PROFESSOR KEVIN BROWNE & DR SHIHNING CHOU

CENTRE FOR FORENSIC & FAMILY PSYCHOLOGYSCHOOL OF COMMUNITY HEALTH SCIENCES

UNIVERSITY OF NOTTINGHAM MEDICAL SCHOOL

KEVIN.BROWNE@NOTTINGHAM.AC.UK

The Number of Children in Residential Care Institutions in Europe and Central Asia: Cause for Concern

Prague November 2015

European survey on young children in institutional care resulted in national surveys

Proportion of all children under 3 years who are in institutional care, 2003 (blue lines are

estimates).

United Nations General Assembly Report of the Human Rights Council on its 11th Session (A/HRC/11/37, Section 11/7, p.23) – Guidelines for the Alternative Care of

Children (2010) – Related Publications

Institutional care without a parent causes physical harm and neural damage to all young children.

Infants my be imprisoned behind their cot bars for up to 18 hours a day

Extent of Institutional Care of Infants and toddlers and

the ‘orphanage’ myth

UNICEF estimate 44,000 young children under 3 in Eastern Europe and Central Asian ‘Children’s Homes’.

In 2003, our EU survey of member states and accession countries showed 23,000 young children under 3 without a parent in institutional care (for more than 3 months).

‘infant homes’ often provide a non stimulating clinical environment for toddlers and young children up to 4 years of age.

Vast majority (94 to 96%) of children in ‘orphanages’ have at least one living parent, often known to the authorities

All Children under 18 years in Care 2013: % residential care, % foster care and total

number

Mon

aco

Lithua

nia

Czech

Rep

ublic

Roman

ia

Austria

Eston

ia

Slova

k Rep

ublic

Sweden

Italy

Denm

ark

Cypru

s

Irela

nd UK

Belar

us

Kosov

o

Ukrai

ne

FYRO Mac

edon

ia

Mon

tene

gro

Turke

y

Russian

Fed

erat

ion

Tajik

ista

n0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

110.0

18

3,022

7,442

32,996

607

41,209

10,847

4,752

2,214

17,887

78,579

2,501575

4,682

280

1,095

947

392,361

12,871

11,905

9,656 18,2762,451

68,951

14,07410,845

16,172

123,386

28,449

40,830

9,159

5,342

241

234

6,366

71,640

13,263

6,047

748

49,2526,051

Percentage (%) in institutions Percentage (%) in foster care

Young Children under 3 years in Care 2013: % residential care, % foster care and total number

Mon

aco

Lithua

nia

Czech

Rep

ublic

Roman

ia

Austria

Eston

ia

Slova

k Rep

ublic

Swed

enIta

ly

Denm

ark

Cypru

s

Irel

and

UK

Spain

Serbi

a

Uzb

ekista

n

Georg

ia

Moldo

va

Bosni

a &

Her

zego

...

Armen

ia

Azerb

aija

n

Kazak

hsta

n

Tajikista

n0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

110.0

120.0

2

754

13661,450

443

130

285

19

104

938

1,213 162

1,568

167

485

154

1,966

2,581

85

3,925

1,921

945

28099

6,071

1,190

657

1,228

7,4072,370

510

6,85020 11

597409,288

1,925

1,986

429

180

3,423

1,800

195

29,683

622

Percentage (%) in institutions Percentage (%) in foster care

Country with children under 3 In Residential Care - 2013

Proportionper 10,000

Change since2003 per 10,000

Country with children under 3 In Residential Care - 2013

Proportionper 10,000

Change 2003 per 10,000

Monaco 67 No info. Sweden* 7 -1

Latvia 54 -1 Germany 6 -1

Lithuania 45 -1 Montenegro 6 -5

Bulgaria 43 -7 Turkmenistan* 5 -1

Czech Republic 38 -22 Italy* 5 -3

Malta 32 +5 Netherlands 5 -11

Belarus 27 -18 Kyrgyzstan* 4 -2

Belgium* 26 -30 Tajikistan* 4 +2

Russia* 24 -15 Georgia 3 -1

Moldova 16 +4 Kosova 3 No Info.

Albania* 15 +7 Serbia* 2 0

Kazakhstan* 15 -1 Turkey 2 0

Romania 14 -20 Spain* 2 -21

FYR Macedonia 14 -1 Uzbekistan* 2 -1

Hungary 12 -32 Azerbaijan 1 -4

Slovak Republic* 10 -21 Denmark 1 -6

Estonia 10 -16 Norway <1 <1

Croatia 10 +2 Ireland 0 -6

Poland 10 +1 Cyprus 0 -4

Austria 10 +7 UK 0 -1

Armenia 10 No info. Slovenia 0 0

Finland 9 -19 Iceland 0 0

Bosnia & Herz* 9 +2 Total (45 countries) 12.8 -1.6

Country with children under 3 In Foster Care - 2013

Proportionper 10,000

Country with children under 3 In Foster Care - 2013

Proportionper 10,000

Monaco 0 Sweden* 28

Latvia 28 Germany 30

Lithuania 38 Montenegro 2

Bulgaria 25 Turkmenistan* na

Czech Republic 41 Italy* 4

Malta 36 Netherlands 28

Belarus 31 Kyrgyzstan* na

Belgium* na Tajikistan* 2

Russia* 3 Georgia 8

Moldova 2 Kosova 17

Albania* na Serbia* 19

Kazakhstan* na Turkey 1

Romania 59 Spain* 2

FYR Macedonia 6 Uzbekistan* 16

Hungary 59 Azerbaijan 1

Slovak Republic* 59 Denmark 20

Estonia 13 Norway 37

Croatia 12 Ireland 28

Poland 43 Cyprus 9

Austria 30 UK 38

Armenia 0 Slovenia 6

Finland 27 Iceland 8

Bosnia & Herz* 1 France na

Countries with significantly less children under 3 in residential care above changes in

birth rates (n=12)

HUNGARY

Country Change Since 2003

Hungary -32 per 10,000

Belgium -30

Czech Republic -22

Slovakia -21

Spain -21

Romania -20

Finland -19

Belarus -18

Estonia -16

Russia -15

Netherlands -11

Bulgaria -7

Countries with significant more children under 3 in residential despite changes in birth rates (n=8)

Country Change since 2003

Austria + 7 per 10,000

Albania + 7

Malta + 5

Moldova + 4

Croatia + 2

Bosnia and H. + 2

Tajikistan + 2

Poland + 1

Countries with children under 3 Years are overrepresented in institutional care

Country Total number in Residential Care (<18)

Rate per 10,000

% of Children under 3

Latvia 345,837 51 18.1

Armenia 690,528 13 13.1

Bosnia & Herzegovina

773,000 9 13.6

FYRO Macedonia 463,561 7 28.1

Bulgaria 1,178,708 47 15.6

Kosovo* 583,612 2 19.4

Albania 7,300,415 1 26.7

Turkey 22,761,702 1 23.8

Reasons for institutionalisation

SOCIAL REASONS FOR RESIDENTIAL CARE

Lack of community nurses and social workers Lack of home based assessments of children in need

and their families Lack of free universal prevention services to reduce

child abuse, neglect and abandonment (eg; positive parenting & counselling programs and community mental health and addiction services)

Weak targeted interventions with families high risk of child abuse, neglect and abandonment.

Slow development of therapeutic foster care.

The health sector must be involved to prevent separation and sustain reunification of children with

their parent(s)

Transforming of children’s services

COMMUNITY SERVICES

FOSTER CARE

RESIDENTIAL CARE

Pyramid of services to children and families

Manual on the Better Care Network: Mulheir, G., Browne, K. and Associates (2007). De-Institutionalising And Transforming Children’s

Services: A Guide To Good Practice.

From Kevin.browne@nottingham.ac.uk OR www.crin.org/bcn

Institutions transformed into polyclinics of non residential services for children and mother & baby units

Day care facilities for children with and without disabilities

Mother-Baby Units to replace Baby Homes No child under three in residential care without a parent