Moldova became independent from the Soviet Union in 1991. An identifying feature in the beginnings of Moldovan independent government was the quick adoption of a child welfare and protection agenda upon joining the United Nations in 1993, with childcare reform launched in 2006.
Cutting costs and creating stable families
The benefits of government deinstitutionalisation are financial, as well as humanitarian. The charity EveryChild assessed institutional care to be 3-5 times more expensive than small group homes and around 8 times more expensive than providing social services to families in the community (see their Family Matters report, 2005).
Importantly, in Moldova, the return of children to families was aligned to the provision of a form of community-based social care service. Plans were approved for the reform of residential institutions and the development of integrated social services from 2007 to 2012. Reintegrated children attended local schools, as well as returning to the family home, and families and children received varying levels of support and input from social workers.
In 1995, 17,000 children under 18 lived in residential institutions; by 2012, just 4,515 children under 18 were living in residential institutions, representing 0.5% of the under 18 population (P4EC).
A model for deinstitutionalisation
This example of Moldova’s childcare reform approach is particularly exciting; hopefully marking progress in the development of a model of national deinstitutionalisation able to benefit children and young people elsewhere.
By contrast, some countries have spent funds to maintain and continue use of institutions. The Bulgarian government paid €140,000 for the renovation of an institution for children and adults with severe disabilities; this institution was later investigated by the UN Committee against Torture following a significant number of deaths through malnutrition. From 1st January 2014, new EU Structured Funds regulations ensure money is spent on transition from institutional care to community services.
A Longitudinal Study of Children’s Reintegration in Moldova assessed the reintegration of 43 children into their families as a consequence of reduction in institutions (Family for Every Child, February 2014). The majority of children and parents strongly preferred the family home to residential care. The relationships, love and affection they experienced in the family were crucial to their emotional health and development. The majority of parents expressed relief and enjoyment at their child’s return home, despite additional financial and practical constraints.
However within this study some parents remained reluctant to take their children back due to financial constraints; wanting to work abroad; new partners or fear of change. Some parents failed to meet and maintain their parental duties, e.g. were neglectful due to alcoholism. Some reintegrated children also experienced discrimination. Although reintegration was positive in many cases, the reasons for loss of parental care still present: poverty; migration; neglect; lack of access to education or health care.
Despite these continuing challenges, Moldova’s childcare reform is particularly progressive. While there are still social issues within families and communities, the social care system is relatively young and can be strengthened through training, sharing practice expertise and further policy development. OFSTED, the UK inspections office, are currently providing support and advice to establish a similar system of accreditation that regulates legal and policy standards in Moldovan social services.
The fact remains that over 12,000 fewer children were living in residential institutions without parental care between 1995 and 2012. These sheer numbers are an undoubtable success and many other comparable ex-Soviet states have achieved nothing like it. In many cases, the deep-rooted Soviet belief in the sufficiency of state care remains, regardless of the high cost attributed to delivering institutional childcare and the lack of service structure to address social issues in the community. The Moldovan example could stimulate progress elsewhere; until then, it can inspire us to continue our support to end the institutionalisation of children and young people.
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