Webinar 14: Deinstitutionalizing the Alternative Care System for Children: Implications for the social service workforce with learning from Rwanda and Moldova

Webinar Summary and Recording

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On December 5, 2013, the Global Social Service Workforce Alliance and the Better Care Network co-hosted a webinar to discuss the implications of deinstitutionalization (DI) for the social service workforce, with specific experiences presented from Rwanda and Moldova.

Florence Martin, Senior Policy and Knowledge Management Advisor with the Better Care Network, opened the webinar by giving an introduction to DI of alternative care systems for children, or the shift from residential based care to family-based care. She explained the impetus for countries to engage in this process with growing understanding of the negative impact of institutional care on children’s development and well being, and of the critical importance of the family environment for children. She highlighted that this recognition is at the core of the Convention on the Rights of the Child and the Guidelines for the Alternative Care of Children welcomed by the United Nations General Assembly in 2009. As a result, reform of alternative care systems and DI processes are taking place in all regions and in a range of country contexts. To support this shift to family-based options, such as kinship care, foster care and adoption, Ms. Martin emphasized the role of the social service workforce (SSW) and the accompanying need to properly train and deploy local professionals and para professionals to ensure quality care for children and their families. She introduced the panel of experts, who then shared information about their experiences with the SSW and the DI process in Rwanda and Moldova.

Dr. Delia Pop, Director of Programs with Hope and Homes for Children, delivered the first presentation summing up learning on the DI process and the SSW. She showcased how the planning of DI can inform the development of the local social service workforce, enabling child protection system reform. DI was defined as the process of eradicating institutional care through the development of prevention and family strengthening services and the development of alternative care. In a five step process, evidence of the causes of institutionalization informs where the capacity building should take place and helps build the content for training the social workforce. Dr. Pop stressed how this process relies on awareness raising and increasing capacity of families and communities not to rely on institutional care. Based on 20 years of experience working in Europe and Africa, Hope and Homes for Children has been a key player in shifting the care of children from institutions to families in a number of countries. To illustrate the steps in the process, Dr. Pop presented learning from Rwanda including the historical and legislative precedents needed to spur the government into investing in DI and training the SSW. She described the situation encountered in the country before the DI process began, when 3,232 children resided in 22 institutions throughout Rwanda, with nearly 30% having spent more than 10 years in institutional care. Much effort was expended in raising awareness of the effects of institutionalization and showing alternatives to institutional care so that critical government commitment to the process could be secured and the wherewithal to close the human resources gap within the professional social service workforce could be realized. Dr. Pop closed her presentation by highlighting the important outcomes of the DI process and factors leading to its success.

Silvia Lupan, Child Protection Officer with UNICEF, added her perspective on the DI process from the context of Moldova. Beginning with a brief orientation to Moldova, its demographics and history, she delved in to the major factors that have historically contributed to the high rates of institutionalization of children in the country, including the nature of the child care system inherited from the Soviet Union, the lack of coordination among agencies responsible for social services and gatekeeping, underlying socioeconomic factors as well as social norms that deemed institutional care a good solution to these issues through the 1990s. Ms. Lupan then illustrated the evolution in caring for vulnerable children and their families that had occurred over the last decade, with family-based alternatives overtaking institutional care, and outlined the progress made in developing the social service workforce required to support these alternative care systems. Through the DI process, the social service workforce in Moldova has become professionalized through legally recognizing the various cadres and providing educational options, establishing gatekeeping commissions that now span the nation and provide 100% coverage, and creating specializations within the workforce to care for children with a range of needs including those with disabilities and victims of abuse and neglect. Equally important has been Moldova’s investment in the existing health and education workforces, as well as other sectors resulting in their increasing professional contribution to the DI process. At the same time, Ms. Lupan described the challenges and concerns that remain, such as the existing equity agenda within the DI process, as children under 3 or with disabilities have not benefitted from the overall country achievements, continued workforce instability, low capacity and the need to further transfer of knowledge and skills from development actors to the social service workforce.

Dr. Stela Grigorash, Director of Partnerships for EveryChild in Moldova, expanded on these workforce development initiatives in Moldova and provided details on the planning and policy work as well as the training programs that had been instituted to educate and retrain social service workers in the country, and to support the DI transition process. She described several specific actions needed to make the whole process work well, such as: supporting the development of university-based social work training; targeting multiple actors at different levels (community level, district level, national level); recruiting and training new members of the workforce; retraining and redeploying existing workforce; developing social work methodologies; training community actors to work together; supporting relevant ministries to plan strategically for social workforce recruitment and in-service training; and building capacities of NGOs as service providers.

Such clear and specific examples are included for possible adaptation by other countries considering a reasonably comprehensive approach. Dr. Grigorash also discussed the creation of support systems for those workers caring for children at-risk for institutionalization including gatekeeping, case management, referral mechanisms, accreditation, and professional supervision. She called attention to one of greatest challenges to the DI process in Moldova: the retraining and redeployment of staff from institutions to other posts. Addressing this challenge required individuals with the proper qualifications and work experience needed for redeployment as well as the ability to manage change and a willingness to be assigned to a new workplace and a different working environment. She closed her presentation with lessons learned from the process overall, particularly how a holistic approach to retraining and redeploying staff can build skills, change attitudes and behaviors as well as result in sustainable impact on the alternative care system.  She also highlighted future priorities for this work in Moldova.

Each country presentation was followed by a brief question and answer session moderated by Jim McCaffery, Senior Advisor with CapacityPlus.Questions focused on the role of community-based workers, how the existing social service workforce was capitalized on for the DI process in Rwanda and Moldova, on the role of in-service training for redeployment of the workforce, and the importance of contextualizing the theoretical basis of DI to the country’s context and needs to gain sufficient government buy in. Participants were interested in what kind of conditions were necessary for governments to make the decision to reform the existing child protection system to rely less on institutionalization as well as how the funding community needed to be involved to ensure financial sustainability of these efforts.