Progress of child care system reform By: Ms. Anna Nordenmark Severinsson, Child Protection Specialist, UNICEF Regional Office for CEE/CIS in Armenia, Belarus, Georgia, Moldova and Ukraine

Aim of the child care system reform Separation of children from biological families – an indicator of family vulnerability! Baseline: CEE/CIS - Separation and institutionalization continues to be among highest in the world:  210,000 children in formal care (out of 14 million children) Risk of separation: 1 in every 70 children Risk of institutionalization: 1 in every 140 children  Small children (below 3) – high rates in some countries!  Major reasons “poverty” and disability Reform goal:  Reducing the risk of separation  Reducing reliance on residential care for children considered at risk

UNICEF Regional office CEE/CIS 3

Emergence of a reform agenda

GDP per capita UNICEF Regional office CEE/CIS 5

What is under reform – reform benchmarks: Services (state and private):  Downscaling, transformation and closing down of residential care institutions:  Diversification of services – different types and equitable distribution across country: Family and child support services, with equitable distribution (day care, outreach with families, psychosocial support and counselling etc.) Family based substitute care services with equitable d(foster care, guardianship care etc.) Regulators defining how the system functions:  Strengthening of statutory functions (processes in the domain of the State): Planning, Monitoring and Evaluation of system performance and policy implementation Financing, budgeting (reallocation of resources towards community based services) Accountability and quality of system towards clients (standards, accreditation, inspection and complaints mechanisms) Decision making processes (case management), targeting of services and service purchasing  Development and strengthening of Governance (structures) to support efficient implementation of functions: Articulation of core functions at decentralized and centralized levels of governance and development of adequate capacity to implement these Improved coordination (clarification of mandates between sectors and improved inter-sectoral referrals)

Developing and reforming services 1.Downscaling, transformation and closing down of residential care institutions 2. Diversification of services

Transforming, downscaling & closing down residential care services Progress:  Policies and legal frameworks in place  All countries have been experimenting with closing down of institutions - the number of institutions reduced  Comprehensive national plans for transformation, downscaling and closing down of residential care services in 2 countries  Finding « new business » for institutions Remaining challenges:  Still main service provider in the system  DI is slow and inconsistent: DI policy but some private providers (NGOs) opening up in paralell  In most countries, still ad. hoc. efforts without an overall reform plan & dislinked from development of new services  Stroing pro-institution attitute by professionals and public  Sometimes without considerations of « best interests » of children

Diversifying services Progress in diversifying services at local level  Policy and legal documents favoring development of a continuum of services  Several new types of family and child support services in all 5 countries  New services established both as pilots and some integrated into public budget (but sometimes slow expansion)  Development of new types of family based substitute care services advanced in some countries (emerging in others)  Availability of family oriented benefits but relative low value and delinked from individual assessments of overall needs (cash and services)  Some services targeted at youth leaving formal care Remaining challenges  Need for further diversification of services - Inequitable distribution in countries (pilots, concentrated in major towns etc.): alternative family based substitute care not developing fast enough, prevention of family separation  Forecasting needs for services and planning the reform (Profile services, Magnitude of services, Targeted beneficiaries, Timeline, Place in the system and budgeting)

Strengthening and reforming system regulators 1.Statutory functions to support redirecting flows of services users to new services 2. Governance to support efficient implementation of system functions

Statutory functions - main achievements Progress in regulating the use of services towards community based- rather than residential services  National level gatekeeping mechansims starting to be strengthened in several countries (inter-ministerial commissions in all 5 countries, comprehensive databases in 2 countries, standards and inspections of services are emerging at least in 2 countries)  Local level gatekeeping functions (revision of mandates & new statutory services at local level, professionalization of social work, more and more individualized response to a child in difficulty, earlier identification of vulnerable families New ways of financing services  Specialised studies to forecast costs for new services in 3 countries  Introduction of results based budgeting  New innovative schemes (“Money follows the child” in Ukraine and “Voucher system” in Georgia) which need to be evaluated for impact on overall reform goals

Statutory functions - remaining challenges Establishing clear targets and benchmarks for the reform  Initial reforms starting with pilots, implemented without plans and management of process  Improvements needed in data collection and use of data for planning, establishing clear benchmarks, indicators and baselines  Need for systematic monitoring and evaluation of progress of policy implementation Improving regulation and targeting of services  National level gatekeeping functions need to be strengthened and enforced in several countries (standards for quality of services, accreditation, licensing of non-state services providers)  Strengthening and enforcing local level gatekeeping functions (should be compulsory, clarifying status and steamlining between different bodies, individual case management and follow-up on cases, complaints procedures) Redirecting resources from institutions to new services and budgeting of child care reform  Results based budgeting and “purchaser-provider” model yet to be implemented  Horizontal and vertical redirection of financial resources

Governance for efficient implementation of functions Changes in Governance to improve coordination and towards decentralization  Consolidation of mandates at central level  Decentralisation efforts Remaining challenges related to incomplete governance reforms and “decentralization before reforms”  A number of preconditions needed to make decentralization successful Remaining challenges to improve inter-sector cooperation and re-articulate child protection mandates in health and education  Joint response of health system and social protection sectors to infant abandonment  To clarify legal status of children de facto without parental care  Inter-disciplinary approach to supporting children with disabilities

Conclusions Reforms - initiated in all countries – reaching tipping point for stock taking and lessons learned, however need to operationalize policies and scale up pilots All countries are yet to establish a minimum of a continuum of services Uneven development and different focus of different countries Decentralization and budgeting reforms ongoing everywhere, but incomplete – need to capitalize on them and strengthen them for child care reform purposes Acceleration of reforms during crisis will create long-term positive effects:  Maximizing development potential for children  Investing in families and children in context of demographic changes;  Strengthening cost effectiveness of systems and maximizing results of budget spending All actors to agree on strategy to cover transition costs

Next steps Place child protection in its broader social welfare context Agree on national reform targets, benchmarks and indicators of progress Develop processes and mechansims for involvement of beneficiaties and staff of current services Regulating state and private service providers based on same standards Complementory data collection to make projections of needs of services Identify sources and methods for reallocating resources to new services Estimate cost of current system provisions and make projections for new system Address gatekeeping failures UNICEF Regional office CEE/CIS 15