Patronage Care for Every Family with a Young Child
UNICEF Bulgaria supports children and their families from the very earliest years
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The Challenge
The birth of a child is a beautiful and emotional moment, but for many families it also comes with a lot of questions, uncertainty and challenges. Parents often need support, guidance and reassurance, yet many families do not have access to such services. Existing systems do not always provide sufficient attention to parents’ mental health, the development of parenting skills, or support for early childhood development. This creates inequalities and leaves many families in vulnerable situations precisely at the time when support matters most.
What is UNICEF's solution?
Patronage care for pregnant women and families with children up to 3 years old
Since 2012, at the initiative of the Ministry of Health, UNICEF supports the development and introduction of the “Patronage Care for Pregnant Women and Families with Children up to 3 Years Old” service. Under the adopted methodology, Maternal and Child Health Centres were established in the regions of Sliven and Shumen within medical centres affiliated with regional hospitals. These centres provide free services to all pregnant women and families with young children who wish to use them.
Each Maternal and Child Health Centre operates with a multidisciplinary team consisting of a manager, social worker, nurses and midwives, a mediator, and drivers who support the delivery of the service, which is entirely based on home visits. All staff members undergo comprehensive initial and advanced training on working in home environments, promoting healthy practices and nutrition, creating safe and stimulating environments for children, and strengthening parents’ caregiving skills.
The specialists provide free home visits to pregnant women and parents of children under the age of three. Every pregnant woman is entitled to at least two home visits, while every family with a child under three can receive a total of five visits. Families facing additional risks - including those living in poverty, single-parent households, families from vulnerable communities, families with premature babies, children with disabilities or developmental difficulties - receive additional visits tailored to their specific needs.
During the home visits, patronage nurses and midwives provide information, counselling and support related to child health, breastfeeding, emotional and cognitive development, immunization, maternal mental health and positive parenting. They promote good childcare practices and assess the family environment, identifying risks such as developmental difficulties, violence or inadequate care. When needed, parents receive support in accessing health and social services. The programme also supports pregnant women with guidance on healthy pregnancies and assists uninsured women in accessing obstetric and gynecological care.
From the launch of the programme until the end of 2024, with the support of UNICEF and our donors and partners, the patronage care service has reached more than 16,700 families, while patronage nurses and midwives have carried out over 200,000 home visits. In 2024 alone, 2,895 pregnant women and mothers of young children received valuable information, guidance and health support from trained nurses and midwives through the home visiting programme.
The development and adoption of a national model for patronage care is included in several key national strategic documents, including the National Strategy for Child and Adolescent Health and Pediatric Care 2030, the National Programme for Improving Maternal and Child Health 2021–2030, the National Health Strategy 2030, the Action Plan for the Implementation of the European Child Guarantee Recommendation (EU) 2021/1004, and the Annual Plan for the Promotion of Early Childhood Development 2024. UNICEF continues to support the development of the national model to ensure that this critically important service becomes accessible to all families across the country.
