What's Next congres 2016 - Delia Pop

The transition from institutional care to family and community based care Dr. Delia Pop Hope and Homes for Children

Moldova Romania

Bosnia

Bulgaria Belarus Ukraine

Mexico

Ghana

Uruguay Argentina

Sudan Rwanda

Russia

Uganda Kenya Ethiopia

South Africa

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35 countries 4 continents 150,000 children/year 81,000 children and adults supported 33,500 professionals and volunteers trained

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93 institutions closed through the development of 368 services

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Evidence of harm • • • •

Brain Development Attachment Behaviour & Psychosocial Cognitive

• Growth & Physical

Abuse & Neglect • The isolated and closed nature of institutions makes children particularly vulnerable to a wide range of abuse. Indeed, physical, emotional and sexual abuse has been reported as existing in a number of institutions worldwide (e.g., Barter, 2003; UNICEF, 2002). These include systematic rape and other forms of sexual abuse; exploitation, including trafficking; physical harm such as beatings and torture; and psychological harm including isolation, the denial of affection and humiliating discipline.

• Kazakhstan: 63% of children in children’s homes had been subjected to violence (Alternative Report of NonGovernmental Organisations of Kazakhstan, 2002) • Romania: almost half of institutionalised children confirmed beating as routine punishment, and more than a third knew of children who had been forced to have sex. (Stativa, 2000) • Ireland: 800 perpetrators were identified as having perpetrated physical and sexual abuse of 1,090 children in residential institutions between 1914 and 2000.

(Commission to Enquire into Child Abuse, 2009) • India: 52% of children in institutions were subjected to beatings and other forms of physical abuse. (Kacker et al 2007) • Middle East and North Africa: Children highlighted violence in institutions as a key concern for them in the 2005 Regional Consultation for the UN Study on Violence against Children. (UNICEF and National Council for Childhood and Motherhood, 2009) • North America: violence against children in residential institutions is six times more prevalent than violence in foster care (Barth 2002)

Negative impact on families

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Negative impact on society • Weakening of traditional family and community mechanisms supporting children at risk • High cost for poor outcomes • Reactive and creating demand “pull factor” • Inter-generational transmission of poverty

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5 Mitigating Factors 1. Age of entering institutional care • In the most severe institutional 2. Duration of institutionalisation environments, where 3. Nature of family care postparticularly harsh conditions and institutionalisation deprivation have a profound effect on development, 4. Motivated and supportive family complete recovery has only been environment of adoptive families 5. Placement stability is also important, observed so far in children who were placed in family-based care as children who have a long term before the age of six months stable placement and/or who are (Beckett et al 2007, O’Connor et placed within their own area are al, 2000). likely to do better.

What are the solutions? • Implement the principles of necessity and suitability and serve the best interest of the child • Replacing institutional care with a range of family strengthening and prevention services and family based alternative care services.

Rwanda 3323 children in 33 institutions 55% boys and 45% girls 0 – 43 years old – 11% aged 0-3; 25.9% aged over 18 37.5% children were aged 0-3 at the time of entry in institution 29.9% children spent over 10 years in institutions, avg. 13 years

Most frequently quoted reasons for institutionalisation: death of one or both parents, abandonment, poverty Children were referred by parents, relatives or by local authorities The majority of children are placed in institutions in their districts of origin Ă“DMP

Rwanda 1. The recruitment and training of professional social workers and psychologists in child care and protection; 2. Transitioning children living in institutional care to family and alternative care; 3. The creation of community-based family services and social protection supports to facilitate the family reintegration of children and child protection; 4. The prevention of unnecessary separation of other children from their families and necessary placement into suitable alternative care .

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Rwanda ① Engagement ② Assessment ③ Design & Development ④ Transition ⑤ Monitoring

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Rwanda 12 out of 33 institutions closed 20 involved in reintegration of children 2,177 out of 3323 children transitioned out of institutions 5 districts out of 30 launched a community based volunteers 78 social workers and psychologists recruited and trained Inshuti z’Umuryango identified in 17 district out of 30 ÓDMP

Achieving Systemic Change

Ingredients for success Systemic change is catalysed when conditions are created across the following four areas: ①Political will ②Know how ③Government and NGOs capacity to deliver for children ④Funding for transition It is NOT a sprint, it is a marathon! It is possible and has been demonstrated in varied contexts with success ÓDMP

Lessons learnt ①Common understanding of deinstitutionalisation ②Shared understanding of why ? And for whom? ③Engagement and broad raising awareness ④Targeted engagement for donors ⑤Competent national social workforce ⑥Systematic and strategic approach to transition ⑦ Transition is supported ⑧Community child protection and gatekeeping are developed ⑨Case management and quality assurance ÓDMP

Transition from Institutional Care • Transformative • With the community • Every institution unique • No child left behind • Specialised services • Inter-connected system