Reforming the system

The challenges of reforming child care systems in CEE/CIS

CEE/CIS countries began reforming their child care systems in the late 1990s with varying degrees of intensity and political commitment. Today, in principle, all countries have accepted ‘de-institutionalization’ as part of their reforms. Yet, again, the process has proven to be challenging and complex.

Growing number of children are being placed in public care despite lower birth rates. At the same time, the pace of ‘de-institutionalization’ has been slow. Moreover, official statistics do not take into account the high turnover rate whereby children are flowing in and out of the system without being counted. A Study in Romania (PDF) based on an institutional census in 1997 showed that as much as 5%-7.5% of Romanian children may have lived in a residential institution at some point.
Over the last 10 years, reforms of social welfare systems have increasingly included the development of family-based care settings such as guardianship and foster care. The number and share of residential placements among all child placements has been gradually decreasing--from more than 70% in 1990 to about 55% in 2002.
Total number of placements of children in public care in the CEE/CIS region and ratio between residential care and alternative care (graph)

Often welfare reforms have not paid enough attention to family separation. In Romania, it was common for parents to abandon their children in maternity hospital but reforms were put in place after a study revealed this problem.

Key issues in the slow pace of reform

UNICEF has identified five key issues behind the slow progress of reform to child protection systems and social welfare sectors in CEE/CIS.

• Decentralization and financing--Many residential care institutions are still financed and managed in a centralized manner. Delegation of responsibilities to the local level is slow, sometimes not supported with policy guidance, setting of standards and development of capacities and incentives for local planning and managing of services.

• Governance--The lack of checks and balances remain a challenge to the reform of child care institutions. Budgets for residential institutions are based on the number of clients and this financial incentive keeps institutions full and encourages corrupt practices such as false record-keeping.

• Political commitment--The responsibility for different residential institutions is often split between different ministries, such as social welfare, education and health. Reform requires a review and reallocation of responsibilities and budgets for child protection and social services, all of which requires strong political commitments.

• Funding—The cost of child protection reform is not budgeted for within the relevant sectors. Additionally, in early stages of reform, child protection and social welfare systems may have to carry both the costs for the old services and the setup of new ones. External guidance and incentives need to be consistent with each other and with national reform policies. They also need to be provided in a coordinated manner to support reform costs.

• Resistance to change—Residential care facilities have an inertia and even resistance to change common to large, traditional institutions—especially when change is aimed at their own transformation, diminishment and even demise. Reform requires setting up preventive services and supports for children and families at risk; alternatives to institutions; “gatekeeping” mechanisms that stem the flow of children into institutions; up-to-date knowledge and training as well as a change in mindsets for the whole range of personnel working in child protection and social welfare.