessment functional abilities and social needs of a person (child)
rather than diagnosis of the health condition.
Future Plans and Challenges - Focus on Disability (cont.)

15. • Completion of Deinstitutionalization for children with disabilities:
• Establishment of alternative community-friendly services for children with
special needs (specialized foster care; small group homes; palliative care)
• Establishment and further development of family support services (Early
intervention, day care, parent support services, etc) to reduce a risk of
separation
Future Plans and Challenges - Focus on Disability
(cont.)

16. - Success of the child care reform in Georgia is based on close cooperation and
coordination with International organizations, donors, local NGOs and
business community
- EU, UNICEF and USAID are the biggest contributors to the reform
Coordination of Activities with
Stakeholders

17. Thank You!