Deinstitutionalisation – science, practices and policies


More than 250 experts from universities, institutions and non-governmental organizations from Europe, Australia, Central Asia and the United States discuss childcare reform at the International Conference on “Deinstitutionalisation of childcare: Investing in change?”

The event was held from November 6 to 8 at the National Palace of Culture. The conference was attended by representatives of the European Commission, the Ministry of Labor and Social Policy and other national institutions, international and local non-governmental organizations, social service providers and policy-makers for children. The conference participants shared scientific data and experience, as well as good practices and challenges in the field of deinstitutionalisation.

The conference was opened by Deputy Prime Minister Tomislav Donchev. He described the deinstitutionalisation of childcare as one of the purest examples of reform in Bulgaria – according to high world standards, with needs assessment and adequate planning.

“The problems are not divided into financial instruments and institutions, but when there is a problem, all institutions that are not used to working together should be activated,” the Deputy Prime Minister emphasized. “There was organized and spontaneous resistance from staff in old type institutions, and it was difficult for experts to explain to everyone what the meaning of the reform was,” he added. “Of the nearly 7,500 children in institutions today, there are nearly 500 left, which does not mean the process is complete. Deinstitutionalising children is not the ultimate goal – there is still much work to be done. Reform is not about changing legislation, but convincing people that this is the way and it cannot be changed, “the Deputy Prime Minister is categorical. He stressed the huge role of non-governmental organizations in carrying out the reform, as main assistant, is the necessary corrective measure. According to Donchev, Bulgaria’s experience with the reform is unique and should be used in other reforms.


Georgi Simeonov, Executive Director of Hope and Homes for Children – Bulgaria, said that it all started with Mogilino, where he and several experts had to evaluate the children.

“Even then, we offered to start the process of deinstitutionalisation. I am very pleased that my personal cause for closing down institutions has become national and our organization actively contributes to the process in 21 districts of the country, “Simeonov addressed to the conference participants.

He recalled that Hope and Homes for Children – Bulgaria supported the closure of 18 Homes for Social and Medical Care and worked directly with families following the model of active family support. “I’m delighted to have attracted people to the team who also took the cause for their own and supported it with all their efforts. We work to close the entrance to the institutions, support the process of returning children to their biological families. Our organization is also working globally to completely eliminate institutional care for children by 2025, “he added.


“The key to successful deinstitutionalisation is that we all looked in one direction and worked together – government, non-governmental sector, academia,” said Deputy Minister of Labor and Social Policy Zornitsa Rusinova.

She recalled that over the past 10 years, 94% of specialized institutions for children were closed. Prior to the start of the reform, some 7,600 children were accommodated in 137 Homes for children with disabilities, Homes for children deprived of parental care and Homes for medical and social care. “We all remember Mogilino, which became a symbol of poor institutional care and forgotten children. Half of the newly created services are small family homes of the residential type, where children live much better, are in a neighborhood, go to school, and are close to a hospital. I believe that the lessons we have learned can be passed on to many of our partners” the Deputy Minister added. Rusinova recalled that the reform of childcare was implemented with the means from the European funds. 450 million BGN has been earmarked for the deinstitutionalisation of the national budget.


The initiator of the International Conference, Dr. Galina Markova of Know-How Center for Alternative Child Care at the New Bulgarian University, also highlighted the damage from the institutions.

“We know a lot about child development. We know a lot about harm from institutions. We know a lot about what programs are that lead to good child development. We know what professional training should be. The question before the conference is how to apply that knowledge in the practice because there is a problem, and it seems that new questions are emerging about what prevents us from applying good practices.

Because the number of foster parents is diminishing, there are barriers to the quality training of professionals and the culture of society as a whole hindering the acceptance of the various. What are we doing in this situation? ”she asked. According to her, people who surround a child with a problem and difficult to understand behavior should learn to make an effort to understand the roots of that behavior and how to create a culture of empathy. “This empathy and support must also exist with regard to the people surrounding the child, because they themselves also experience many difficulties,” she added.


Alexandrina Dimitrova, Executive Director of the Cedar Foundation, talked at this conference how we provide quality care and support to children and young people who were brought out of specialized institutions.

“Our experience has shown that Family type placement centers have the most severe cases of intellectual disability, often with challenging behavior, mental health problems or children who have no disabilities but have experienced extremely traumatic events in their childhood, often many separations. In order for these children and young people to receive adequate care, it is important who are the people who work in family-type placement centers because it is they who provide the care. And so our message is to invest more in them – in their motivation, in their training and their continued support. Also, responsibility for these children and young people should not rest solely on the social system, social services, child protection departments. It is time to share responsibility so that disadvantaged children and young people can receive quality care” she said emphatically.


UNICEF Representative in Bulgaria Dr. Jane Muita said that the process of deinstitutionalisation in Bulgaria was going very well. “Our goal in the coming years is to have no children in institutions. But deinstitutionalisation is much more than the closure of institutions – we must focus our efforts on preventing child abandonment, on quality support for families” she added.


The head of the Lumos Foundation for Europe, Irina Malanchuk, stressed that there is a wealth of scientific evidence that shows the negative effects on children from institutional care. She believes that it is important for all of us to know about them, but it is more important to start talking about practical solutions that will change, what specific steps to take to make children feel safe and loved, how to develop foster care for children with disabilities and how best to support parents who have difficulties. “There are many questions and I hope this conference will answer some of them,” Malanchuk added.


Richard Pichler, Special Representative for External Relations and Resources at SOS Children’s Villages International, began his remarks on what a young man who grew up in a social service shared with him. “I want to grow up in a place where I want to go back for Christmas,” he answered, asking what he would say to the next children who would grow up without parents. According to him, this should also be the ultimate goal of politicians, society and professionals. “When considering child protection reform, my call to you is to have the courage to delve deeper into the problem beyond the facade, because deinstitutionalisation is only a small part. You need to define the quality of care these children need, define a vision and elevate the process of deinstitutionalisation to a higher level. We at SOS Children’s Villages will support the Bulgarian authorities in this effort, as we have done for almost 30 years, “he added.


In a separate Thematic panel of the Conference, Georgi Simeonov, Boryana Klimentova and Elena Petkova from Hope and Homes for Children – Bulgaria presented two working models – Active Family Support and District DI Coordination Mechanism (DDICM). These models over time prove their effectiveness in reintegrating children into the biological family and in preventing abandonment. Active family support provides an opportunity to work with children and families in a timely manner, as it is fast, timely, responsive to the needs of children and helps in preventing crises. It mobilizes all the resources of the family and the resources of the community, making the family system sustainable in the long run and enabling children to grow up in a loving environment.

DDICM is a tool that connects local authorities, professionals, institutions and case management organizations with children, for whom almost all assistance opportunities have been exhausted. The combining of power resources and specialized assistance enables concrete, adequate and accountable support. This tool is not for writing strategies, plans and assessments, but it supports the most vulnerable families and enables the improvement of child and family protection systems. More than 8,000,000 children grow up in institutions around the world, and children without families are over 140,000,000, which makes our task even more responsible and the implementation of working mechanisms leads more and more children to grow up in a family environment.


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With the participants in the children’s and youth participation program at Hope and homes for children – Bulgaria, we visited the children and youth placed

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