Presentation by Florence Martin, Senior Coordinator at Better Care Network during the "Expert Consultation on Family and Parenting Support," Florence, Italy 26-27 May 2014.

1. Family Support for Prevention of Family
Separation
Expert Consultation on Family and Parenting Support
Florence, Italy 26-27 May 2014

2. The family being the fundamental group of society and the natural
environment for the growth, well-being and protection of children, efforts
should primarily be directed to enabling the child to remain in or return
to the care of his/her parents, or when appropriate, other close family
members. The State should ensure that families have access to forms of
support in the caregiving role.
The Guidelines for the Alternative Care of Children (2009) II.A.3.

3. International legal and policy framework
1) Parents/legal guardians have primary responsibility
for the upbringing and development of the child. (UN
CRC Article 18)
2) Government responsibility to render appropriate
assistance to parents and legal guardians in the
performance of their childrearing responsibilities.
3) The Guidelines address the issue of “children deprived
of parental care, or at risk of being so” and emphasize
support to the family caregiving environments, including
those whose capacity are limited by a range of factors.

4. Why do we want to prevent child-family
separation?
 Research shows relation between parenting
quality and child development (Bowlby 1982; Sroufe 2005;
Rutter 2007 etc.)
 Research also shows poorer outcomes for
children in alternative care, particularly younger
children in large scale residential based care
(cognitive and socio-emotional development);
(Bucharest Early Intervention Project 2003; Leiden studies 2012; Schoenmaker et al.
2014)
 Some evidence of longer term negative outcomes
for children who have been in care into adulthood
in relation to access to higher education,
incarceration, employment, mental health. (Mostly HIC)

5. Children deprived of parental care
 Estimate of 151 million children who have lost one or both
parents (combined single/double orphan data, UNICEF estimate 2011)
Worrying lack of accurate data on children in formal
alternative care outside of North America/ European
context.
 # children in residential care (2 to 8 million???)
 626,000 children in residential care in the 22 countries or
entities that make up Central and Eastern Europe and
the Commonwealth of Independent States, CEE/CIS. (At
home or in a home, UNICEF 2010)
 # in other formal alternative care? (foster care,
Guardianship, residential care)
 # in informal care, including kinship care?

6. What are the factors that lead to separation?
 Poverty
 Illness and parental death,
including HIV/AIDS pandemic
but also mental health issues
 Disability (60% of children in
residential care in some countries)
 Lack of access to (good) quality
services close to home,
particularly education
 Violence, abuse and neglect in
the home, including DV
 Family breakdown and
reconstruction (aftermath of divorce
and remarriage)
 Discrimination and social
exclusion (inc. minorities, single
parent, children born out of wedlock,
laws that criminalise victims of sexual
violence)
 Emergencies, including
armed conflict and natural
disasters
 Displacement and migration
(children left behind; children
migrating for work)
 Inappropriate policies which
support the
institutionalization or
detention of children (and in
some contexts parents)

7. Who cares for children?
Parental and family care

13. The diversity of children’s living arrangements
Children under 15 living with
both parents
 Jordan 94.5%
 Namibia 27%
 Swaziland 22.5%
Children under 15 living
with only one parent
(other parent alive or dead)
 Swaziland 44.9%
 Gabon 39.9%
 Namibia 38.5%
 Kenya 28.4%
 Jordan 5%
Children under 15 not living with a
biological parent, both parents
dead
 Lesotho 5.4%
 Zimbabwe 4.7%
 Swaziland 3.7%
 Jordan 0%
Children under 15 not living
with a biological parent,
both alive
 Namibia 23.6%
 Swaziland 18.18%
 Sierra Leone 17.6%
 Colombia 0.1%
 Egypt 0.1%

14. Children under 15 living with single parent, other
parent alive
Living with mother only,
father alive
 Swaziland 32.4%
 Gabon 30.5%
 Columbia 29.4%
 Nepal 28%
 Cambodia 5.7%
 Timor Leste 3.5%
 Jordan 2.4%
 United States?
Living with father only,
mother alive
 Sierra Leone 8.5%
 Liberia 7.8%
 Haiti 4.5%
 Rwanda 1.3%
 Pakistan 0.3%

15. 53%
7%
16%
22%
2%
Sierra Leone: Children under 18 by living
arrangements, MICS4 2010
Living with both parents
Living with father only
Living wth mother only
Not living with either
parents
Missing Information
87%
11%
2%
Sierra Leone: Children under 18 by
survival status of parents, MICS4 2010
Both alive
One parent alive
Both dead
39.6
9.15.3
3.2
24
8.3
1 5.7 1.1 1.4
Sierra Leone: Children under 18 not living
with biological parents by relationship to the
head of the household, MICS4 2010
Grandchild
Brother/Sister
Son/Daughter (not
biological)
Brother in law/Sister in
law
Niece/Nephew
Other relative
Wife/husband
Adopted/Fostered
Son in law/daughter in
law
Not related
70%
7%
16%
7%
Sierra Leone: Children under 18 not
living with a biological parent by
survival status of parent, MICS4 2010
Both parents alive
Only father alive
Only mother aiive
Both parents dead
Missing Information

16. Why is this relevant?
 Parental death (orphanhood) not the primary reason for children
not living with their biological parents although a risk factor
(particularly one parent dead)
 Significant % of children are not living with their parents have
both parents (reasons? remarriage, abandonment of family, DV,
migration of parent or child to access opportunities, child protection
issues, access to social services, redistribution of family resources
etc…)
 Single parents as primary caregivers
 Critical role of kinship care (and not just in low and middle income
countries- in the United States 2.7 million children live in extended
family care) (In Australia, statutory kinship overtook foster care in
2010)

17. Knowing who needs what in terms of family and
parenting support
 We need to understand who the caregivers are to meet
their particular needs;
 Single parent families tend to be poorer and face a
range of risk factors, inc. access to social services, lack
of social support, greater care support needs >>
institutionalization.
 Research has also shown that kinship care givers tend
to be older, poorer and face issues of health and access
to social services; (UK and Sub-Saharan Africa)
 Some research has also highlighted in some contexts
higher child protection risk factors for children in kinship
care than for biological children (schooling, work, stigma)

18. Preventing separation
Addressing risk factors through parental and family support

19. Prevention of abandonment and relinquishment of infants
and young children
 Support to pregnant and
young mothers (through
health sector)
* Bulgaria For our children model
tackles the abandonment of new-
born infants in maternal health units
with a system of social worker
referral and response;
* Kazakhstan Kuan Sabi program of
primary health care workers trainings
and parenting training for caregivers;
 Home visitation/outreach
programs to strengthen parenting
skills, improving parent-child
relationship and connect parents to
sources of support;
* Chile (with adolescent mothers);
*Pakistan (through community health
program)
 Support to primary
caregivers of children with
disability
* Short-break (respite) services
for children with disabilities (St
Petersburg, Russia);
* Early detection of disability
and home visits by
pediatricians in Belarus;
*Community-based
rehabilitation (CBR) model in
Nepal

20. Prevention of breakdown in family care and
protection concerns
 Social work outreach/case management services:
- Parenting and conflict resolution skills (Individual, Group)
- Support access to social services, including addressing living
conditions, health, access to education, but also legal documentation
- Early detection and gatekeeping mechanism- Ensuring appropriate
care response when child protection concerns arise
- Placement in kinship care (formal or informal- with or without
support) and use of temporary alternative care (foster care, respite
care, temporary residential care)
Examples:
 Rwanda: Hope and Homes ACTIVE Family Support Program: early referral by
community members of families at risk of separation and case management
 Indonesia: PDAK Child and Family Support Model, non-residential model of
response to address child protection concerns based on comprehensive assessment,
case management and psycho-social, legal, financial support for child in family;
 Moldova: the Gatekeeping commission model, with Community Assistant to
identify and assess early needs and support appropriate response.

21. Prevention of separation through social
protection
Social transfers focused on supporting care (Orphans and
vulnerable children; kinship caregivers; caregivers with disability;
children affected by an emergency)
Examples
 Ghana’s Livelihood Empowerment against Poverty (LEAP)
Program: social cash transfer program that provides cash and health
insurance to extremely poor households across Ghana, including a
single parent with an orphan or vulnerable child (OVC);
 Kenya Cash Transfer for Orphans and Vulnerable Children (CT-
OVC): To encourage the fostering and family retention of children
affected by AIDS in particular. Eligible households, which are those
who are poor and contain an OVC, receive a flat monthly transfer of
US$21.
 South Africa Child Support Grants for any primary care giver of
child under 18.

22. Prevention of separation as a result of
emergencies or crises
 Family Tracing and Reintegration services following an
emergency with family support programs, including
scholarships (Aceh, Haiti…)
 Reintegration services for children in residential care, living
on the streets, children who have been trafficked.
Examples:
 Rwanda: Genocide Survivors Support and Assistance Fund,
(5% of the national budget), supports more than 300,000
victims of genocide. Families at risk of separation receive a
monthly economic allowance, livelihood support, educational
scholarships and/or medical assistance.
 Retrak model for reintegration of children connected to the
streets (Ethiopia and Uganda).

23. Some key issues
 Many interventions are at piloting level- need for better
evidence of impact and of scaling up.
 Measuring the impact of social transfers on prevention of
separation, not only on access to education and health.
 Social transfers targeting single parent families, other
caregivers? Issues with targeting OVC rather than
caregiving for all children in family.
 Support to kinship caregivers (dilemma of regulating it)
Subsidies for formal kinship care vs. foster care)
 Family and child centered policies that are shown to
strengthen capacity of care givers in HIC applicable to
LMICs? (Parental leave; social protection floors; access
to day care; health insurance; child credit/benefit…)

24. And finally…
 A lot of focus on babies/young children… majority in alternative care
were placed when they were older?
 Most prevention interventions rely on functioning community level
professionals/para professionals working with families> informal
support network/ peer support?
 Need for a life course perspective:
- early critical period (home visitation, ECD, health care system);
Eliminate placement of under 3 in institutional care
- transition to school (primary and secondary),
- transition in families (divorce and remarriage, abandonment of
family),
- teenage relationships, reproductive health and parenting education
(focus on early marriage, prevention of early pregnancies and
parenting education)
 Need to tackle vested interests in the use of residential care;