Pathways to better protection
Taking stock of the situation of children in alternative care in Europe and Central Asia
The purpose of this report is to provide contextualized analysis of the situation of children in alternative care and adoption in Europe and Central Asia on the basis of TransMonEE data and other sources. It takes the form of an analytical report card that can be used for priority-setting and decision-making for international and national child protection policies and programmes and for achieving better outcomes for children, especially socially excluded children. The main audience of this report is regional partners, national governments, academia, and civil society actors, including care leaver associations and networks as well as child and youth advisory boards.
It should be noted that – in keeping with the Guidelines on Alternative Care for Children (United Nations, 2009) – children in adoption are not considered to be in alternative care, as their legal and care situation is equivalent to that of children who are in the care of their birth parents. Children who enter adoption, however, usually do so from different types of alternative care, including pre-adoption placements with their future adoptive parents, so data on adoption is important as they provide information about the outcomes of alternative care for some children. Throughout this report, the term ‘adoption’ will only be used to refer to children who are legally adopted. Otherwise, the report focuses mainly on children in formal alternative care, which is made up of residential care (including family-type residential care homes) and family-based care (including foster care, kinship care and other types of family-based care, such as guardianship care).
UNICEF last issued a comprehensive regional report on the situation of children in alternative care and adoption in 2010 with ‘At home or in a home’, a report which was focused on the countries of Eastern Europe and the Caucasus. Since then, a draft statistical manual, including a core set of child protection indicators, was developed based on a comprehensive desk review, indicator testing, and regional consultation. The statistical manual includes a revised set of TransMonEE child protection indicators and was discussed and agreed upon at a TransMonEE meeting in 2019. This report aims to follow up on the 2010 report and update the understanding of the situation, using data gathered in line with the revised statistical manual, while also reflecting on challenges relating to indicators and data on children in alternative care and ways that they can be addressed.
The changes to the TransMonEE indicators and data collection and reporting processes and protocols based on consultations and testing of indicators have resulted in data improvements in several countries in the region. To enable better use of the available data, there is a need to contextualize the data for a better understanding of the situation of children in alternative care and adoption in the region and, eventually for better policymaking. The TransMonEE indicators mostly fall within the ‘Family Environment and Protection from Violence and Harmful Practices’ domain of the new UNICEF (ECA) child rights monitoring framework which is intended to harmonize data collection across a range of domains and indicators relevant to global and European child rights frameworks.
The availability, quality, and comparability of data and indicators on children in alternative care have been studied by the Conference of European Statisticians and by Eurochild and UNICEF in their joint DataCare project. The results show that the countries studied all collect some data on this group of children, but that methodological work and common guidelines for data collection and reporting are required to improve data quality and international comparability. There are also several European Union initiatives, such as the European Child Guarantee, that identify children in alternative care as a group of children who are being left behind and facing disadvantages that create barriers to social inclusion and increase their risk of poverty. They too have highlighted the challenges of comparable data relating to children in alternative care. At the same time, they create an opportunity for countries to integrate this group of children into their national Child Guarantee action plans and monitoring and evaluation frameworks and to invest in data improvement actions.
This report draws on the findings and recommendations from all of these initiatives. There is a growing awareness in the child protection and child care professional community globally that while access to good data can improve decision-making, statistical data alone have limited value in monitoring alternative care for children. Official statistics tend to report on single episodes of care and offer a series of ‘snapshots’ at specific points in time. TransMonEE data share these constraints as TransMonEE offers statistical data on children in alternative care at specific points in time and during specific periods of time (for example, the number of children entering a given type of alternative care during the year) but cannot offer information about outcomes for specific children or their pathway through the alternative care system. It can, however, through disaggregation by sex, disability, and age, begin to identify which groups of children in formal alternative care in different countries may need greater attention from decision-makers at all levels. As the guidance of the Conference of European Statisticians notes, administrative data ‘cannot address information about outcomes nor about determinants of wellbeing for children in pre-, in-, and post-care’. Additionally, these data have limitations for international comparison due to their primary focus on gathering information for management and monitoring the performance of national systems. They can, nevertheless, offer timely, relatively low-cost basic information about children in alternative care including children outside family-based care who are not usually captured in census or household surveys.
After the 2019 revisions, the TransMonEE direct data collection from countries is limited to those indicators that concern potentially vulnerable groups of children, about whom it is not possible to find data elsewhere. Children in alternative care are one of these groups. The countries that directly participate in TransMonEE provide data from their systems of alternative care for children and adoption. Collecting and reporting disaggregated data on this group of children is part of the countries’ reporting duties to the CCRC and the Committee on the Rights of Persons with Disabilities (CCRPD). The countries that are also European Union (EU) member states additionally have reporting responsibilities relating to a number of indicators related to children (but not specifically children in alternative care) to the European Statistical Office (Eurostat), and they pursue European standards in their data management systems and government statistics in line, for example, with the European Statistics Code of Practice. At the time of writing, there are no EU-wide reporting obligations on children in alternative care.
The Sustainable Development Goals do not have specific targets and indicators relating to children in alternative care or adoption, but all countries monitor SDG implementation, and some indicators and targets, especially those on violence against children, relate indirectly to the situation of children in alternative care. Evidence indicates that violence, neglect, and abuse are among the factors driving the placement of children in alternative care, and children in alternative care are more vulnerable to violence. Where relevant and available, this report also draws on SDG monitoring data.
Factors leading to the entry of children into alternative care in the region are well documented and include social and economic factors such as poverty, the systematic exclusion of children with disabilities or children from ethnic or other minority groups, parents being in custody, and children being on the move as refugees or as economic migrants.
Other factors relate to the system of child protection, family support, and alternative care itself, with the ongoing challenge of strengthening the social work and social service workforce and developing policies and programmes that can prevent the need for placement into alternative care in the first place, as well as providing suitable alternative care for children who need it. TransMonEE data alone cannot identify factors driving children into the systems of alternative care in the region, but they can provide analysis of the population of children currently in alternative care or entering adoption in terms of a range of characteristics such as age, sex, and disability. Survey and census data and thematic research or monitoring reports by child rights monitoring institutions can help to complete the picture provided by TransMonEE and, together they offer the opportunity for producing regular report cards that can address the following key questions:
About children in alternative care and in adoption in the ECA region:
- What do we know about the profile of children placed in alternative care and adoption? Are there particular groups who are over- or under-represented – by age, disability, sex, or other characteristics (such as migration status) – in different types of alternative care (residential or family-based care)?
- Are there significant differences between countries, forms of care, or subgroups of children that require the attention of decision-makers?
- What are the trends in rates of children in formal residential and family-based care and adoption? In entry and exit?
- What do we know about family support and prevention of unnecessary family separation, suitable alternative care, quality of alternative care, and reintegration/reunification with their family or family network?
- What do we know about outcomes for children in alternative care and care leavers?
About data systems:
- What are the national, regional, or international reporting requirements for countries in the region when reporting on children in alternative care, including the CRC, SDGs and CRPD?
- What lessons can be learned from global and regional child protection data system reforms? What progress is being made in the development of internationally endorsed norms, definitions, classifications and measurement tools for reporting on children in alternative care?
- Are there promising/good examples from inside or outside the region of sustainable family environment data ecosystems, data quality management, interoperable data systems, and linking of administrative data with survey-based data?
- What are priority actions for strengthening data systems and improving data in the region to effectively monitor and evaluate the results of family environment policies and programmes for children?
The report is broadly structured around these questions. Chapter 2 briefly presents the methods and constraints relating to the data used in the report from TransMonEE, as well as other sources. Chapter 3 offers the latest data on children in alternative care globally and how the ECA region fits into the global picture. Chapter 4 presents the findings from contextualized, secondary analysis of the latest TransMonEE data for 2021 (published in 2022) alongside, where relevant, other data sources. Chapter 5 presents a discussion of key lessons and issues related to alternative care data systems that can be drawn from the TransMonEE analysis as well as other data sources and initiatives. Chapter 6 presents key conclusions and recommendations for priority actions to strengthen alternative care data systems in the ECA region, building on work done.
Main findings, conclusions and recommendations
Children in alternative care and adoption
According to UNICEF estimates based on data from national surveys and social service administrative records, there are still nearly half a million children (around 456,000) living in residential care in the Europe and Central Asia region. This is equivalent to a rate of 232 per 100,000 children aged 0-17 years and is the highest rate of all regions worldwide and is higher than the global average of 105 per 100,000 children.
The rates of children in formal alternative care have reduced since 2010, but the rates have not changed substantially in many countries since 2015.
The proportion of children in formal alternative care, including residential care and family-based care, has reduced considerably since the ‘At home or in a home’ report published in 2010 using data from TransMonEE 2007. Since 2015, the pace of reduction has decreased in most countries reporting data to TransMonEE, and the rate has not changed substantially in this period. Latvia, Lithuania and the Republic of Moldova are exceptions where a steady decrease in the rate of children in formal alternative care is notable. Overall, the formal alternative care rates in many of the countries in the TransMonEE network are now within the range of the rates reported by other European countries.
The composition of the types of care available in the formal alternative care system has changed substantially.
There is a greater proportion of children in formal family-based care, especially foster care, than previously and a smaller proportion of children in residential care. In 2010, on average, an estimated 859 children per 100,000 population aged 0-17 years were in residential care across the region, according to the ‘At home or in a home’ report. Fourteen years later, TransMonEE data for 2021 indicate a very different situation. The highest residential care rate in the region has fallen below 700 children per 100,000 population aged 0-17 years. In 15 out of 23 countries for which there are data for both formal family-based and residential care, more than two-thirds of children in formal alternative care were in formal family-based types of care in 2021. These changes in the composition of the formal alternative care system are the result of governments implementing deinstitutionalisation policies and programmes.
There is a need to revise historical TransMonEE data using the TransMonEE standards to be sure that the increasing use of family-based care and decreasing use of residential care, and overall decreasing formal alternative care rate in some countries are a sustained trend and not resulting from the way that formal alternative care types have been redefined or the way children in formal alternative care have been counted.
The TransMonEE data for 2021, however, indicates a reducing rate of entry into formal family-based care in certain countries since 2015 that may reflect a reduced need for family-based care. For example, the Republic of Moldova and Latvia have overall reducing rates of children in formal alternative care. Or this rate may indicate that some alternative care systems have exhausted the available supply of foster carers or other families able to take care of children in need of formal family-based care.
The sex distribution seems to be relatively even across the rates of formal alternative care, formal residential care and formal family-based care among the countries reporting data to TransMonEE. The DataCare project found that sex-disaggregated data are commonly available for children in alternative care for all countries surveyed, which permits the analysis of specific issues affecting girls or boys in alternative care.
Formal guardianship and kinship care account for around two-thirds of formal family-based care provision, while formal foster care represents around onethird across the countries reporting data to TransMonEE, for which there are data in 2021.
In countries such as Romania and Georgia, formal foster care now represents around 50 per cent of formal family-based care provision, and the increasing use of this type of formal family-based care can also be noted in other countries that are implementing deinstitutionalisation reforms, including Armenia, Latvia, Lithuania, and the Republic of Moldova.
Children with disabilities are over-represented in formal alternative care, particularly in residential care.
Comparisons between countries are difficult because of how children with disabilities are assessed and counted in national management information systems. It is clear, however, that the proportion of children with disabilities in formal residential care across 20 countries of the region has increased between 2015 and 2021 and that children with disabilities are 6 to 30 times more likely to be in formal residential care in these countries than children without disabilities (assuming a prevalence rate of children with disabilities of between 1 and 6 per cent). It is also clear that this is an underestimate in some countries where boarding schools or other types of residential social care or health services for children with disabilities are not included in the data on children in alternative care. Children with disabilities tend to be placed in formal family-based care to a lesser extent than children without disabilities; however, an increase in the share of children with disabilities accessing formal family-based alternative care can be noted. Since 2015 in Lithuania, 2017 in the Republic of Moldova and Romania, and 2018 in Albania, the share has been steadily increasing.
Young children appear to no longer be at greater risk of being in formal alternative care than older children and are more likely to be in family-based care than residential care.
In most countries where data is available, the rate of children under 2 or 3 years of age in formal alternative care is about half or less than half of the rate of children aged 0-17 years, and the rate of children aged under 2 or 3 years of age in family-based care is substantially higher than the rate of children aged under 2 or 3 years in residential care. Young children are more likely to be adopted than older children.
However, in some countries, young children with disabilities are less likely to be placed in domestic adoption than young children without disabilities.
In many countries where data is available, more than a third of residents in formal residential care institutions intended for children are young adults aged 18-24 years, and this proportion has been increasing in certain countries. Many of these cases likely involve young adults with disabilities.
Children in informal care and in boarding schools are technically in alternative care but are not monitored by the system of formal alternative care in many countries.
Survey data suggest that there may be considerable numbers of children in informal family-based care in certain countries, particularly Kyrgyzstan. These children are generally not monitored as part of the system of formal alternative care. Given the limitations of both survey-based data and administrative data on children in alternative care and the limited number of countries monitoring children in informal care, it is currently not possible to estimate the prevalence of children in all formal and informal forms of alternative care in Europe and Central Asia.
Data and indicators on children in alternative care
TransMonEE has shown that it can coordinate data collection and validate data using a common set of indicators across 27 countries.
The efforts to improve TransMonEE data need to continue as issues of comparability, definitions, coverage, and quality persist in many countries. Nevertheless, as time series data continue to be amended and definitions are consistently applied, nuanced and informative data are being produced that can inform decision-making at all levels. The role of National Statistics offices (NSOs) within the TransMonEE network helps to address challenges of cross-sectoral monitoring and consistent application of definitions and quality standards for cross-country comparability.
Consistent application of agreed definitions and quality standards for data management for core indicators is required to enable cross-country comparability.
The 2021 DataCare study, the 2022 CES review and the latest validation of TransMonEE data for 2021 have all confirmed that these are the main challenges for the development of global, comparable statistics on children in alternative care. TransMonEE nevertheless demonstrates that if resources are invested in validating data, and countries are supported with data improvement, then it is possible to use a common set of indicators for cross-country comparisons relating to children in alternative care to attain a consistent, useful, and granular dataset that meets the United Nations Fundamental Principles of Official Statistics.
Recommendations for improved data comparability
Continue efforts to develop and adopt a global set of core indicators and standard disaggregation variables and improve data comparability.
While DataCare and CES guidelines represent a good foundation for a core set of indicators that are already included in the TransMonEE indicators, solutions need to be found to the challenges of comparability relating to defining disability so that disability disaggregation can also be added.
UNICEF can develop an annual report card system for all countries in the ECA region using the three core indicators recommended by CES and disaggregation by sex, age, and disability.
A more comprehensive and in-depth analysis should be conducted every 3-5 years using the full set of 26 TransMonEE alternative care and four child disability indicators.
This analysis should focus on systemic changes and emerging strategic issues while incorporating greater disaggregation.
Continue to invest in the TransMonEE approach to revising historical data, ensuring consistent definitions with current data and increase investment in improving data quality by strengthening data management systems for alternative care and integrating them with other relevant management information systems, including health, education, social protection, and justice.
Further work is needed to define indicators and address monitoring children in boarding schools and in informal care.
Following the definitions outlined in the Guidelines on Alternative Care of Children, especially in relation to children outside of parental care and in alternative care.
This report provides an in-depth analysis of the situation of children in alternative care and in adoption in Europe and Central Asia (ECA) based on available data from TransMonEE, as well as other sources such as MICS, DataCare and the Conference of European Statisticians (CES). It marks the first analysis of data on children in alternative care by the UNICEF ECA Regional Office since the publication of the ‘At home or in a home’ report in 2010, highlighting the developments and challenges in collecting and reporting data on children in alternative care and adoption and summarises recommendations derived from recent data review initiatives.