Why children with disabilities need family-based care
Children with disabilities are up to 30 times more likely than their peers to live in residential care facilities – missing out on this crucial factor for their long-term health, happiness and development
The research is clear: children fare best when they are raised in nurturing, supportive family environments. Numerous studies have found that children who are raised in residential care, rather than family settings, are at a greater risk of a variety of negative outcomes, from developmental delays to difficulty with relationships.
Children with disabilities are even more likely to be placed in residential care facilities than children without disabilities. Given that they are already more at risk than children without disabilities to experiencing poor treatment, such as discrimination, neglect and abuse, this means their risk is compounded.
The Europe and Central Asia region has the world’s highest rate of institutionalized children in the world. Around 232 of every 100,000 children live in residential care, more than double the global average. In Western Europe in particular, it is even higher: 294 per 100,000 children.
Thousands of these children in institutions have disabilities – in some countries, the rate is as high as nine in 10. In fact, UNICEF has found that children with disabilities are up to 30 times more likely to live in residential care facilities in Europe and Central Asia than other children.
Although progress has been made in the region on moving children into family-based care, children with disabilities often have been left out and left behind. In more than half of all countries with available data in Europe and Central Asia, there was an increase in the proportion of children with disabilities in residential care from 2015 to 2021.
But change is possible. In countries including Moldova and Romania, for example, the proportion of children in family-based care with disabilities has been steadily increasing.
In Moldova, for example, the government’s clear and ongoing commitment to rehousing children in residential institutions, including boarding schools, has made huge strides. From 2008 to 2015, Moldova closed 67 boarding schools. Children were rehoused in family environments, whether relatives’ homes or foster care. A linchpin in this effort was the process of ‘gatekeeping panels’: local panels that assessed the medical and learning needs of children with disabilities who were not in their parents’ care, placing the children with a local family wherever possible. Today, only two residential homes remain for children, and both are also in the process of being closed.
UNICEF’s position is clear: no child should ever be placed in alternative care because of poverty, disability or challenging behaviour, or because their family lacks access to services they need to care for their own child at home. On the rare occasions when alternative care is in the child’s best interests, it should always be family-based – never institutional.
On the International Day of Persons with Disabilities, we call on all countries to design and implement effective child care reforms, invest in the development of family support services, ensure that alternative care is family-based, improve the protection of children in care, and close all large-scale residential facilities for children by 2030 – steps that will improve the lives of all children, and, disproportionately, will improve the lives of children with disabilities.
Read more about Leveling the playing field for children with disabilities and why UNICEF is determined to keep families together in Europe and in Central Asia.
