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Prevention is better than cure: changing the emphasis in Romania’s child protection system

Children are more at risk in times of austerity

by Debbie Stowe, UNICEF Consultant

In the early 1990s, Romania’s institutionalised children were one of the major global news stories. Images of disturbed, neglected children, several hundred to an institution, flashed round the world. Even today it is not known precisely how many children lived in these pitiable conditions – proper records were not kept – but estimates suggest 100,000.

UNICEF was one of the international agencies working with local NGOs to address this humanitarian crisis. The first phase of response involved quick-fix solutions, improving the look of the institutions and training up staff. This helped the children who lived in them, but just in the short term.

The second phase, from 1997, involved actual reform of the system.This brought the development of alternatives to institutions, such as foster care, with the help of UNICEF-funded NGOs and support from the European Union. A child protection system was built from scratch. Services for children’s welfare – previously divided between disparate departments with little cooperation or cohesion – were put under county authority.

From 2002, the third phase saw the government fine-tune the system, establishing the legal framework, bringing in quality standards, methodological guides and codes of ethics. Foster care was developed and residential care improved; where once several hundred children were packed into institutions, the maximum was cut to 50. Professionals were taught new knowledge, skills and attitudes. The Convention on the Rights of the Child was largely adopted into Romanian legislation.

And yet, the number of children in care in Romania was 100,000, as high as it had been in the early 1990s.This was also despite the fact that falling birth rates meant there were significantly fewer children in total in the country – 4 million, down from 5.2 million. How could this be so?

In medicine, prevention is more desirable than cure – both for reasons of wellbeing and cost. Likewise, in the area of childcare, it is better to prevent children from being separated from their families than dealing with the consequences when they are. So the emphasis is now shifting from solely improving the child protection system to focus on the prevention system, keeping children with their biological families whenever possible.

This is not straightforward. Providing services for children in the care system is largely tangible and quantifiable. Preventing children from being taken into care in the first place, on the other hand, requires changes in behaviour and mentalities andany success is difficult to measure.

And there are many barriers in the way. The local authorities who are tasked with prevention suffer from a lack of resources, qualified professionals and technical knowledge. The law is not clear from where they receive their funding for this work.The challenge is also cross-sectoral: solve one problem in one area and many others are likely to remain.

Furthermore, effective prevention is an achievement that will pay off a decade or two down the line, when Romanian society has more healthy, well adjusted, contributing members – vital if the country is going to have the young adults needed to support an ageing society. However, politicians eyeing the next election often sacrifice long term goals for more immediate results.

UNICEF is trying to mobilise local authorities and NGOs to provide effective prevention services, and to encourage the public toaccess them. It also wants to help generate the funds necessary for the process. Aside from the fact that most children’s welfare is best served if they can remain with their birth family, preventing a child from entering care costs much less than keeping that child in care.

This is why the articles on the following pages of this newsletter focus on prevention, from the point of view of professionals who play a key role in this vital area.

Romania has made great progress over the past two decades with its child protection services, going from the horrendous, impersonal communist-era institutions of the 1990s to smaller, more personal facilities and foster care. But such options should be a last resort, called upon only in the worst cases.It is better if children and families can access the quality services – be it a family doctor, the education system, a baby-friendly hospital, support for new mothers – that will keep the family together in the first place.

The change must come from society. Will we stand by as thousands more Romanian children are needlessly shunted into the care system, depriving them of their right to fulfil their potential with their natural family and depriving society of the functional members on which its future relies? Or will we take the brave and necessary steps to bring about a fundamental change in outlook and make the child protection system serve those it was intended to – the extreme cases – rather than generations of children who, if just giventhe right help at the right time, could be growing up at home?




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