Consultancy - Child Protection Consultant to develop guidance paper on deinstitutionalization of children with disabilities in Europe and Central Asia, Geneva, Switzerland

The Regional Office for Europe and Central Asia (ECARO) is seeking a qualified consultant to develop a guidance paper on deinstitutionalization of children with disabilities in Europe and Central Asia.

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Background

Institutional care is widely understood by governments and civil society to be harmful for children. The Convention of the Rights of the Child, the UN Convention on the Rights of Persons with Disabilities and the UN Guidelines for the Alternative Care of Children all recognise that the ideal setting for a child to grow up in, and for persons with disabilities to fulfil their potential and participate as full citizens, is within a family environment that provides a nurturing and loving atmosphere, or, when necessary, within a community-based care system which is suitable to meet their individual needs. In addition to the human rights case, there is a strong economic case for choosing family- and community-based care over institutions. The cost of providing family- and community-based care is often less expensive and the social return is much higher.

After decades of evidence-based advocacy and policy dialogue, many governments have led reforms to close or transform large-scale institutions and replace them with community and family based alternative care services and put in place family support services to prevent children from being unnecessarily separated from their families. Throughout the countries in the Europe and Central Asia Region, significant progress has been made in terms of the development of new child and family services, although continued investment and momentum is required to ensure the reforms are irreversible and no child is left behind.

At the same time, the varying paces at which different services have been developed, and their uneven availability across time and space, have hindered the reforms and sometimes created unintended consequences. There is an increasing concern amongst child care professionals in some of the countries of the region that an emphasis on small group homes (SGHs) may contribute to the re-institutionalization or trans-institutionalization rather than re-integration and inclusion of children. Moreover, within a desired continuum of needed social services, the construction and running of SGHs may be burdensome on the child care budget, taking the lions' share of it and thus jeopardizing the development of community-based care and preventive services, the latter being the element of the reform which, across the entire region, appears still to be the least well developed. There is also recognition that small-scale, residential care, plays an important (albeit smaller) role in the child protection and child care system. And that in the context of dismantling large scale institutions, there may be a slightly larger role for SGHs in the medium term given the profiles of children who have spent years in harmful large institutional care and may be less inclined to move into family-based care. Furthermore, there are unresolved questions around when a small group home or small residential facility becomes too big, and therefore is no longer appropriate? There is guidance around the characteristics of a small group setting, but the specifics have not been agreed across organizations and stakeholders. This has led to variations in practice, and the possibility that governments and others are not being accurate in their classification of care placements. The continued uncertainty about what constitutes an appropriate small residential facility, and an inappropriate institution, also confuses the data and statistics around the number of children in institutional care in any given country or territory.

Moreover, there is no professional consensus about children placed in boarding schools and whether these children are in residential/institutional care and should be addressed by the national deinstitutionalization efforts.  The dividing line between residential care and boarding schools is blurred. In the Europe and Central Asia l region and in many parts of the world, facilities described as ‘boarding schools’, ‘internats’, ‘hostels’ share many of the characteristics of residential care/even institutional care, and children in such facilities share similar experiences to other children in residential/institutional care. Some children in such facilities may return to communities and families regularly but others may not, leaving them more vulnerable to abuse and to the problems associated with a loss of attachment.

Attempts to distinguish between boarding schools and residential care are further complicated by the fact that, many children enter residential care to gain an education (usually a special education in the case of children with special educational needs or disabilities) or access to other services, rather than because they are in need of care and protection. The motivations for placing children in residential care should not be considered as the primary factor distinguishing residential/institutional care from boarding schools. Children living in facilities because they lack parental care, or because they have parents willing and able to care for them but lacking access to basic services close to home, can all potentially be in residential care. Consideration of the definition and characteristics of residential care, particularly of degrees of contact with homes and communities, can be used to help determine whether children are in boarding schools or in residential care. The difference between boarding schools and residential care is neatly summarized in the following quote from Tolfree: “Children’s homes (or orphanages) ....are quite different from boarding schools in that they tend to replace parental roles. Boarding schools seek to supplement parental roles and responsibilities: parental responsibility remains intact and children normally return home for the holidays”[1].

In 2013, UNICEF commissioned an independent evaluation to assess the extent to which child care reforms in eleven countries^[2] during the period 2005-2012 had triggered results for children. The evaluation concluded that: Across the countries covered, there has been a noticeable decline in the rate of children in institutional care. The rate of children in residential care has decreased the most in Bulgaria (by 41.5per cent from 2005 to 2012). In Moldova, the number of children living in institutional care was reduced by over 50per cent (over 5,000 children were placed into family based care during the period 2005-2012). In the Former Yugoslav Republic of Macedonia, the total number of children in institutional care dropped by 27.6per cent (2005-2012), while the number of foster families increased by 60per cent in the same period (111 to 178). The reform of child care systems in EU new member states (Bulgaria, Croatia and Romania) showed significant progress in creating a comprehensive legal framework aimed to contribute to the improvement of the quality of care.

While de-institutionalization has been (and will continue to be in many countries) the entry point for reforming the child care system, it is not an end goal in and of itself. The process of de-institutionalization leads to diversified family-based alternative care services at community level, and to the further development of family support services. These services need to be maintained, improved and expanded in response to the needs of communities and families. Ensuring quality interventions requires setting standards, ensuring monitoring and support, and sustaining and expanding national budgets for these services.  

“Though governments increasingly recognise the inevitability of deinstitutionalization, there is less clarity with regard to the mechanisms that replace institutionalization and what would constitute a human rights-based response.” [3] This led to the development of The Common European Guidelines on the Transition from Institutional to Community-based Care[4], commonly referred to as the “Common European Guidelines” which brought together European and international best practices to “provide practical advice about how to make a sustained transition from institutional care to family-based and community-based alternatives.”

Since the UN CRPD, a paradigm shift is occurring away from a medical model of care, towards a social rights model where individuals are supported to become active citizens making a contribution to their own communities. This has been accompanied by a wider understanding of the adaptations which society must make in order to ensure that the rights of people with disabilities are vindicated:[5] a re-shaping of how services are provided, the development of new services not currently available to meet new and changing needs and/or the integration in the services of a person centred, inclusive, participative and individualised approach, adopting the new social rights model of disability. This paradigm shift therefore requires a movement. One of the areas requiring improvements and/or changes is the way provision of long term and/or intense care is provided to children with disabilities.

The Common European Guidelines[6] see it as imperative that in managing the transition process people with significant disabilities and complex needs are not left behind as this only generates additional needs. Promoting a person-centred approach will inevitably require services to develop innovative solutions, providing greater choice and control throughout life.

Regarding community based services, the guidelines refer to the spectrum of services that enable individuals to live in the community and, in the case of children, to grow up in a family environment as opposed to an institution. It encompasses mainstream services, such as housing, healthcare, education, employment, culture and leisure, which should be accessible to everyone regardless of the nature of their impairment or the required level of support. It also refers to specialised services, such as personal assistance for persons with disabilities, respite care and others. In addition, the term includes family-based and family-like care for children, including substitute family care and preventative measures for early intervention and family support.

For UNICEF, the issue of child protection, including de-institutionalization and child care reform, is closely linked to broader social protection reform. Linkages between the two areas have been and will continue to be essential to successfully support governments in larger reform efforts that have an impact on child care.

There is some consensus that deinstitutionalization becomes a better prospect when some of the building blocks of the child welfare system are already in place. Deinstitutionalization is easier to plan and implement if there is a single ministry in control of the process and if all the institutions are under one ministry. There must be technical capacity at central government level to plan, but also to make policy, collect information to monitor and evaluate. When government makes funds available for deinstitutionalization it is an expression of concrete commitment.  The government working together with donors such as the EU on deinstitutionalization adds further political weight to the process. It is necessary to have systems in place that prevent other entities from filling the perceived residential care gap and building residential care facilities or small group homes that are outside the public care system.

The reforms, although moving well, require continued investment and momentum to ensure no child is left behind. Frequently deinstitutionalization and child care reform plans have not prioritised the most vulnerable within the system of institutional care namely the children under three years of age and children with disabilities. Few children with disabilities are being fostered or locally adopted.

Evidence and data show that children with disabilities have benefited the least from these reforms. A child with a disability in the region is almost 17 times more likely to be institutionalized than a child without a disability. As a result, approximately half of all children living in public institutional care in the region are children with disabilities – in some countries it is as high as 70 per cent. There are other countries in the region where progress has been slow overall, with little political will of governments to start important child care reforms.

The region can be largely divided into three categories: 1) countries that have made significant progress, and require a final push to transform and close the remaining large institutions, ensure that the proliferation of unregulated orphanages is prevented, and accelerate the quality and availability of the relatively new family support services and diversified alterative care system; 2) countries that have demonstrated the political will to reform the child care system, but are still in the middle of the de-institutionalization reform stage and require intensive technical and financial support to continue towards a diverse, family-based care system; 3) countries that are at the early stages of child care reform, still have a number of large institutions for children, and require support to generate political will and new services to tackle the problem.

It is important to mention that children with disabilities represent unfinished DI business for all country groups. Many countries of the ECA region face big challenges in planning and implementing DI plans for children with disabilities, lacking knowledge and expertise in meeting the needs of children with disabilities and their families outside institutional care, as well as international evidence and guidance, capacities and resources.

The challenges for children with disabilities are primarily social and cultural. The support services should be directed towards the ability and potential of these children, as well as their relationship with the environment, and not on the disability. There is a rights and economic imperative to ensure that there is equal access to all services and that these are designed to meet the needs of children with disabilities. If there is discrimination and inadequate support for helping children with disabilities grow and learn to live independently, they will continue to need the support of the state into adulthood.[7]

In all contexts, social norms around institutional care, especially for children with disabilities, are of particular importance. Closing institutions for children with disabilities and establishing high quality family- and community-based care and preventive services requires a multi-sectoral approach across health, education and social welfare – as well as intensive efforts at community level to overcome the stigma and discrimination associated with disability.

The UNICEF ECA Regional Office provides a comprehensive partnership and policy framework as well as technical support functions to these reforms. Child care reform is a priority area for UNICEF across the region. The Regional Office has and will continue to lead the development of solutions and strategies for child care reform. Partnerships at the regional and global level are also particularly important. The EU’s groundbreaking Ex-Ante Conditions associated with Institutional Care, for example, were successfully advocated for in close collaboration with the European Expert Group in Brussels nearly ten years ago. In 2020 these conditionalities, which prohibit the use of EU structural funds for institutional care, will be up for review. In close partnership with Oak Foundation, UNICEF is working to ensure that policy makers in the EU are aware of the importance of these conditions, and pledge to strengthen and extend them into the next EU budgeting framework post 2020.

How can you make a difference?

Purpose of the assignment

Under the supervision of the Regional Advisor Child Protection, and in close collaboration with other child protection consultants and the focal point for disability, the consultant will provide technical support to UNICEF Europe and Central Asia Regional Office in developing a technical guidance paper on deinstitutionalization of children with disabilities. In doing so, the consultant will also look into all types of institutions caring for children with disabilities, including boarding schools (special schools) and small group homes (small residential care settings).

The paper intends to accomplish the following:

1. Promote better decision-making among policy makers and child welfare professionals in the region regarding deinstitutionalization of children with disabilities, by examining the institutions caring for these children, including boarding schools and small group homes, as well as family-based alternatives, community support systems and services and mainstream universal services.  
2. Establish, based on an extensive review of evidence and common practices, concrete definitions (main characteristics) of what constitutes an acceptable form of small group home (or small residential care setting) and boarding school (or “internats”) in their roles in the transition from institutional to community-based care and in an established child care system.  
3. Outline effective evidence-based strategies to promote appropriate deinstitutionalization of children with disabilities, including increasing political will for the development of a balanced child care system to cover for different needs of children, catalysing preventative work to reduce overall numbers in the child care system, and promoting family-based alternatives for the clear majority of children in the care system. 

Main tasks

The main tasks of the assignment are as follows:

1. Guidance on child care reform (De-I) and children with disability

1. Develop the methodology (approaches, methods and tools) for the development of the disability and child care reform guidance document.
2. Undertake a desk review of the issue.
3. Undertake primary and secondary data collection as required.
4. Work with a broad number of partners to collectively develop the paper on DI of children with disabilities. These include the members of the reference group and other internal and external stakeholders.
5. Draft the guidance paper.
6. Reach the consensus with the reference group, widely consult and validate the paper.   

2. Contribute to the drafting of the small group home white paper under development by ECARO

1. Provide specific research support to the development of the white paper (by channelling relevant research from the guidance note into the white paper)
2. Review and input into the first draft of the white paper
3. Attend meetings of the reference group as a technical resource as required

Outputs/Deliverables

1. Guidance paper on child care reform (De-I) and Children with Disability

          Research methodology (5 days)

          Desk review and report (5 days)

          Research and data collection and analysis (20 days)

         Guidance paper drafted and validated (10 days)

2. White paper on small group homes

• Compile relevant research from Output A that can feed into the white paper (2 days)
• Review and contribute to draft document (2 days)
• Participate in reference group consultation (2 days)

Estimated Duration of the Contract

15 September – 15 December 2018.    

Consultant’s Work Place and Official Travel

The CP specialist will work from home. He/she may be asked to travel to the ECA Regional Office in Geneva Switzerland or/and countries of the region.

Estimated Cost of the Consultancy & Payment Schedule

Payment will be made at the end of each month, based on the above-mentioned deliverables.

To qualify as an advocate for every child you will have…

• Advanced university degree in sociology, social work (preferred) or another relevant field
• Minimum 10 years of progressively responsible professional work experience in child protection, and in particular child care reform, at the national or international levels
• Expert knowledge of child care reform, including relevant instruments and guidance
• Knowledge of the ECA region an asset
• Excellent analytical and written skills
• Fluency in English (oral and written). Knowledge of another UN language is an asset.

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.

Remarks:

Please include a full CV and Financial Proposal in your application. Additionally, indicate your availability and monthly rate (in US$) to undertake the terms of reference above. Applications submitted without a monthly rate will not be considered. Only shortlisted candidates will be contacted and advance to the next stage of the selection process.