November 2019
Special Issue on the 10th Anniversary of the
Guidelines for the Alternative Care of Children
"The time has come for a change in the childcare system. It is necessary to invest resources, firstly, to help families with children in crisis, and secondly, to create a sufficient number of foster families of different types. Children should live in families, not in institutional care, and the state is obliged to provide this."

- Z henya Ershova, Speech given at the Celebrating 30 Years of the Convention on the Rights of the Child Workshop
Introduction to this Special Issue
November 20th 2019 marked two important anniversaries- 30 years since the adoption of the Convention on the Rights of the Child and a decade since the  Guidelines for the Alternative Care of Children  were ‘welcomed’ by the UN General Assembly (UNGA) in 2009. To mark the occasion, Better Care Network asked several key actors to write brief reflections on different topics and aspects of children's care for this special issue of the BCN newsletter, focusing on the last 10 years of progress in the care reform movement, as well as hopes and recommendations for the future. 

These partners were asked to consider the following questions: What has been some of the most significant progress on this issue since the Guidelines were adopted? What are the key challenges now? And where do you see things going in the next ten years?
The collection of contributions below allows us to take stock of where we are now and to consider some of the opportunities as well as challenges ahead. We are deeply grateful to them for sharing these thoughtful reflections.

Ten Years On
Collaborating for change
by Florence Martin, Director of Better Care Network

When the Committee on the Rights of the Child first recommended that “standards and guidelines for the protection and alternative care of children without parental care" be developed by the international community as part of its Day of General Discussion in September 2005, it envisaged that they would provide practical guidance addressed not only to governments but also to international bodies and organizations, civil society, professionals, voluntary organizations and the private sector.

Four years later when they were endorsed by the UN General Assembly (UNGA), they became a critical tool for both governments and civil society actors to frame care reform efforts and inform the system-wide shifts needed in laws, policies, services, budgets, personnel and structures to redirect responses towards preventing unnecessary child-family separation and ensuring appropriate alternative care is available for children who need it, prioritizing family based alternatives and ending child institutionalization.

A decade later, reforms of child care and protection systems are taking place in all regions of the world , supported by an ever growing partnership between governments, international organizations, donors, and civil society actors.

As this international movement has progressed from setting the standards to implementing them, the challenge has turned increasingly from the ‘ what’ needs to be done to the ‘ how’. Several of the contributions in this special issue reflect on some of the lessons learnt in diverse contexts to support this transition.

How do we move from ‘good pilots’ to system-wide transformation at country level? How do we redirect funding effectively and recruit or re-skill a social service workforce that is critical to delivering child and family centered services at the community level? How do we make sure that all key stakeholders of this system are at the table, to inform the changes, and advocate as well as contribute to them?
These key actors must include children and youths who are care-experienced, parents and families who are involved in the system, disabled people’s organizations who are working to address the stigmatization and discrimination that has led to children with disabilities’ over-representation in residential care, and LGBTI youths and their organizations who are almost entirely absent from these conversations. They must also include the residential care managers and service providers, often faith based, whose engagement is central to the success of these reforms.

As we celebrate these anniversaries, the UNGA is in the final stage of adopting its first ever Resolution on the Rights of the Child focused on the theme of children without parental care. An unprecedented coalition of over 250 organizations, networks, and agencies working at local, national, regional and global levels across all regions came together to develop and advocate for a comprehensive set of Key Recommendations.

For the first time in its history, the General Assembly will call on its 193 member states to take concrete action to address the root causes of unnecessary separation and to ensure children are cared for effectively by their own families and communities. It will express deep concerns about the harm of institutionalization and call for its progressive replacement by redirecting resources to family and community based care services.

It is in those collaborations, in the growing partnerships and willingness to engage, learn, share, innovate together but also be willing to fail, that the complex answers to these ‘ hows' will be found and better systems of care and protection for children will emerge over the next decade.
Reflections on care systems reform 
by Cornelius W illiams, Associate Director and Global Chief of Child Protection for UNICEF Programme Division

This year marks the 30 year anniversary of the Convention on the Rights of the Child, and ten years since we welcomed the Guidelines for the Alternative Care of Children, recognizing the vulnerability of children without parental care. We are at a critical moment to not only reflect on how far we have come but also to recommit to advancing progress towards securing the rights of all children everywhere.
Despite increased investment by States in care reform, many children continue to be separated from their parents. The harmful effects of family-child separation and institutionalization of children are well-documented; as are the vulnerabilities of children with disabilities, children of indigenous and minority communities, children fleeing armed conflict, and children on the move.
Poverty, discrimination, conflict and migration are some of the underlying causes of family-child separation. Yet the real drivers are lack of social protection and inclusive social services combined with a need for strong child protection systems to support families.

Countries are committing to de-institutionalization as a means to reduce the number of children living in institutions. However, despite these advancements, much more needs to be done to ensure that family-child separation and placement in alternative care is not based solely on reasons
of family poverty, disability or other discriminatory practices. Investments in de-institutionalization need to be matched with equally significant investments in preventing unnecessary family separation by focusing on effective gate-keeping, providing targeted cash transfers, investing in inclusive education and community-based services as well as a strong social service workforce to support and work with families. When alternative care is necessary, countries should prioritize family-based alternative care options such as kinship care and foster care. 
As we re-commit to the care reform agenda, and to leave no child behind, we must strive to end all institutionalization of children, including “voluntourism” which often draws more vulnerable children into institutional care and away from their families. Investments must be reprioritized, and resources re-directed to what is most effective: a fully integrated child protection system linking services to support families and prevent separation. Our measure of success is not the scope and scale of the alternative care options states can provide, but in the number of children who grow up in families in an atmosphere of happiness, love and understanding.
The Alternative Care Guidelines: Setting compass for global policy
by Philip S. Goldman, President of Maestral International

Over the last decade, the Guidelines for the Alternative Care of Children have played an invaluable role in informing global and national policies. Experience shows that the Guidelines can set a clear direction for alternative care reform, while allowing for care systems to be contextualized to account for local circumstances and needs. Today, the Guidelines are becoming increasingly important as the transformation of care rapidly accelerates globally.

The Guidelines have actively shaped the policies and strategies of U.N. and regional organizations, bilateral aid agencies, international NGOs, faith-based organizations and funders. These organizations have often worked in tandem to promote the Guidelines to regional and national stakeholders, and to provide resources and tools to facilitate implementation. Their efforts have been met with notable successes – recent European Commission dialogues on improving alternative care in the EU have regularly referenced the Guidelines.
The Guidelines are making an important impact on nations as well. For example, the Government of Kenya issued comprehensive Guidelines for the Alternative Family Care of Children in Kenya in 2014.  These referenced international conventions and Kenyan national legislation to outline measures for (i) supporting families and preventing family separation in Kenya; and (ii) the provision of alternative care measures that are specifically responsive to Kenya’s needs. Since 2014, Kenya has been intensively working to build its capacity to implement these measures.

Despite these and other successes, the Guidelines have faced challenges. Social welfare ministries have complex mandates but are usually the least resourced. These weaker ministries can be tested when tasked with coordinating the kind of intergovernmental efforts needed for quality care reform. Powerful constituencies (such as children’s institutions and their supporters) often actively oppose reform, and social attitudes and practices are frequently accommodative of institutionalization.

We can work together on three priorities to ensure that the Guidelines inform care reform over the next decade. First, we can find a common voice on the family and community-centered principles of the Guidelines and work collectively to further their objectives. Second, we can elevate care reform on national agendas on poverty reduction and social development, ensuring it is appropriately supported and resourced. Care of children does not belong on the margins! Finally, if care reform is truly accelerating, then our efforts on enumeration and evidence must accelerate as well.

If we manage this by 2029, we can be confident that the lives of countless children, families and communities will be greatly improved.
Recognize and prioritize the role of families
The centrality of family for children’s development, well being and realisation of their rights:
A consideration of what this means for child welfare reform
by Amanda Griffith, CEO of Family for Every Child

Our recent consultations with children affirm the importance children place on the care and protection of family. The United Nations Convention on the Rights of the Child (UNCRC) underlines the primary role for care, protection and development played by families. Yet public policy has all too often focused on a deficit model of the family, particularly those living in poverty, and implemented systems focused on the removal of children from their families well beyond instances of abuse and neglect. The Guidelines for the Alternative Care of Children has shifted the emphasis to promoting a policy and practice focus on strengthening families and preventing unnecessary family separation.
The vast majority of children outside of parental care are not in the formal care system. There are estimated to be 50 million refugee and asylum seeking children, over 100,000 street connected children, 5.5 million children trafficked and 250,000 associated with armed groups. Though not all are outside of family care, they are extremely vulnerable to family separation. The UN Study of Children Deprived of Liberty refers to at least 7 million children of which 5.4 million are in institutions. Child Welfare Reform needs to take all these populations into consideration.

There are excellent initiatives addressing family strengthening and prevention of separation. However, they are often limited to parents and fail to recognise the crucial role the extended family plays. Parenting programmes, for example, are usually taken up by mothers and yet research shows that different family members play a distinct and crucial role in the life of a child. A more systemic approach is needed to capitalise on the resources available within an extended family to care for children.

A major achievement for child welfare reform in the coming 10 years will be an investment in the support and monitoring of kinship carers. 1 in 10 children are in extended family care and yet little data exists or research conducted into this form of care. It is highly valued by children but the least invested in. The advantages are many. Outcomes for children in kinship care tend to be better than those in formal alternative care. Kinship care enables children to maintain their sense of identity and cultural traditions. When in their best interests, it maintains a relationship with parents during separation and it facilitates reintegration back into the family. It can provide the flexibility for families to manage difficult times. To be effective, interventions must target the wider family not just parents.
Country Case Study: Moldova
Care reforms in Moldova
by Stela Grigoras, Senior Child Protection Consultant for UNICEF Europe and Central Asia

The child care reform in Moldova started with the adoption of the national strategy (2007-2012). At that time, there were 12.000 children in institutions and few family-based alternatives. By 2012, there had been a 54% reduction in the number of children in institutions, but the most significant progress was achieved when Moldova initiated the development of the Law on Special Protection of Children which brought the national legislation in line with the Guidelines on the Alternative Care of Children. After the law entered into force in 2013, other legal mechanisms were adopted to support the implementation of child care reform. These were the regulations and quality standards for family support legislation, foster care, gate-keeping, 2 inter-agency mechanisms for collaboration on child abuse and neglect and on primary risks prevention, etc.

These efforts impacted the lives of the most vulnerable children (168,000 children). Since 2010, the number of children in institutions has been reduced by almost 9,000 and 45 residential
institutions have been closed. To support deinstitutionalization efforts, support services for inclusion of the most vulnerable children were established with the creation of about 500 resource centres and over 600 support teachers deployed across the country. In 2018, over 60,000 children received family support and more than 10,000 children with special educational needs and disabilities were included in mainstream education.

Main lessons learned from Moldova:
  • Comprehensive child care reform is possible if there is a vision developed and shared by all stakeholders.
  • Collaboration between state and NGOs helps to mobilize resources and know-how and implement reform actions in a uniformed way across the country.
  • Putting in place a coherent independent gatekeeping system is crucial to preventing child-family separation.
  • Prioritizing family support and reintegration and avoiding building new, smaller institutions helped in designing a system based on family and community care and redirecting resources from institutional care to new services.
  • Investing in community social service workforce (1225 community social workers across the country) made the transition effective and sustainable.

Child care reform in Moldova is not yet complete. 1100 children with disabilities left behind in institutions should be helped to return to family and community care as soon as possible. But we are optimistic, as the government remains committed and civil society remains united in the provision of support to national and local authorities to undertake the full transition as is planned in the current national Child Protection Strategy for 2014-2020. 
Support families and prevent unnecessary family-child separation
Is child protection charting a definitive course towards
family support?
by Joanna Rogers, Head of Strategic Development for P4EC Russia and P4EC Europe and Central Asia Regional Alliance

The Guidelines and the ‘necessity’ principle have been really important in supporting a change in thinking in many organisations and national governments towards a systemic approach to child protection and towards recognizing that parents and caregivers need support (in accordance with articles 18 and 27 on parental responsibilities and state party support to parents and legal guardians) to be able to care for children adequately and fulfil their duties under the CRC. There is greater understanding and recognition of the important role that parents and caregivers play in achieving positive outcomes for children and how working with and supporting parents can prevent and reduce violence, abuse and harmful practices. The goals of many organisations and government policies are no longer to ‘rescue’ children from ‘bad’ parents, but to work systemically to change the situation in the family and secure strong, caring families for children. Of course progress has been slow and not all governments and
organisations take this approach. Many children are still separated unnecessarily from parents and families. But the ship is turning towards family support and strengthening as a strong pillar of child protection.

A key challenge is the need to really address gaps in knowledge about outcomes for children in families living in poverty so that poverty, and the stress that it causes to families leading to violence, abuse, neglect and separation, can no longer be a reason for child separation. This means steadily and systematically researching the links between family and parent or caregiver support interventions and the results they can achieve for children in terms of reducing violence, abuse and neglect; improving child well-being, education and health outcomes; and preventing unnecessary separation, not only in childhood but into adulthood. We really lack strong, longitudinal evidence on how family support and reunification can succeed for children and families compared to other child protection strategies adopted by governments such as placing children into alternative care or adoption. This applies for children and families in all situations where poverty or other underlying factors (migration, conflict, natural disasters) are driving separation. If we can gather strong, valid evidence, we will be able to make strong and compelling cases for investing in family support and strengthening as a matter of course.

Another challenge is to really consolidate efforts around ensuring that community based services to support children with disabilities and their families become the norm. Ending the institutionalization of children with disabilities is a major, urgent priority in nearly every country around the world.

Within the next ten years I hope that the ship will continue to gather steam in the direction of community-based family support and strengthening as a strong pillar of child protection and as the no-question first response for children with disabilities and their families.
Addressing poverty to support family care
by John Williamson, Senior Technical Advisor for USAID Vulnerable Children Fund

While household poverty is only one of the factors contributing to children separating from their families, studies have consistently found it to be a primary contributing factor. The Guidelines recognize that poverty should never be the basis for removing a child from their family, placing a child in alternative care, or preventing family reintegration “but should be seen as a signal for the need to provide appropriate support to the family.”

In countries with weak social protection systems, the most viable way to enable specific families to better provide for children’s needs is through household economic strengthening. For decades projects supporting the reintegration of children into family care have sought to do this, often with
mixed results because those of us engaged with such work generally have skills in areas other than developing sustainable economic activities. The challenges are multiplied many times over by the widely different contexts in which families live and the skills and capacities they have. In the last decade, however, many organizations that support family reintegration and alternative family placements have recruited personnel with skills in household economic strengthening and begun to learn about the tricky business of strengthening families economically. 

Recognizing a need to consolidate learning in this area and provide relevant guidance, USAID’s Vulnerable Children Fund supported FHI 360 to develop practical guidance for use by program designers, funders, and implementers. Over five years The Accelerating Strategies for Practical Innovation & Research in Economic Strengthening (ASPIRES) Family Care project did an extensive literature review, a global survey of organizations working to prevent unnecessary separation of children from families, interviewed practitioners in depth, and did operational research through two projects that used a variety of interventions to prevent unnecessary family separation and enable already separated children to reintegrate into family care. From this learning and research, the ASPIRES Family Care project created Meeting the Costs of Family Care: Household Economic Strengthening to Prevent Children’s Separation and Support Reintegration, A Resource Guide , which was launched in the October 2019 BCN newsletter. Undoubtedly, the coming decade will see more learning in this area, and it provides practical guidance to be built upon.
Regional Case Study: Latin America
Kenya commits to family and community based care for children
by Fred Mutinda, Project Director of Changing the Way We Care

As we celebrate the anniversary of the UNCRC and the Guidelines, we take pause to reflect on the change in Kenya. The Government of Kenya has embraced care reform and made significant progress in support of the reunification of children and young adults from institutional care into family and community-based care. In 2008, the Department of Children Services (DCS) undertook an Alternative Care Technical Assessment, which identified several gaps in both the provision of and knowledge about alternative care, recommending the strengthening of alternative family-based care models. Subsequently, they developed the National Minimum Standards for Best Practices for Charitable Children Services (2013) and later the Guidelines for Alternative Family Care in Kenya (2014). In 2017, the Kenyan Government placed a moratorium on the registration of new charitable children’s institutions (CCIs) [1] and, most recently, have issued a ban on international adoption [2] .The Kenyan Guidelines were aligned with the UN Guidelines (2010) and a significant step towards improving the care of children in the country. This work spurred care reform forward. The DCS included care reform within its 2018/19 annual work plan, [3] specifically focusing on decreasing reliance on residential care, promoting family-based alternatives and increasing prevention services for children at risk of family separation. Family-based care is also an integral part of Article 11 of the children bill currently before Parliament.

With a view of care reform framed around strengthening families and preventing separation, transitioning of CCIs to community services, and strengthening family-based alternative care, the care reform journey at the county level has started with a DCS/UNICEF pilot in Kisumu County to implement the Guidelines for Alternative Family Care. Changing the Way We Care (CTWWC) - an initiative designed to promote safe, nurturing family care for institutionalized children or children at risk of separation - launched in 2018, helping the government scale to four additional counties.

A national Case Management for Reintegration package was developed, building on models from other countries, which is key to supporting the reintegration of children and young adults back to
families and/or communities. DCS was also supported to complete a situational analysis in five counties looking at over 200 CCIs and Statutory Children Institutions, the children residing in them and the knowledge and attitudes amongst the CCI staff. This data is helping government to make evidence-informed decisions and to have a consistent approach to launching reforms nationally.

The care reform momentum has most recently brought together a multi-disciplinary team led by the National Council of Children Services (NCCS) and drawing from state and non-state partners to undertake a national care system assessment, which will guide development of a national care reform strategy focused on prevention, protection and promotive aspects of child protection. Family strengthening and unnecessary separation of children from their families is at the core. Additionally, and most importantly, the Government of Kenya has committed to careful planning of the reunification of children with their families or alternative families. The process to assess the needs and strengths of children in care has started, [4] along with tracing families and training of alternative families. The Kenya stage is set for great change for and with children, youth and families, and is proud to have care leavers at its side throughout the entire process. Together Kenya will be an example in the region.

[1] Ministry of East African Community, Labour and Social Protection , Office of the Cabinet Secretary. (November 01, 2017). Reference: MEACL&SP/7/13(S)SP/Vol.1/ (8). Suspension of Registration of New Charitable Children’s Institutions (CCI/SCIs).
[2] Special cabinet sitting chaired by the president held in12 September, 19.
[3] Department of Children’s Services Annual Workplan; Institutional Care and Alternative Family-Based Care Sections.
[4] Press statement on state of reforms on child welfare, Adoption and Protection; Ministry of Labor and Social protection: Cabinet Secretary, May 6, 2019
Relevance of the Guidelines in matters related to
adoption and surrogacy
by Mia Dambach, Children's Rights Specialist for the International Social Service (ISS)

Over the last ten years, the Guidelines have improved adoption practices, in conjunction with other international standards such as the 1993 Hague Convention. Whilst the Guidelines do not extend to adoption, which is parental care, they are applicable to “pre-adoption or probationary placement of a child with the prospective adoptive parents” (para 30(b)). In particular during this pre-adoption period, the Guidelines have provided concrete guidance on how to respect the principle of subsidiarity , notably by prioritizing support to families of origin and preventing unnecessary separation. Furthermore, the Guidelines have promoted the availability of a wide range of options, ideally family-based, which allows for continuity in the child’s upbringing (example: paras 57, 60, 74) in the child’s country of origin prior to the consideration of cross-border options. Overall, the Guidelines have shown stakeholders the importance of undertaking an individualized assessment of the child’s needs to ensure that his or her best interests are duly upheld.

One of the main challenges in terms of adoption is that poverty often remains the key driving force for separation of children. Connected to this is the prevalent view among families of origin and even stakeholders that life in a more developed country is better than living with less material goods. This frequently creates an environment that draws children unnecessarily into intercountry adoption.
Likewise, another challenge is when adoptive families and others – often well-intentioned –provide financial support to child protection systems linked to intercountry adoptions such as residential care institutions. This can generate expectations within countries of origin that if they “produce” more children for intercountry adoption, they will receive more support, drawing again children unnecessarily into intercountry adoption.

In the next ten years, my hope is that we continue to build on the progress that the Guidelines have achieved and that less children will be unnecessarily separated from their parents. I dream of a world where poverty is not the reason why children cannot live with their parents. I can also see a role for the Guidelines in surrogacy cases, in the unexpected circumstances when neither the surrogate mother nor intending parents are able/willing to care for the child. I hope that the Guidelines will be upheld so that children born through surrogacy will be able to live with families and institutional care will not be prioritised as is currently the case. 
Christians are shifting support to family strengthening
by Elli Oswald, Executive Director of Faith to Action Initiative

The global church plays a vital role in care reform, as perhaps the largest group of direct providers of care to children and significant funders of residential care. Over decades Christians have unknowingly played a role in the unnecessary separation of children from families every time they built, visited or funded orphanages.

However, since the development of the UN Guidelines on Alternative Care, there has been increased momentum to support quality family care for vulnerable children.

We are witnessing a shift of Christian support for vulnerable children from orphanages to efforts that strengthen families, preventing the need for children to be separated from their parents. ​

However, there is still much to be done. We must address the underlying assumption among the broader Christian culture that mistakenly says, “orphans need orphanages.” If these assumptions are not addressed, we will continue to battle the building of more orphanages by Christians. We must also ensure that reintegration is done with best practices, prioritizing the safety of children, and that Christian organizations work in effective partnership with local and national governments in care reform efforts.

Faith to Action has witnessed the great potential for change among Christians. When their efforts are redirected, they have the ability to bolster family-strengthening efforts, alternative family-based care models, and care reform. Christians have always valued family and cared for the most vulnerable people in society. I believe the church will continue that legacy by reintegrating children into families and strengthening families so they can care well for their children. In 10 years, my hope is to see Christians leading in the effort to see children cared for in safe, loving families.
Protect children without parental care and ensure high-quality, appropriate alternative care
Eliminating violence against children in all care settings
by Najat Maalla M’jid, Special Representative of the Secretary-General on Violence against Children

The collective voice of the international community to end violence against children is amplifying. This year, as we celebrate the 30th Anniversary of the UN Convention on the Rights of the Child (CRC), the 10th Anniversary of the Guidelines for the Alternative Care of Children and the 10th Anniversary of the Mandate of Special Representative on Violence against Children, the UN General Assembly is in a process of adopting the Resolution on the Rights of the Child with a specific focus on children deprived of parental care. This is an encouraging milestone! This would not have been possible without the hard work and joint advocacy of those who promote the rights of children in alternative care settings, many of them readers and contributors of this newsletter.

While we have a lot to celebrate, there is much more to be done. It is widely recognized that children without parental care are more likely to experience human rights violations, such as exclusion, violence, abuse, neglect and exploitation. We have by now research across the world on how detrimental institutions are for children’s development and well-being. Children
experience developmental delays, especially during early childhood, and potentially irreversible psychological damage by growing up in such environments. Even in a well-staffed institution, a child rarely gets the amount of attention he or she would receive from their own parents and families, or from substitute caregiver families in the community. In fact, over sixty years of research advises that even where institutions are well run, the very process of institutionalization is harmful to a child’s development. Despite this vast recognition of the negative impact on the institutionalization on children, we still too often see well-meaning, but ignorant efforts, that in fact fuel the business of orphanages and child trafficking.

One of the children who participated in the CRC anniversary side event in New York said in his remarks, “I am here today because I don’t want other children to be brought up in an institution.”

Services that assist and support families in the local community can help prevent children needlessly entering into institutions and ensure that separating a child from their family is only ever a last resort. Many children can return to live with their birth or extended families when the appropriate community-based services have been put in place.

In order to prevent and end violence against children in care settings, we must ensure that parents never have to give up their children due to poverty, ignorance or other preventable root causes. And if placement in care is clearly in the best interests of the child, different options should be available depending on the child’s situation, needs and wishes, and in line with the child’s ability to participate in the decision-making process, to avoid a “one-size-fits-all” solution and to allow children to grow up in a protective and enabling environment and to develop to their fullest potential.

Only then can we ensure that we leave no child behind! 
Ensuring high-quality, appropriate alternative care
by Becky Smith, Senior Child Protection Adviser, and Bill Bell, Head of Child Protection & Child Rights Governance for Save the Children

The recognition of the harm of institutional care and the prioritization of family and community care has led to an exciting period of experimentation, innovation and learning that now needs to be consolidated and used to inform future implementation.
In Cambodia for example, the Family Care First │REACT programme is piloting a variety of different types of foster care (from informal community foster care clusters to much more professional foster care for children with significant needs) to support the diverse needs of children. In Moldova, trialling different foster care models highlighted the advantages of using professional parental assistants. Set against these positive experiences of testing different options, however, it is also clear that the expansion of family-based alternative care, at scale and across the continuum of care, continues to face a number of challenges
One of these challenges is how best to support informal kinship carers - a form of family-based alternative care that is common in many countries around the world compared with formal foster care. We are still gathering evidence on the best ways to support kinship carers, especially in countries where large percentages of children live with relatives at some stage in their lives. Save the Children conducted child led research in East and Southern Africa on children’s experiences in kinship care which illustrated that while kinship care was effective in meeting the basic needs of many children, it also came with risks. Yet overly formalizing kinship care to try and mitigate these
risks, as was initially done in Namibia, overwhelms the system and is neither cost effective nor necessarily appropriate. More successful practices such as creating community monitoring mechanisms or providing cash transfers and social protection schemes to all poor families, including kinship carers, have proven more effective. As we support the expansion of family and community care, we need to bear in mind that all forms of care come with some inherent risks that need to be mitigated.
Over the past decade, we have become much better at beginning to define what high quality alternative care looks like. This includes: being able to access services and support, being able to integrate into the community, form stable relationships, maintain the child’s identity, receive individual attention, be able to contact friends and family if safe, and be prepared for independence upon leaving care. 
For our sector to move forward, we need to focus on defining and showing the benefits of a variety of high-quality alternative care options delivered at scale. We need to be measuring outcomes for individual children and making sure that children placed in any form of family-based alternative care are thriving.
Country Case Study: Uganda
Reflecting on the journey of alternative care in Uganda
by Emily Worrall, Communications, Advocacy, and Fundraising Director at Child's i Foundation

Today as we celebrate the 10th anniversary of the adoption of the Guidelines on the Alternative Care of Children, we are reflective of our own 10-year journey in Uganda. We have come a long way and learnt many lessons since our early days running a babies’ home. We have seen immense commitment in Uganda towards alternative care in the past 10 years. A unit has been established in the Ministry of Gender to oversee all alternative care issues, they have issued guidelines on gatekeeping and foster care and are leading the process of updating the National Alternative Care Framework.
In addition to this Government commitment, in March 2016 Uganda's Parliament passed the Children Amendment Act 2016. Previous to this, legal guardianship had been used as a conduit for trafficking of children outside the country, leading to an unprecedented increase in inter-country adoption. The law now streamlines the provisions of legal guardianship, domestic adoption and inter-country adoption, providing that legal guardianship to be granted strictly to Ugandan nationals.
While this is promising, our work is far from over. One of the biggest issues is we don't know the depth of the challenge we are facing. There aren't clear statistics of the amount of orphanages in Uganda, and the number of children growing up in
orphanages was last estimated in a baseline survey at 50,000 in 2012.

While we still have a long journey in front of us, in another ten years we hope to see all Districts in Uganda committed to prioritising families and alternative care. By directly working with the Government, we are creating a blueprint to guide how to build supportive communities and gatekeeping structures to move children safely into families, and help orphanages repurpose their services. With growing momentum to prioritise family-based care, we need to ensure the transitions are done safely and effectively. We hope to see Uganda lead the way in best practice for alternative care and child protection.
One thing we know for certain is this work can't be done alone. The Government, social workers, community volunteers, orphanages, communities, and the families worried they may have to place their child in an orphanage all have a role to play to ensure that no child in Uganda grows up without a family.
Care and protection of children in humanitarian settings
by Hani Mansourian, Co-coordinator of the Alliance for Child Protection in Humanitarian Action

As we celebrate the 10 th anniversary of the launch of the Guidelines for the Alternative Care of Children, and the 30 th anniversary of the Convention on the Rights of the Child (CRC), it is prime time to take a critical look at how we are doing vis-à-vis our obligation to protect children affected by humanitarian crises, in particular those who lose the care and protection of their families and communities.

One in four children continue to live in countries affected by conflict or disaster, many of whom are at risk of separation from their caregivers. The Guidelines for the Alternative Care of Children continue to provide grounded guidance for our response to the issue of care for unaccompanied and separated children. Many of the elements reflected in these Guidelines, such as the emphasis on keeping families together to prevent unnecessary separations, or supporting families and communities to care for their children, have been increasingly adopted into standards and practical guidelines developed specifically for humanitarian settings. The Guidelines are a successful example of a public good that has continued having a positive impact both at policy level and on quality of practice at the field level.

Despite progress, children continue being unnecessarily separated from their caregivers in almost all humanitarian settings; both accidentally and intentionally. At times, this is caused by malicious actors (such as those aiming at exploiting them for financial or other gains) and other times by well-intentioned actors (such as those who remove children from their families and
communities to ostensibly provide them with better quality of life). Some governments fail to respect the most basic principles outlined in the Guidelines in their juridical and immigration proceedings. Other governments fail to include internally displaced or refugee children in their existing systems, such as social welfare, education and health systems. Armed forces and groups continue recruiting vulnerable children with impunity. Humanity cannot afford to allow these patterns to continue. The cost of inaction is simply too high.

Scientific and anecdotal evidence continues to reaffirm the recognition made in the CRC that “… the child, for the full and harmonious development of his or her personality, should grow up in a family environment, in an atmosphere of happiness, love and understanding.” It is time for us, as a global community of actors, to redouble our efforts in ensuring the well-being and healthy development of children affected by humanitarian crises through responsive and protective care. This involves changes in policy and practice as well as increased funding for operational agencies who implement much needed interventions to prevent and respond to separation of children in humanitarian settings.
Ensuring the rights of LGBTI children to grow up in a safe,
supportive family environment
by Mark Canavera, Co-Director of the Care and Protection of Children (CPC) Learning Network

Like all children, lesbian, gay, bisexual, transgender, and intersex (LGBTI) children and youth have the right to grow up in a supportive family environment. Unfortunately, families—who should serve as protective mediators who support LGBTI children in navigating schools, communities, and peer groups—often pressure these children to conform to heterosexist and heteronormative conventions of sexuality and gender identity, resist their expressions of gender and sexuality, or even reject and abandon them. We simply must invest more in ensuring that families and alternative care providers are able to understand and support all children.
In settings all over the world, LGBTI children and youth often face a basic lack of understanding from their families. Rather than simply rejecting their LGBTI children, families may also mistreat them, or suggest or insist upon various forms of “reparative” therapy. And family abandonment—the throwing out of LGBTI children and youth from their homes—is a problem that occurs in every region of the world. These children and youth may face homelessness, poverty, and sexual exploitation and experience greater risk of high-risk behaviors like survival sex, sex work, and drug use. A nationally representative survey in the U.S. revealed that LGBT youth were 120% more likely to report homelessness than their non-LGBT peers [1] . Another recent study suggested that the same was likely to be true across a variety of countries, with specific mentions of Colombia, Jamaica, Switzerland, the Democratic Republic of Congo, Russia, Vietnam, and countries across the Commonwealth of Independent States.  
The  Guidelines indicate that States should provide appropriate care and protection for vulnerable children—listing a number of groups of vulnerable
children without mentioning LGBTI children. They also suggest vaguely that “special efforts should be made to tackle discrimination” but do not mention sexual orientation, gender identity and expression, and sex characteristics (SOGIESC)-based discrimination. Yet the rates of family abandonment of LGBTI children suggest that these children are likely to be over-represented in alternative care settings, which may be ill-adapted to meet their needs. In addition, LGBTI children in alternative care often face significant levels of stigma, discrimination, and bullying within institutions. [2] , [3] , [4] , [5]

Furthermore, in a recent global survey , 38% of residential care facility workers stated that lack of capacity played a part in preventing LGBTI* children from being adequately safeguarded, and 53% of respondents felt that their system for monitoring and reviewing safeguarding measures does not take into account the needs of LGBTI* children. The good news that emerges is the overwhelming suggestion that staff members would like to learn more about protecting, supporting, and caring for LGBTI children and youth, according to the survey.
Given the central role that families play in the lives of LGBTI children and youth—and the potential for family rejection to have long-term consequences for these children and youth—there are surprisingly few services and supports that target LGBTI children’s families. Moreover, for those children who are living in alternative care settings or on the streets, work to understand how best to support these children is also only embryonic. Examples of programs include:
  • Information and support for parents and families of LGBTI people
  • Family mediation or strengthening for non-accepting families
  • Making alternative care environments more inclusive and supportive for children
One could imagine a scenario in which family strengthening approaches would in fact become the  majority  of services and supports for LGBTI children, a goal for future work.

[1] Morton, M.H. et al.  Missed opportunities: Youth homelessness in America. National estimates.  Chicago, IL: Chapin Hall at the University of Chicago, 2017.
[2] Dreilinden gGmbH and SOS Children’s Villages International.  “Skirt? Nope, not for me!” Sexual and gender self-determination for children and youth in alternative care settings: An issue paper for development iNGOs . Hamburg and München: Authors, 2016.
[3] Dreilinden gGmbH, SOS Children’s Villages International, Keeping Children Safe.  “Let Me Be Me!” Better Care for LGBTI* Children: A Working Paper for iNGOs . Hamburg, Innsbruck, and London: Authors, 2017.
[4] Mallon, Gerald P.  Let’s Get This Straight: A Gay- and Lesbian-Affirming Approach to Child Welfare . New York: Columbia University Press, 2000.
[5] ---.  We Don’t Exactly Get the Welcome Wagon: The Experiences of Gay and Lesbian Adolescents in Child Welfare Systems . New York: Columbia University Press, 1998
Recognize the harm of institutional care for children and prevent institutionalization
How deinstitutionalisation has led to system change
by Delia Pop, Director of Programmes and Global Advocacy for Hope and Homes for Children

Since the adoption of the Guidelines I’ve witnessed, and most importantly I was part of, a real movement for change mostly focused on the development of alternatives to institutions, the transition from reliance on institutional care and the development of coordination and gatekeeping mechanisms. At government level, I have seen political will translated into national legislation and action plans focused on the transition from institutions to family and community-based care. I have seen a significant number of governments implementing moratoria on the placement of young children in any forms of residential care and a variety of policy provisions for the development of different forms of alternative care, including after care. More and more local pilot initiatives have led to an increasing confidence that home-made solutions can be implemented, and institutionalisation can be eliminated.

Such local examples have led to the development of national social workforces in several contexts and the recognition that the para social workforce plays a key role in shifting how we care for
children in families, starting at the grass roots level. These developments accelerated over the last 5 years, most likely supported by an increasing number of donors, private, corporate and institutional who committed funding for the transition of children into families and the development of alternative care for children. A fantastic result is an increasing awareness of the harm of institutions and the recognition that sometimes helping is not helping and that orphanages contribute to the displacement of children out of their families and communities.

The biggest challenges we are facing are threefold. Firstly we need to make sure we capitalise on the increased political will and the growing local confidence and expertise to ensure we take a system change approach to develop child protection and care systems which are sustainable, adaptable, well monitored and of high quality in serving the best interest of all children. Secondly, we have to focus much more attention to strengthening families and gatekeeping mechanisms. We need to scale up successful projects and local initiatives and embed them into national law and budget. Thirdly, children with disabilities, are still left behind, and are over-represented in institutions and residential care. They must become a priority and we need to build the capacity of the civil society to advocate, support and provide services for their families.
We have to remain focused on ending reliance on institutions and fight the issue fatigue and the myths still surrounding the scale of impact of care reform and deinstitutionalisation programmes. Collaboration, convergence and system change should enable us to raise care reform and the elimination of institutions as a global priority. I wish that families, never orphanages will become our umbrella under which we can ensure children grow up in safe, loving families, supported in resilient communities and assisted by responsive child protection and care systems.
Trafficking and other forms of exploitation in orphanages
by Dr Kate van Doore, Griffith University Law School Lecturer and Co-Founder of Forget Me Not

Whilst research has shown that institutional care is harmful to children for decades, recently more attention has been paid to the exploitation and trafficking of children in orphanages. Some children in orphanages are reported as being subject to sexual exploitation, forced and bonded labour, and even slavery like practices. These children are both more vulnerable to these forms of exploitation, and experience them at higher rates than children in the community. There are reports of children being held in poor conditions that threaten their health in a deliberate ploy to gain more sympathy and funding from visitors and volunteers. It is also reported that many orphanages provide enticements of better opportunities to parents in order to elicit a child’s transfer or recruitment to an orphanage.

Whilst this was previously regarded as a gatekeeping or admissions issue, the systemic nature of the issue is now being recognised more broadly as a form of child trafficking. Where children are recruited or transferred into orphanages for the purpose of exploitation and profit, it is known as orphanage trafficking. This represents a significant disruption to the discourse on the alternative care of children, particularly as it relates to how and why children are admitted to care institutions. Orphanage trafficking is being increasingly recognised as an emerging form of exploitation internationally with the Australian, United States, Dutch and United Kingdom governments all considering the issue recently.
The introduction of Guidelines presented the potential of enhanced mechanisms on admission and gatekeeping for residential care that targeted the issue of recruitment into orphanages (see guidelines 125 and 127) and included specific protections from abuse and exploitation for children living in alternative care (see guidelines 92-93). However, such mechanisms are not effective without enforcement. The key challenges currently are to encourage governments to both implement the Guidelines into legislation, policy and practice, and to act to enforce them in order that children in care situations are protected, and care institutions are not sites of exploitation or trafficking. 

As we progress into the coming decade, it is imperative that we work towards explicit recognition of the offence of orphanage trafficking as one method of ensuring that children in care are not commodified. We must also keep emphasising that orphanage trafficking is just one symptom of a child protection system that exhibits an over-reliance on institutional care for children generally, and is not the sole cause. 
Country Case Study: Cambodia
Growing community support for family-based care in Cambodia
by Srey Ny Sorn, Project Manager, and Lisa Yunker, Technical Advisor for Children in Families ABLE Program

Children In Families, a local Cambodian NGO, has been championing the need for family based care in Cambodia since 2006 and has witnessed significant progress since the adoption of the Guidelines on the Alternative Care of Children. While CIF was one of only a very few pioneers in family based alternative care at the time the Guidelines were adopted, in recent years there has been a significant growth in the number of organizations supporting family based care in Cambodia. What’s more, strong partnerships have been developed to help these organizations work together to promote and implement best practice.

The Cambodian government is also increasing its efforts to back up its policies on alternative care and reduce the number of children in institutions. We are seeing a positive change in local community perspectives. People are getting the message and are steering families away from looking to orphanages as a solution. Local officials are increasingly referring children in vulnerable situations to organizations with a family based approach. Even for children with disabilities, who have sometimes been overlooked in the push for family based care in Cambodia and elsewhere, there has been encouraging forward movement. Children In Families now has at least five times the number of children enrolled in its ABLE Project, which provides specialized services to help support the care of children with disabilities
and/or chronic health issues, as it did at the start of the project in 2013. Additionally, other family based care organizations are expressing interest in becoming equipped to be more inclusive of children with disabilities.

Despite this promising progress, challenges remain. There still is a lack of adequate support services for families to address the problems which resulted in large numbers of children being placed in orphanages to begin with. This is especially true in more rural areas. As the government is encouraging the reintegration of children out of residential care and back into their families, care needs to be taken to ensure that the families and children are prepared for this transition and that issues such as poverty, food security, educational opportunity, access to medical and rehabilitative services, etc. are being addressed. Still, there is reason for optimism that the current momentum will remain strong. We anticipate continuing to see more of the population recognize the advantages of family based care over institutional care, along with greater availability of support and continued improvement in practices. 
Orphanage Voluntourism
by Justine Williams, Campaign Manager for Better Care Network

In the last 10 years, there has been a rise in the number of orphanages – particularly in areas that are popular tourist destinations. This has been linked to the growth in popularity of voluntourism – a form of tourism in which travellers participate in volunteering. This means that the good intentions of volunteers are in fact perpetuating the cycle of children being needlessly separated from their families – and weakening care reform efforts to implement the Alternative Care Guidelines.
The good news is that in recent years there has been a positive shift in the voluntourism sector.  In 2013, a cross-sectoral global coalition called ReThink Orphanages (formerly Better Volunteering Better Care) was formed. It brought together individuals and organisations from a range of sectors, including child protection, travel and education, with a shared goal – to end orphanage tourism.   

Since the ReThink Orphanges movement was established, a growing number of volunteer-sending organisations have ceased the promotion and facilitation of orphanage volunteering and there is an increasing awareness about its harm. This year has also seen the launch of the first-ever global standard for volunteering (Forum Standard
for Volunteering for Development), which includes a clear statement prohibiting orphanage volunteering, and the inclusion of wording on the need to “prevent and address the harms related to volunteering programmes in orphanages” in the Key Recommendations for the UNGA 2019 Rights of the Child Resolution is a significant and historic step in the right direction.  

That said, there is still a long way to go. The global billion-pound voluntourism sector remains largely unregulated and the demand for international volunteering opportunities as a gap year or a career break continues to grow. Overseas volunteering is actively encouraged by schools, colleges, universities and even corporations, through their graduate recruitment programmes.  
There are several challenges ahead. The first is to ensure that as volunteer-sending organisations transition away from relationships with orphanages, they do so responsibly and do not leave children vulnerable. A divestment resource which is being developed through a partnership between the travel and child protection sectors, is designed to support travel companies through this process.  

Secondly, there is a risk that as volunteer-sending organisations cease orphanage volunteering programmes, they may shift to other forms of volunteering with equally vulnerable children. To avoid this and build on the existing collaborative efforts with the travel sector, a framework for volunteering in ethical and sustainable ways to support children and families overseas needs to be developed.  

Finally, change is needed within the education sector. To reduce student participation in orphanage volunteering there needs to be a shift in how schools, colleges and universities approach volunteering overseas more broadly. This includes breaking down the cultural assumptions, which are known to contribute to ineffective international volunteering, and teaching, guiding and preparing students to participate in more ethical, responsible and thoughtful volunteering.  
Regional Case Study: Africa
Challenges and opportunities: Reflections on care in Africa for the last 10 years
by Stephen Ucembe, Regional Advocacy Manager of Hope and Homes for Children

Since 2009, when a Resolution welcoming the Guidelines for the Alternative Care of Children was adopted by the United Nations General Assembly, African countries have had mixed experiences in relation to child care reform. Only few governments have domesticated and contextualized the Guidelines; this has contributed to a lack of prioritization of children without adequate parental care and generally led to slow progress in achieving structural transformations. The Guidelines’ 10-year anniversary offers a unique opportunity to regain political momentum, identify and address the evident gap in skills and knowledge within the social workforce, and help mobilize resources from different stakeholders to catalyze reforms.

In the past 10 years we have experienced increased general awareness on the harm of institutional care. However, change has been scattered and inadequate: awareness has to translate into evidence-based action. Investing in data and information on children without parental care across the region is critical. This will not only help understand the number and experiences of institutionalized children, but also identify the underlying structural issues that push children into institutions - including poverty, lack of access to healthcare and education, as well as attitudes and beliefs discriminating against certain categories of children, such as children with disabilities. 

In order to trigger change, we need enhanced political will. Historically, many African countries have laws, policies and regulations that reinforce the practice of institutional care. We need governments to revise these policies and explicitly rule out institutions as a care option for children.
Moreover, we have to move from rhetoric and pronouncements and lock in political commitment into care reform strategies and action plans, with adequate resource allocation and enhanced processes for monitoring and oversight.

Civil society organizations need to mobilize and pull together, improve their coordination and hold governments accountable. Their role is equally important in supporting and supplementing government efforts in care reform - by contributing resources, piloting projects and developing technical knowledge and skills on how to move away from institutional care. Critically, this know-how and learning has to be upscaled and used to inform national interventions.

Although the task ahead remains daunting, taking into account the current socio-economic and political realities, it is reassuring to see the efforts of some African countries that are pioneering care system reform. These countries are effectively demonstrating that change is possible and can inspire others to act. We trust that in the next 10 years governments, civil society organizations and international donors will divert investment for institutions and focus instead on preventing the unnecessary separation of children from their families and rediscover those family and community-based approaches to care that our continent has traditionally cherished and promoted in the past.
Children with disabilities and care reforms
by Lucy Richardson
Human Rights Officer for the International Disability Alliance

For thirty years, the Convention on the Rights of the Child (CRC) has promoted the rights of all children, and for ten years the Guidelines on the Alternative Care of Children have provided a framework for ensuring the rights of children without (or at risk of being without) parental care. For children with disabilities, alongside the CRC and the Guidelines, the 2006 Convention on the Rights of Persons with Disabilities (CRPD) adds further clarification on their rights and how to uphold them. As the CRPD has been ratified and implemented on the ground, it has supported the great strides towards fulfilling the rights of all children with disabilities.

Of particular importance is CRPD’s Article 23 on the right to family and home life, which states that children with disabilities have equal right to family life, and “With a view to realizing these rights, and to prevent concealment, abandonment, neglect and segregation of children with disabilities, States Parties shall undertake to provide early and comprehensive information, services and support to children with disabilities and their families.” Children with disabilities face a range of physical, economic, societal and attitudinal barriers that contribute to their over-representation amongst children experiencing forced family separation, parental abandonment, or placement in institutions. In many places around the world, parents of children with disabilities have been encouraged or even forced to place their child in an institution – often told that is in the child’s best interests, to ensure his or her access to education and services. In other cases, negative societal attitudes and inaccurate understanding of disabilities (including beliefs that disability is due to witchcraft or sin) have prompted parents to place their child in institutions themselves, or even abandon their child. For some parents, poverty and lack of social protection schemes leaves them
unable to afford care for their child with disabilities who requires specialized services or equipment.

Care reforms are welcomed, but they do not always adequately address the specific needs of children with disabilities, or recognise their inherent rights on an equitable basis with other children. In some cases, the phenomenon of transinstitutionalisation occurs – where children with disabilities are simply moved from one type of institution to another. It is important to note that insitutions are not merely defined by size or name, but rather by elements such as isolation and segregation from independent life within the community, lack of freedom and choice, and rigidity of routines. Children with disabilities are disproportionately more likely to be institutionalised, and more likely to suffer abuse in these environments. There are reports of large institutions that have been converted into “small group homes” by renaming each floor as a separate “home” but retaining the same policies, staff, and practices as before.

So we see that there is still a long way to go, but we have roadmaps to get us there that need only the political will and funding of decision makers. Through implementing and aligning to the CRPD via targeted policies and programs, reviewing and revising discriminatory legislation, and reforming infrastructure and systems, all actors – including local and national government, civil society, and private sector – can enable full realisation of the right to family life for children with disabilities. 
Engaging residential care managers
by Peter Kamau, Director of Administration for Child in Family Focus

Attainment of political will and the domestication of the UN Guidelines for the Alternative Care of Children (UNGAC) to various country contexts has ensured that the recommendations in the Guidelines are embedded in legal and policy instruments. For example, the launch of the Guidelines for the Alternative Family Care of Children in Kenya in 2015 was followed by a moratorium on registration of new Charitable Children Institutions in 2017 and the ongoing process of developing a care reform strategy. All these developments are anchored on the UNGAC.

When the desire to transform or close orphanages runs ahead of the capacity of families to receive children, then children are often placed in dangerous situations. Care reform is a gradual process and should not be rushed.
Reactive interventions that come into play after a child is already separated from his/her family have resulted in family disintegration leading to flocking of children into the streets in their hundreds while sprawling children’s homes have increasingly replaced family. Children that are lucky to remain within families are increasingly faced with the risk of severe neglect, abuse and exploitation as families reel under the weight of economic hardships and social disintegration. There is need for states to invest more in preventive services to tackle root causes of children’s separation from their families and abandonment.

Resistance by residential care managers, lack of demonstrable alternatives to institutionalisation, inadequate professional capacity of the workforce and lack of budgets for system reform are additional challenges.

Taking cognizance of the integral role residential care managers play in child protection and ensuring that they are given a seat at the care reform discussion table will contribute to success in alternative care in the coming years.

Mitigating resistance from residential care managers, staff and donors calls for continued sensitization and engagement – understanding where they are at, why they do what they do and giving them a seat at the table. We must avoid the use of language that is condescending and demonizing as this adds to the resistance.

Committing to journeying alongside them by building their capacity to implement alternative care as well as linking them up with entities that have undergone the transition goes a long way. Also, dispelling their fears and being the listening, caring and supportive partner has proved helpful in the transition process.
Country Case Study: Rwanda
Child care reform in Rwanda
by Innocent Habimfura, Rwanda Country Director for Hope and Homes for Children

As we celebrate the 30 th anniversary of the UN Convention on the Rights of the Child (UNCRC), there is an opportunity to highlight major progress in the advancement of children’s rights.

The Rwanda national strategy for child care reform of March 2012 is an elucidation of the implementation of the UN Guidelines for the Alternative Care of Children (UNGAC). With adoption of resolutions, the Government of Rwanda launched a Deinstitutionalization project in October 2010 in partnership with Hope and Homes for Children. The pilot institution closure and the national survey for children in institutions revealed that a majority of children in orphanages had at least one living parent.

The “Tubarerere Mu Muryango-TMM” (Let us raise children in families) Program provided a clear orientation on how children living in orphanages would regain their right to live in family, strengthen families to stay together and establish a gatekeeping mechanism. 
With this strong political will rooted in traditional values of raising children in families, the TMM Program was implemented diligently. Eighty-four percent of orphanages were closed. Children were reintegrated in families, placed in foster care or domestic adoption, and young people supported to live independently. The orphanage has become unnecessary for children, families and communities.

Child care reform has revealed itself as the engine towards strengthening child protection systems with full capacity to develop services in the best interest of the child.

Deinstitutionalization of centers for children with disabilities is in its pilot phase, implemented jointly by the National Council for Persons with Disabilities, Hope and Homes for Children and the National Commission for Children. The very first professional closure was made on the eve of the 30 th anniversary of the UNCRC. All children were reintegrated with their families or placed in special foster care. THIS IS WHERE THE WORK STARTS!

Some challenges occurred throughout the journey including the resistance of some institutions’ owners, managers and donors; an emerging social workforce; and lack of inclusive community day care services. UNGAC should be disseminated with the legislature, judiciary and the National Human Rights Commission to play an active role in ensuring no one is left behind. This is to reduce delay tactics of institutions’ supporters who strategically refuse to release children.

With great foundations gradually erected, all ingredients are in place for a child protection system capable to address all child protection concerns. In the coming 10 years, Rwanda will be free from orphanages and children with disabilities institutions. In brief, institutional care for children will be unacceptable. 
Strengthen child welfare and protection systems and services (including ensuring adequate financial and human resources & improving data collection)
The role of the social service workforce in children's care and care reforms
by Nicole Brown, Deputy Director of Global Social Service Workforce Alliance

As we celebrate the 10 th anniversary of the Guidelines for the Alternative Care of Children, now is the opportune time to take stock of both progress and challenges in the role of the social service workforce in the implementation of the Guidelines. The social service workforce is one of the key advocates and implementers in promotive, preventative and treatment programs to ensure children’s rights are realized and upheld, and this workforce is on the frontline of family strengthening efforts that help keep children and families together.

Over the last 10 years, the term ‘social service workforce’ has become better understood and the significant role of the social service workforce, including para-professionals, in children’s care and care reform has been given greater recognition. Child protection and other child welfare officers now have more tools, knowledge and support to address all forms of violence and strengthen families. And the evidence base to demonstrate the impact of these workers in children’s lives is growing, as is the availability of tools and resources to increase capacity and advocacy.

The push for care reforms has also led to a need for better provision of social services and capacity-building of this workforce. Social service workforce strengthening has been incorporated into several national care reform strategies. For example, Moldova’s National Strategy and Action Plan for the Reform of the Residential Childcare System 2007– 2012 aimed to establish a network of community social workers, and the 2013 Law on Special Protection of Children at Risk and Children Separated from Parents introduced child
protection specialists, a new workforce at the community level (as mentioned in The Role of Social Service Workforce Development in Care Reform) .

Yet there is also a significant challenge in provision of planning, development and support to this frontline workforce. In celebrating reductions in violence and family separation, the numbers don’t tell the full story. We know it takes people to realize these results. Without the proper training, adequate staff numbers and remuneration, the social service workforce is not best positioned to support children, families and communities.

The Key Recommendations for the UNGA 2019 Resolution on the Rights of the Child call for the strengthening of, and provision of adequate funding to, the social service workforce. Our vision is that over the next 10 years, all social service workers will gain the funding levels and programmatic support needed to prevent family separation and ensure that all children are able to live in safe and nurturing family care. In doing so, the Guidelines will be fully realized.
The role of donors in care reforms
by Dan Lauer, Senior Program Officer of Global Development for GHR Foundation

It is an exciting time in care reform, with much accomplished since the launch of the Alternative Care Guidelines 10 years ago. This includes what many believe to be a pivotal point in elevating the importance of family care for the world’s orphans and vulnerable children. While much remains to be done, there is a palpable shift in awareness globally toward a greater understanding of the long-term benefits for children who are raised in family-based care, outside of institutions.
This shift is the next challenge in care reform and offers a unique space for the donor community - philanthropy and government founder - to lean into. This is especially true as we consider taking family-based solutions, in line with the Alternative Care Guidelines, to scale.

Whether alternative care placements are effective, practical and scalable across cultures, countries and continents remains an elusive aspiration. Without clarity on effective approaches that strengthen and preserve families, support reunification of children and their reintegration into family, community and society, foster care and adoption, we will fall far short of our collective push for family care for all children, including those with disabilities.
The care community’s opportunity over the next 10 years is to shift from merely talking about alternative care to building the concrete evidence of practical alternative placements that provide safe, sustainable, family care. Our challenge, as donors, is to be disciplined in targeting our funding on the evidence, tools and approaches that can be scaled to a future in which family care for all children is the norm, and institutionalization is an approach of the past.
Regional Case Study: Europe
Care reforms across Europe
by Jana Hainsworth, Secretary General of EuroChild

Since 2013, the EU and its institutions have shown a great commitment to de-institutionalisation (DI) in both policies and funds. [1] , [2] Almost €2.7 billion has been made available through European Structural and Investment Funds (ESIF) to support the transition from institutions to family and community-based living. [3] Additionally, twelve European countries have prioritised DI in national strategies and associated EU funding [4] and visible progress has been made.
Family-based care has grown while institutions for children are in decline. For example, in Romania, Bulgaria, Latvia, Lithuania, Hungary, Serbia and Moldova, the number of children without parental care who grow up in foster and kinship families has exceeded the number of children living in institutions.

In a handful of countries such as Poland, Estonia, Bulgaria, Romania and Moldova, there has been an uptake in the development and mainstreaming of community-based services to support families at risk/in need of social assistance or children with disabilities and to prevent children’s abandonment or institutionalisation.
We need common definitions, better data & more balanced monitoring of progress. The lack of recent quantitative data on children without or at risk of losing parental care is a major impediment towards the implementation of national deinstitutionalisation strategies.
The issue of DI is now considered to be relevant for all EU countries, not only those with an “identified need”, and should be reflected in every
country’s strategy for poverty reduction and social inclusion.

There are challenges with the use of EU funds for deinstitutionalisation for children across EU Member States. Evidence from Croatia and Romania suggests that in 2018 and 2019 there have been considerable delays. In Hungary and Poland there are concerns that EU funds are predominantly used to modernise existing facilities or to build small institutions. 

Despite a generally positive trend with the development of foster care in Europe, there is still an insufficient number of foster families in Croatia, Estonia, Romania and Greece. Moreover, the child protection sector is underfinanced and lacks capacity to deal with transformation of welfare and protection services.
We need to make sure that the next seven-year Multiannual Financial Framework (MFF) 2021-2027 will address the issues of the transition from institutional to family- and community-based care. Although negotiations are still ongoing and a final agreement will not be reached until the end of 2020, a number of extremely promising trends can be observed. The European Social Fund+ (ESF+) recognizes both child poverty and the transition from institutional to family- and community-based care as a cross-cutting issue. There is growing support for a Child Guarantee scheme , originally proposed by the European Parliament, which would allocate 5% of ESF+ (a dedicated budget of 5,9 billion euro) to tackle child poverty and social exclusion across the EU. EU political pressure & funds need to be better harnessed and there is a need for better guidance on the use of funds for both the European Commission and national level authorities.
We also need to give voice to and strengthen the agency of those directly affected, by engaging with care leavers associations, parents whose children are at risk, and others.

[1] The European Commission Recommendation on Investing in Children [1] in 2013 created some momentum as it called on Member States to use Structural Funds to stop the expansion of institutional care in Europe and promote quality family- and community- based care.
[2] Regulation (EU) No 1304/2013 article 8, Regulation (EU) No 1301/2013 article 5
[3] Structural Funds Watch 2018
Strengthening data and data systems for children in
alternative care
by Chris Desmond, Director of the Centre for Liberation Studies

Based on the data that is available we know that there are millions of children living in various forms of alternative care around the world. The data we have, however, make estimating the exact size of this population of highly vulnerable children difficult, and heavily reliant on assumptions. Accurately estimating numbers by type of alternative care, age, gender, disability and so forth is even more difficult, near impossible.
This situation persists in spite of there now being at least some data available on children in alternative care in most countries. And despite the Guidelines requiring countries to collect appropriate data. The challenges arise because of irregular data collection, poor data quality and differences in the definitions used rendering comparisons difficult. 
Irregular data collection is common in contexts where children in alternative care are surveyed rather than monitored. Occasional data collection exercises are conducted and reported on, rather than the careful management of an appropriate administrative monitoring system. Where taken, this approach arguably betrays the state’s narrow view of its responsibility to children living in such situations.
Poor data quality is common in many countries and typically relates to undercounts in official data, particularly in countries where informal provision of alternative care is common. While there are ways the data on informal provisions can be improved, substantial improvements in data quality are only likely when states take greater responsibility for this sector.
Definitions remain a challenge. What is included under the residential care definition varies greatly, particularly regarding institutions which have a dual purpose, such as boarding schools which act as residential care facilities. The challenge of
agreeing definitions is well established. It is, however, time for some compromises. Any definition will be problematic, but agreeing one will help improve data quality. A definition with sub-categories which can be included or excluded at the country level would still allow for some variability. Institutional care is similarly defined in a variety of ways around the world. Correcting for this is difficult, given that definitions typically rely on physical characteristics and institutionalisation is perhaps best characterised by the nature of care. However, a definition of residential care with sub-categories, even if characterised by physical features, may usefully side-step this issue. We would get a sense of the types of residential care, without having to say which features classify a model of provision as institutional in all contexts.  
While the data challenges remain large, good examples are available, from the UK and Australia, for example. Moreover, steps to improve data have been taken in a number of countries. Notable examples include Cambodia and India. In both cases, the efforts of these two countries highlighted the difficulties of establishing a baseline and insights into the strengths and weaknesses of alternative approaches to improving data quality.  
In the end, data systems reflect the value states place on protecting children in alternative care. Where this value is high, the systems are good. Where it is low, they are poor. Lobbying to improve data systems may help, but real progress will only come from a shift in values and the associated acceptance by states of their responsibilities. 
Country Case Study: Ukraine
Using the Tracking Progress Tool in Ukraine
by Andro Dadiani, Regional Program Advisor for SOS Children's Villages Ukraine

Use of the Tracking Progress Initiative (TPI) Tool in Ukraine started as a component of an idea to establish an independent, NGO-lead platform for monitoring implementation of the UNCRC in Ukraine. Monitoring of alternative care provision was selected as the primary focus, and as a methodology to assess the state of the alternative care system, TPI was selected.

Children in care represent the most “visible” group of children whose rights are vividly violated. There are over 106,000 children living in large-scale institutions in Ukraine. Although there are national strategies in place which are meant to help
achieve deinstitutionalization of these children, the progress has been very slow.

Therefore, we sought to better understand the status of the alternative care system in Ukraine, using the Guidelines for the Alternative Care of Children as a standard against which the quality of the system would be measured. 

Although the relevant ministries of the government did not participate, the process of using the TPI in itself was valuable for the members of the NGO group. The tool helped to brush up our knowledge of the Guidelines; get a coalesced picture of what parts of the alternative care system are in place and which are not, and helped organize relevant evidence. It enabled us to look at some “blind spots” and remember the groups of children that are not routinely seen as a target group by those working in alternative care, e.g. unaccompanied migrant children. TPI allowed us to examine legislation, regulations and services in place for addressing the needs and rights of these children, or lack thereof. As a group of organizations that plan and implement projects to reform the child protection system, the TPI has helped us to realize some of the bottlenecks that we were not aware of before undertaking the exercise.

As a group of NGOs participating in the process, we faced the challenge of how to bring the results of the TPI to the government’s attention so that they could not afford to ignore them. With the CRC reporting process taking place shortly, it was decided to use the alternative CRC reporting to convey the findings of the TPI to the government as well as the wider society. We hope that the government will learn about the gaps in its implementation of the Guidelines in the alternative care system and prioritize addressing those properly in its strategies, budgets and actions.
Ensure full participation of children without parental or family care
Still not enough: The need to ensure care leaver engagement in care reform efforts in Africa
by Ruth Wacuka, Secretary of the Kenya Society of Care Leavers

The past several years have seen a movement towards care reform in many African countries, including Kenya. Care reform focuses on both decreasing reliance on residential care (orphanages) and strengthening family-based care for children. Family-based care refers to families of origin as well as in alternative family-based care. 
As governments and civil society organizations promote these concerted efforts to ensuring a child’s right to safety and protection within a nurturing family environment, the experiences and voices of young people and children who have resided in care, also referred to as care leavers, has been sought out. The stories shared by this important group of stakeholders has been solicited and heard at global conferences, regional meetings and in local media. Their stories have often resulted in or influenced changes made within policy and programming. In the past year, two significant documents ( How to Engage Care Leavers in Care Reform  and  The Care Leaver Experience: A Report on Children and Young People’s Experiences in and After Leaving Residential Care in Uganda ) have been published and care leavers have presented at global conferences targeting faith-based groups, young
people, governments and donors. Their stories are moving, emotionally charged, and personal.

However, care leavers are also asking to be more than just their stories. As highlighted in a recent webinar , care leavers want to be engaged in care reform but in a way that is pro-active and reflects their agency. Whilst their stories are powerful tools for helping people to understand the effects and personal consequences of living in residential care, care leavers are also active, smart and ready to participate in care reform in other ways. This includes organizing themselves into care leaver associations and developing their own professional skills in advocacy, social work and public speaking. Care leavers want to act independently and create their own agenda and space within the sector. They don’t want to be “add-ons” and are tired of what they deem to be tokenistic approaches to their engagement.
Regional Case Study: Latin America
Children's care reforms in
Latin America
by Matilde Luna, Director of RELAF

The welcoming of the Guidelines for the Alternative Care of Children by the UN General Assembly in 2009 has been a historic global feat with a strong impact in Latin America and the Caribbean. Since the issuing of the Guidelines, it has been possible to enhance the conditions necessary to put the issue on the agenda of the region's governments, as well as to boost reforms of the alternative care systems.

A first key aspect involves the visibility of the situation of children deprived of parental care. As a result of the production of surveys and situational analyses carried out by the Member States, severe rights violations suffered by the region's children came to light, especially those violations endured by institutionalised children. Overall, confinement was revealed to be an extended, rooted "protection" practice.

This new visibility brought new changes and transformations within the framework of the construction of comprehensive child protection systems, still in progress. In the last few years, innovative programmes have been launched and established and previously existing programmes have been adapted to the new paradigms; primarily, the reform of alternative care modalities. The practice of foster care has become stronger and its availability has multiplied, and residential care modalities have been transformed and adapted in order to provide quality care in compliance with the suitability principle of the Guidelines. Progress has also been made regarding the establishment of policies and
programmes aimed at strengthening families and communities and their childcare abilities in order to prevent unnecessary separations and abandonment, in line with the necessity principle.

Finally, the strategies to support those children who leave the alternative care system have been improved: on one hand, by enhancing the inclusion opportunities of adolescents who leave the system towards an autonomous life; on the other, by strengthening families so that they can be responsible for their children and look after them adequately, preventing new separations after family reintegration is achieved.

There is still a lot to do. In the last years, thanks to the Guidelines, many entities and organisations that have been working in the field for many years, such as RELAF, have seen their working perspectives enhanced and strengthened. This celebration is an opportunity to reaffirm the commitments and to double the efforts so that, within the next 10 years, the right of all Latin American children to live in a family and in a community is guaranteed.
Putting Care Reform on the Global Agenda
Putting care reform at the heart of the 2030 agenda
by Alex Christopoulos, Deputy Chief Executive of Lumos
Looking at the big picture, progress over the past ten years has been significant. Major funders and influencers, such as the EU, UN and national governments, have made substantial commitments that recognise the importance of family strengthening, building alternative family-based care, and the harms of institutionalisation.
The message is starting to get through and resistance to the basic fact that children do better in loving, supportive families than in institutional care, is waning. But in order for us to deliver transformative change for future generations and the millions of children who continue to live in institutions, we need to ensure that care reform is understood as indispensable to global development and is prioritised accordingly. In this regard, the 2030 Agenda for Sustainable Development offers an unprecedented opportunity.
The Sustainable Development Goals (SDGs) seek to tackle many of the issues which continue to fuel the institutionalisation of children, including poverty, discrimination, and insufficient access to education. Yet, in spite of this clear alignment and the commitment to “to reach the furthest behind first”, children in institutions remain absent from the SDG indicators and monitoring frameworks. Through the promise to invest in education, health, early child development, and prevent trafficking – the SDGs have the potential to play a key role in strengthening families and preventing separation. But these linkages must be recognised and monitored, or they will be lost.
As a community of practice, we must now work together to ensure that children in institutions are not left behind and that the strong framework provided by the CRC and the Alternative Care Guidelines informs implementation and monitoring of the 2030 Agenda. We must guarantee that SDGs work to create the kind of inclusive and supportive societies that we want to live in, in which all children are able to flourish and fulfil their potential.
It is our responsibility to pull up our sleeves and assist governments and partners embarking on change. This compels us to pool our expertise to determine how proven solutions can be applied in new contexts; to agree on definitions, standards, and measures; and to prioritise support and guidance where it matters most. All of which needs to be done with a sense of humility and inquisitiveness that reflects that we still don’t have all of the answers.

Over the next decade, placing care reform at the heart of the agenda will not only shine a light on some of the world’s most vulnerable children, but will also unleash extraordinary human potential to help fulfil our ambitions for 2030 and beyond.
M arking the Anniversaries

On November 20 and 21 Member States of the UN General Assembly participated in a High-level meeting on the occasion of the thirtieth anniversary of the adoption of the Convention on the Rights of the Child.

The  opening segment of the meeting , included statements from high level speakers such as:  H.E. Amina Mohammed , Deputy Secretary-General of the United Nations; Ms. Henrietta Fore, UNICEF Executive Director; Ms. Najat Maalla, Special Representative of the Secretary-General on Violence against Children; and Mr. Andrew Morley, CEO World Vision, Representative from Civil Society appointed by the President of the General Assembly. It was followed by a 'kids takeover' and an interactive panel discussion. 

During the general debate of the two-day meeting, more than 100 Member States spoke about their efforts to realize the Convention on the Rights of the Child. A number of delegates made reference to the theme of the 2019 UNGA Resolution in the Rights of the Child which focuses on children without parental care, the Anniversary of the Guidelines on the Alternative Care of Children, and work in support of children without parental care. These included: Argentina, Armenia, Bulgaria, the European Union, Guyana, Hungary, Moldova and Rwanda.

The webcasts for the High-level meeting are available for  November 20 morning ,   November 20 afternoon November 21 morning , and  November 21 afternoon .

On 18 November 2019, a workshop led by International Social Service Switzerland and Child Rights Connect was held in Geneva to mark the 30th anniversary of the Convention on the Rights on the Child (CRC), the 10th anniversary of the UN Guidelines on the Alternative Care of Children, and the 5th anniversary of Optional Protocol on the CRC on a communications procedure. The workshop was part of a  three-day event in Geneva marking the 30th anniversary of the CRC .

The objectives of this workshop were to:
  • Highlight areas for celebration and where progress has been made for children and their families
  • Pinpoint where further progress is needed and should be prioritized
  • Identify opportunities for synergies to build on progress and respond to ongoing shortfalls 

Learn more about the event and access the presentations and other materials here .

View some of the short videos presented at this workshop below.

The video, presented at the workshop event , features the work of the medical social work program run by Angkor Hospital for Children in Cambodia, that aims to prevent and respond to child abandonment with the goal of strengthening families to provide adequate care for their children.

The video is a shortened version of the full video, found here .

 This video from Vanitashray , a shorter version of which was presented at the workshop event , tells the story of Anu, who was abandoned as an infant and grew up in a large institution in India, later opening her own home for orphaned and abandoned girls, only to realize that this was not the best way to care for the children.
Using the Tracking Progress Tool in Costa Rica

In this video from SOS Children's Villages (Aldeas Infantiles) Costa Rica, Melissa Leiva, SOS Costa Rica's Advocacy Coordinator, shares the experience of using the Tracking Progress Tool - an interactive diagnostic and learning tool designed to enable national actors to determine the extent to which their country has effectively implemented the Guidelines and to identify the priorities for change still ahead - in Costa Rica.
Supporting informal kinship care - a case study from Colombia

This video from Taller de Vida of the Family for Every Child Alliance was presented at the workshop event . It tells the story of an Indigenous girl in Colombia whose family became displaced and who went to live with her grandmother. It underscores the importance of supporting informal kinship carers.
Care reforms underway - a case study from Paraguay

This video from Enfoque Niñez of the Family for Every Child Alliance was presented at the workshop event . In the video, Alejandra Rodriguez of Enfoque Niñez describes care reform efforts underway in Paraguay.

Arigatou International has developed this report to mark the occasion of the 30th anniversary of the Convention on the Rights of the Child. This study examines the Convention on the Rights of the Child (CRC) from the perspective of seven major religions, identifies the important role played by religious communities in advancing the rights and well-being of children over the past 30 years, seeks to identify the common values shared among different religions and the CRC and promotes continued action by religious communities to further implement the CRC in the future.

This report from Child Rights Now! reviews the situation of vulnerable children and children's rights and concludes with a call to action to improve the lives of children. The report includes a section on children in vulnerable family settings, including a brief case study on deinstitutionalization in Romania and the problems that persist there.

Published in connection with the 30th anniversary of the Convention, this report from UNICEF is intended as an advocacy tool to both celebrate the achievements of the past three decades and generate dialogue on the critical work that remains – especially for children who have been left behind.

Marking the 10th anniversary of the adoption of Guidelines for the Alternative Care of Children, this booklet from SOS Children's Villages International informs children and young people about their right to live in a supportive family environment in accordance with the Guidelines.


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