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Strategic planning for deinstitutionalisation (Part 1)

Introduction to deinstitutionalisation
Old piano in a dirty corridor.
© Skrebtsov, Shutterstock

The UN Guidelines for the Alternative Care of Children urge States ‘where large residential care facilities (institutions) remain’ to develop alternatives ‘in the context of an overall deinstitutionalisation strategy, with precise goals and objectives, which will allow for their progressive elimination’.

In 2003, more than 600 professionals from 71 countries participated in an international conference at which The Stockholm Declaration on Children in Residential Care (2003) was agreed. The Declaration notes the ‘indisputable evidence that institutional care has negative consequences for both individual children and for society at large’ and, calls on States to ‘restructure the system of public care in order to diminish the use of institutions, develop alternative care approaches and strengthen effective community-based preventive and protective social services’.

Although the goal of deinstitutionalising alternative care is now virtually uncontested as a positive move, there is still much confusion about what constitutes an institution, as discussed earlier in this course, and what deinstitutionalisation should mean in terms of both general policy and practice.

Too often deinstitutionalisation is oversimplified as essentially the closure – usually by not well planned means – of large residential facilities, coupled with the return of children to the care of their families or reallocation to other care settings. In fact, the main focus of a strategy should be on deinstitutionalising child protection and alternative care systems.

Deinstitutionalisation strategies

In line with the Guidelines (paragraph 23), each State should develop its own tailored strategy for reducing both the actual and perceived need for placements in institutional facilities. What is required, therefore, is political will and long term commitment to strategies for the development and reform of an overall child protection system that fully integrates all aspects of suitable alternative care for children only when necessary.

It requires a child protection and care system that does not use residential facilities which, due to concerns including size, impersonal environments, and often social and geographical isolation, are inappropriate for the emotional, physical, intellectual, and social development and care of children.

In devising such deinstitutionalisation strategies, it is suggested the following issues are considered:

  • A strategy is wide-ranging in scope and, first and foremost, takes a preventive approach. This means focusing efforts on enabling the child to remain within his or her family whenever possible;
  • A strategy developed with the participation of all stakeholders, including children, young people with care experience and families;
  • Policy and legislative measures that tackle the reform of the child protection system as a whole, establishing standards, statutory guidance, and regulations with appropriate mechanisms to enforce them. However, these measures must be supplemented by initiatives to create a favourable climate and positive attitudes toward change, without which the successful implementation of the reform will be compromised;
  • Appointment by the State of one body with responsibility for oversight and coordination of the child protection and care system;
  • Development and implementation of a deinstitutionalisation strategy that clearly defines the structures, resources, roles, and responsibilities for its delivery.

In the next course step, we will continue to consider strategic planning for deinstitutionalisation and consider some of the elements of a deinstitutionalisation plan.

The ‘See Also’ section below has links to other reading materials that may be of interest to you.

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Getting Care Right for All Children: Implementing the UN Guidelines for the Alternative Care of Children

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