Deinstitutionalization

While the Government of Romania has made significant progress in the past 28 years in reducing the number of children in state care, the country still has one of the largest alternative care systems in the region. It tends to the needs of over 56,000 children. Of these, approximately 18,000 are in foster care, 13,900 with relatives, 4,800 with other families, and 18,500 in state-run institutions. Only around 3,000 of these children are adoptable.

When children grow up outside a family environment, their chances to develop to their full potential drop. Research has shown that every three months a child under three spends within an institution delays their physical development by one month.

There is also a risk of delays in cognitive and language development.

Social stigma adds to all this, as children from institutions are often regarded as different and marginalized.

It’s worth mentioning that most of the children in state care are so-called "social orphans", as their mother is alive and known for over 90% of children and 48% of children also have fathers. Without helping vulnerable families that struggle to keep their children with them and avoid child separation, some 5,000 children still enter the childcare system every year. Among the various reasons are poverty (~ 41% of cases), abuse, neglect, exploitation and different forms of violence (~ 28% of cases) and child disability (~ 9.5%).

Many times, separation happens because parents can no longer afford to buy food, or have no proper housing over the winter and children would be, they think, better off in a centre where it’s warm and they can get a meal. Sometimes children come from split or single-parent families where making ends meet is a struggle. Most times, it’s not just the separation from family that adversely impacts these children. Their families most likely do not know that they are eligible for social aid or have no idea how to apply. Then there’s violence, early pregnancies, and illnesses due to there being limited to no access to at least a social worker or a nurse, if not a doctor.

In most cases, families provide the most protective and adequate environment for children. 

A decision to separate a child from his or her family is an extreme measure that should only be taken if absolutely necessary and in the best interest of the child. It needs to be accompanied by a detailed plan for each child, ideally leading to alternative community based family-type care or foster care.

To find the most strategic pathway to system reform, the National Agency for Social Assistance and Child Protection (NAPCRA) together with the World Bank and UNICEF have undertaken a thorough analysis of the public childcare system in Romania. The results show that these institutions need to be closed-down and formulate a clear solution: alternative services.

The first part of the solution is finding a family-like setup for every child: the family of birth, extended family, or family-based and family-like care options, such as foster care. Also, since most of the children in public childcare are adolescents, soon about to start out in life, they will also need training for essential skills in independent living, such as a trade or profession, guidance in finding a job or organizing a household. Another option is the setting up of small apartments, where adolescents are guided and supported to live together.

Many things can cause a family to separate from a child. An effective solution needs to handle all those causes. The earlier the better.

Our response has been to test and put in place a system to find these cases early, offer help and prevent the crisis in the best interest of the child: The Minimum Package of Services.

UNICEF works with the Government of Romania, civil society and with support from companies and private individuals to make available a Minimum Package of Services to all families, particularly the most vulnerable ones. The social protection, healthcare, and education services included could prevent, at a fraction of the cost, many of these issues. Our solution is being implemented in 45 communities in the county of Bacau, with great results for children and effective cost-benefit ratios for the community. A simple calculation of costs needed for an integrated team of professionals working at community level with costs for services for a child in public care ranges from 1:40 to 1:80. These services are the day-to-day job of a team of three to five professionals, who work in and with the community to support vulnerable children and their families as soon as possible.

As a result of our work over the years, the number of foster carers or maternal assistants — professionals trained to raise children in their own homes, or with their families, and look after their best interests under direct and constant supervision of the social worker — has gone up. Over 18,000 children have found a home with these professionals in the past 15 years.

A more in depth look at Deinstitutionalization available in Romania: Children in Public Care 2014 study.

News from our work in advocacy to promote and protect the rights of all children in Romania.