What will it take to create conditions for every child to grow up in a loving family environment?

SKOPJE, 18 January 2024 – “Today in Geneva, UNICEF launched a new regional report highlighting that nearly half a million children – or 456,000 – across Europe and Central Asia live in residential care facilities, including large-scale institutions and other facilities like small group homes.

“The report 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.

“When comparing the situation of children in North Macedonia, we must acknowledge that this country has been at the forefront when it comes to caring for children who for various reasons cannot be cared for or are separated from their family. This country was able to transform all large scale institutions for children and today zero children are placed in large scale institutions. The rate of children in other forms of residential care facilities is 24 per 100,000 which is ten times below the regional average and all children are being cared for in small group homes.

“The country’s progress was a long process and the result of decades of commitment to deinstitutionalization reform from multiple Governments. Furthermore, it was the result of continued commitment to strengthen and invest in alternative family-based care. Now 82 per cent of all children in state care are cared for in family-based care such as foster care and kinship.

“And while many countries in Europe and Central Asia have a long way to go before ending the legacy of institutionalising children, North Macedonia has a unique opportunity to be one of the first countries in the region to celebrate that every child grows up in a family environment.

“All political parties are preparing for the upcoming parliamentary elections. Now is the time to make commitments to close this unfinished agenda so that every single child, today and in the future, enjoys their right to grow up in a loving family environment.

“It should be acknowledged that since 2019, children in residential care are cared for in one of sixteen small group homes throughout the country. While small group homes are a better alternative to large-scale institutions like orphanages, a child’s place is in a loving family environment. The next steps include the gradual closure of small group homes and ensure every child in state care is cared for in family-based alternatives. This could take some years, but the commitment and work should start now. This also requires investing in strengthening all forms of foster-care services including specialised foster families for children at risk, emergency foster families and continuing to invest in other family-based care.

“The country needs to continue its commitment to invest in systems and services to keep families together. Concrete plans include investments in prevention and family support through establishing gatekeeping systems, and support early identification and early intervention for children at risk, a strong social service workforce, family support services to prevent unnecessary family separation. It requires investing in the implementation of a national parenting strategy so that all parents, and especially those with complex needs, receive the support they need so that children grow up in their own loving family environment.

“Sadly, there will be times when it’s not possible, not safe, or not in the best interest of a child to live with their own family, so there will always be a need for high-quality alternative family care. The country should ensure the best interest of children is central in all decisions made for children. This also requires strengthening the adoption process to bring it in line with international standards and the best interest of the child. Changes are needed such as in selection criteria for adoptive parents, increasing the maximum age of adoptive parents, and introducing option for foster carers to adopt a child that has been in their long-term care. Commitment is needed to align to internationals standard and fulfil children’s right to be told of their adoption and know their biological parent's identity, should they wish.

“There is also a need to invest in improving the implementation of support to care leavers. Children leaving state care are often left without appropriate protection, guidance, and support, leaving them to bring decisions on their own or even bringing them back to root causes of diverse risks. Investment is needed in programmes and support so they can plan their future, have the skills, and means they need to start an independent life.

“Lastly, considering that children with disabilities are far more likely to be placed in residential care facilities than children without disabilities, continuing commitments are needed to invest in a whole-society approach to inclusion of children with disabilities. Children with disabilities can realize their full potential if society changes the way it sees them, and that inclusion can only be improved if we remove the barriers that prevent them from participating. They need multi-sector action to be able to fulfil their potential and take up their rightful place in society.

“The negative impacts of family separation and institutionalization on children’s health, development and well-being are well-documented. When children are not able to grow up in a nurturing and loving environment, supported by caring and responsive adults, they often face emotional neglect and higher rates of abuse and exploitation, exposing them to mental health problems, psychological distress, and trauma. By staying committed to close this unfinished agenda, the country has an opportunity to create the conditions that every child needs to fulfil their potential.”