Family Support for Prevention of Family Separation

Expert Consultation on Family and Parenting Support

Florence, Italy 26-27 May 2014

The family being the fundamental group of society and the natural environment for the growth, well-being and protection of children, efforts should primarily be directed to enabling the child to remain in or return to the care of his/her parents, or when appropriate, other close family members. The State should ensure that families have access to forms of support in the caregiving role.

The Guidelines for the Alternative Care of Children (2009) II.A.3.

International legal and policy framework1) Parents/legal guardians have primary

responsibility for the upbringing and development of the child. (UN CRC Article 18)

2) Government responsibility to render appropriate assistance to parents and legal guardians in the performance of their childrearing responsibilities.

3) The Guidelines address the issue of “children deprived of parental care, or at risk of being so” and emphasize support to the family caregiving environments, including those whose capacity are limited by a range of factors.

Why do we want to prevent child-family separation?

Research shows relation between parenting quality and child development (Bowlby 1982; Sroufe 2005; Rutter 2007 etc.)

Research also shows poorer outcomes for children in alternative care, particularly younger children in large scale residential based care (cognitive and socio-emotional development); (Bucharest Early Intervention Project 2003; Leiden studies 2012; Schoenmaker et al. 2014)

Some evidence of longer term negative outcomes for children who have been in care into adulthood in relation to access to higher education, incarceration, employment, mental health. (Mostly HIC)

Children deprived of parental care Estimate of 151 million children who have lost one or

both parents (combined single/double orphan data, UNICEF estimate 2011)

Worrying lack of accurate data on children in formal alternative care outside of North America/ European context.

# children in residential care (2 to 8 million???) 626,000 children in residential care in the 22 countries

or entities that make up Central and Eastern Europe and the Commonwealth of Independent States, CEE/CIS. (At home or in a home, UNICEF 2010)

# in other formal alternative care? (foster care, Guardianship, residential care)

# in informal care, including kinship care?

What are the factors that lead to separation? Poverty

Illness and parental death, including HIV/AIDS pandemic but also mental

health issues

Disability (60% of children in

residential care in some countries)

Lack of access to (good) quality services close to home, particularly education

Violence, abuse and neglect in the home, including DV

Family breakdown and reconstruction (aftermath of

divorce and remarriage)

Discrimination and social exclusion (inc. minorities, single

parent, children born out of wedlock, laws that criminalise victims of sexual violence)

Emergencies, including armed conflict and natural disasters

Displacement and migration (children left behind;

children migrating for work) Inappropriate policies which

support the institutionalization or detention of children (and in some contexts parents)

Who cares for children?

Parental and family care

The diversity of children’s living arrangementsChildren under 15 living with both parents Jordan 94.5% Namibia 27% Swaziland 22.5%

Children under 15 living

with only one parent

(other parent alive or dead)

Swaziland 44.9% Gabon 39.9% Namibia 38.5% Kenya 28.4% Jordan 5%

Children under 15 not living with a biological parent, both parents dead

Lesotho 5.4% Zimbabwe 4.7% Swaziland 3.7% Jordan 0%

Children under 15 not living with a biological parent, both alive Namibia 23.6% Swaziland 18.18% Sierra Leone 17.6% Colombia 0.1% Egypt 0.1%

Children under 15 living with single parent, other parent alive

Living with mother only, father alive

Swaziland 32.4% Gabon 30.5% Columbia 29.4% Nepal 28% Cambodia 5.7% Timor Leste 3.5% Jordan 2.4%

United States?

Living with father only, mother alive

Sierra Leone 8.5% Liberia 7.8% Haiti 4.5% Rwanda 1.3% Pakistan 0.3%

53%

7%

16%

22%2%

Sierra Leone: Children under 18 by living arrangements, MICS4 2010

Living with both parentsLiving with father onlyLiving wth mother onlyNot living with either parentsMissing Information

87%

11%

2%

Sierra Leone: Children under 18 by survival status of parents,

MICS4 2010

Both aliveOne parent aliveBoth dead

39.6

9.1

5.33.2

24

8.3

1 5.7 1.11.4

Sierra Leone: Children under 18 not living with biological parents by re-

lationship to the head of the household, MICS4 2010

Grandchild

Brother/Sister

Son/Daughter (not bio-logical)

Brother in law/Sister in law

Niece/Nephew

Other relative

Wife/husband

Adopted/Fostered

Son in law/daughter in law

Not related

70%

7%

16%8%

Sierra Leone: Children under 18 not living with a biological par-ent by survival status of parent,

MICS4 2010

Both parents aliveOnly father aliveOnly mother aiiveBoth parents deadMissing Information

Why is this relevant? Parental death (orphanhood) not the primary reason for

children not living with their biological parents although a risk factor (particularly one parent dead)

Significant % of children are not living with their parents have both parents (reasons? remarriage, abandonment of family, DV, migration of parent or child to access opportunities, child protection issues, access to social services, redistribution of family resources etc…)

Single parents as primary caregivers Critical role of kinship care (and not just in low and

middle income countries- in the United States 2.7 million children live in extended family care) (In Australia, statutory kinship overtook foster care in 2010)

Knowing who needs what in terms of family and parenting support We need to understand who the caregivers are to

meet their particular needs; Single parent families tend to be poorer and face a

range of risk factors, inc. access to social services, lack of social support, greater care support needs >> institutionalization.

Research has also shown that kinship care givers tend to be older, poorer and face issues of health and access to social services; (UK and Sub-Saharan Africa)

Some research has also highlighted in some contexts higher child protection risk factors for children in kinship care than for biological children (schooling, work, stigma)

Preventing separation

Addressing risk factors through parental and family support

Prevention of abandonment and relinquishment of infants and young children Support to pregnant and

young mothers (through health sector)

* Bulgaria For our children model tackles the abandonment of new-born infants in maternal health units with a system of social worker referral and response;

* Kazakhstan Kuan Sabi program of primary health care workers trainings and parenting training for caregivers;

Home visitation/outreach programs to strengthen parenting skills, improving parent-child relationship and connect parents to sources of support; * Chile (with adolescent mothers); *Pakistan (through community health program)

Support to primary caregivers of children with disability

* Short-break (respite) services for children with disabilities (St Petersburg, Russia);

* Early detection of disability and home visits by pediatricians in Belarus;

*Community-based rehabilitation (CBR) model in Nepal

Prevention of breakdown in family care and protection concerns Social work outreach/case management services:

- Parenting and conflict resolution skills (Individual, Group)- Support access to social services, including addressing living conditions, health, access to education, but also legal documentation- Early detection and gatekeeping mechanism- Ensuring appropriate care response when child protection concerns arise- Placement in kinship care (formal or informal- with or without support) and use of temporary alternative care (foster care, respite care, temporary residential care)

Examples: Rwanda: Hope and Homes ACTIVE Family Support Program: early referral by

community members of families at risk of separation and case management Indonesia: PDAK Child and Family Support Model, non-residential model of

response to address child protection concerns based on comprehensive assessment, case management and psycho-social, legal, financial support for child in family;

Moldova: the Gatekeeping commission model, with Community Assistant to identify and assess early needs and support appropriate response.

Prevention of separation through social protection

Social transfers focused on supporting care (Orphans and vulnerable children; kinship caregivers; caregivers with disability; children affected by an emergency)

Examples Ghana’s Livelihood Empowerment against Poverty (LEAP)

Program: social cash transfer program that provides cash and health insurance to extremely poor households across Ghana, including a single parent with an orphan or vulnerable child (OVC);

Kenya Cash Transfer for Orphans and Vulnerable Children (CT-OVC): To encourage the fostering and family retention of children affected by AIDS in particular. Eligible households, which are those who are poor and contain an OVC, receive a flat monthly transfer of US$21.

South Africa Child Support Grants for any primary care giver of child under 18.

Prevention of separation as a result of emergencies or crises

Family Tracing and Reintegration services following an emergency with family support programs, including scholarships (Aceh, Haiti…)

Reintegration services for children in residential care, living on the streets, children who have been trafficked.

Examples: Rwanda: Genocide Survivors Support and Assistance Fund,

(5% of the national budget), supports more than 300,000 victims of genocide. Families at risk of separation receive a monthly economic allowance, livelihood support, educational scholarships and/or medical assistance.

Retrak model for reintegration of children connected to the streets (Ethiopia and Uganda).

Some key issues Many interventions are at piloting level- need for

better evidence of impact and of scaling up. Measuring the impact of social transfers on prevention

of separation, not only on access to education and health.

Social transfers targeting single parent families, other caregivers? Issues with targeting OVC rather than caregiving for all children in family.

Support to kinship caregivers (dilemma of regulating it) Subsidies for formal kinship care vs. foster care)

Family and child centered policies that are shown to strengthen capacity of care givers in HIC applicable to LMICs? (Parental leave; social protection floors; access to day care; health insurance; child credit/benefit…)

And finally… A lot of focus on babies/young children… majority in alternative

care were placed when they were older? Most prevention interventions rely on functioning community

level professionals/para professionals working with families> informal support network/ peer support?

Need for a life course perspective:

- early critical period (home visitation, ECD, health care system); Eliminate placement of under 3 in institutional care

- transition to school (primary and secondary),

- transition in families (divorce and remarriage, abandonment of family),

- teenage relationships, reproductive health and parenting education (focus on early marriage, prevention of early pregnancies and parenting education)

Need to tackle vested interests in the use of residential care;