Nearly half a million children in Europe and Central Asia live in residential care facilities
Bulgaria has made significant progress with childcare reform with UNICEF support

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GENEVA, Sofia, 18 January. Nearly half a million children – or 456,000 – across Europe and Central Asia live in residential care facilities, including large-scale institutions, according to a new report published today by UNICEF.
Pathways to Better Protection: taking stock of the situation of children in alternative care in Europe and Central Asia notes that the rate of children living in residential care facilities across Europe and Central Asia is double the global average, with 232 per 100,000 children living in residential care facilities compared to 105 per 100,000 globally.
“We have a long way to go before ending Europe and Central Asia’s long and painful legacy of institutionalising children. While there have been some improvements, progress has been far from equal. Children with disabilities have largely been left behind,” said Regina De Dominicis, UNICEF Regional Director for Europe and Central Asia.
Western Europe has the highest rate of children in residential care facilities at 294 per 100,000 children – nearly triple the global average. While facilities in Western Europe tend to be small and integrated into communities, there remains an overreliance on residential care instead of family-based care. The higher rate is partly due to an increase in unaccompanied and separated children and young people seeking asylum in Europe in recent years.
The report also highlights some positive trends. For example, since 2010 many countries have seen a decrease in the proportion of children living in residential care facilities. In Bulgaria, Moldova and Georgia, data suggest that family-based care has become the dominant type of formal alternative care arrangement as governments pursued deinstitutionalisation policies and made significant investments in family-based care. In Türkiye and Romania, investments in prevention, family support and promotion of foster care helped reduce the number of children in certain types of residential care facilities, such as children’s homes.
Still, there has been little progress for children with disabilities who are far more likely to be placed in residential care facilities than children without disabilities. In countries where data is available, children with disabilities account for between 4 per cent and up to 87 per cent of children in residential care facilities. In more than half of countries with available data, the proportion of children with disabilities in all types of formal residential care has increased between 2015 and 2021.
In Bulgaria, the number of children in institutional care dropped from more than 7,500 to 202 as of end of December 2023. In 2000, when the Child Protection Act was adopted, there were 168 large-scale institutions for children (32 infant homes, 104 homes for children deprived of parental care and 32 homes for children with disabilities). Currently, there are only 4 medical-social care homes for children under the Ministry of Health which are envisaged to be closed by 2025. The number of social services for children and families has almost tripled - from 241 in 2010 to 725 in 2023. 1,548 children live in foster families and 4,057 are in kinship care as of October 2023.
„The negative impacts of family separation and institutionalisation on children’s health, development and well-being are well-documented. Children living in large-scale institutions often face emotional neglect and higher rates of abuse and exploitation, exposing them to mental health problems, psychological distress, and trauma. “, said Christina de Bruin Representative of UNICEF Bulgaria and added:
„Bulgaria achieved an significant progress in the child care system reform and I am pleased that UNICEF played a key role and supported the closure of the homes in Mogilino and Shumen and the development of innovative new models and services supporting vulnerable children and parents such as the Family Consultative Centres and foster care including for babies and young children“.
UNICEF is committed to continue supporting the national and local authorities and all stakeholders to close the remaining four infant homes and overcome the challenges related to ensuring quality of family-support and alternative services as well as improving the capacity of the child protection system and competencies of the specialists working with children and parents.
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