Improving Care for Children in Ethiopia Study

A June 2010 report (126 page pdf) compiled by Ethiopia MoWA, UNICEF, and North Carolina-based FHI, a global health and development organization that uses science-based programs for lasting change, called Improving Care Options for Children in Ethiopia through Understanding Institutional Child Care and Factors Driving Institutionalization can be found at the FHI website.

Common strawman arguments that we repeatedly see given by adoptive parents and the adoption industry to keep troubled programs open include poverty, AIDS, and that the local culture does not accept foster care. Domestic adoption is often discounted as impossible. We hope that this recent study opens your eyes to the possibilities for family preservation, foster care and domestic adoption as real options for Ethiopian children. Adoption agencies and faith-based ministries are NOT the only ones that can help the child welfare situations in countries either.

As explained on page 11, the overall objective of this study was to “understand the scope of the information on institutional care practices in Ethiopia, as well as the quality of this information and the gaps therein, with the purpose of informing efforts to improve the quality of alternative care—including institutional care—for children in Ethiopia.”

Specific objectives included to

• “Assess the primary factors that leave children without parental care.
• Document the main reasons institutionalization is chosen as alternative care for children.
• Determine the scale of institutionalization and the number of child care institutions in Ethiopia.
• Assess current practices within child care institutions, including quality of care, in relation to nationally and internationally recognized standards of care.
• Document good alternative care practices for children.”

This study was conducted only at orphanages NOT engaged in international adoption, at MoWA’s request.

Listed on Page 12, The 87 child centers studied were broken down into the following locations:

•  33 (37.9%) from Addis Ababa
•  21 (24.1%) from Oromia
•  12 (13.8%) from SNNPR
•  10 (11.5%) from Amhara
•  6 (6.9%) from Tigray
•  3 (3.4%) from Harar
•  2 (2.3%) from Dire Dawa

• The main factors influencing the number of orphaned and/or unaccompanied children in Ethiopia are HIV and AIDS and related illnesses, and severe poverty.
• The development of new child care institutions (by nongovernmental and/or faith-based institutions) has been increasing over the past several years, but the development of other alternative care options has not been growing at the same pace.
• Little emphasis has been placed on developing other alternative care options, such as kinship care or foster care.
• Community members, child care management and staff, and some authorities have a positive perception of institutional care, and are not aware of the negative effects caused by institutionalization.
• There are limitations in supervision of child care institutions by authorities and minimal knowledge of and adherence to the minimum care standards outlined in the NGAC.
• There are limitations regarding uniform structures of accountability and oversight from the three main governmental institutions involved in the child protection system (MOWA, MOLSA, and MOJ).
• The government oversight bodies (mainly BOWA and BOLSA) do not have the financial and human resources to implement their 15 mandated responsibilities, and their relationship with child care institutions is mostly confined to reporting.
• Quality care is compromised in many child care institutions, due to limited financial resources, lack of supervision, and minimal awareness about child development issues.
• Children residing in institutions are subject to discrimination from community members, experience psychosocial problems, and are frequently subjected to physical, sexual, and psychological abuse and exploitation while in institutional care.
• Current procedures within institutions inhibit interaction between children and their families. This results in an increase in the likelihood of extended institutionalization and limits possible reunification.
• A significant number of child care institutions (62.1 percent did not have adequate documentation or case planning for each child. The limited emphasis on the temporary nature that institutionalization should have increases the likelihood that children will not be reintegrated or placed in a family-based care situation.
• Children who have left institutional care frequently feel they do not have the necessary skills to cope with life outside of the institution.
• Implementation of family preservation initiatives that combine parent education and family income strengthening appear to have positive effects on preventing institutionalization of children.
• Foster care strategies, whereby an institution identifies, trains, and supports a family willing to take in an unaccompanied child with regular financial and material support from the institution, is found to be an acceptable form of alternative care and readily fits into current cultural practices.
• There is a general lack of understanding of the relevance of domestic adoption (i.e., the relevance of legally formalizing the relationship between a caregiver and an unrelated child for whom they are caring on a permanent basis). Current domestic adoption procedures also are perceived to be cumbersome and intimidating for Ethiopian families interested in national adoption.
• Efforts targeting the creation of a family-like atmosphere, through self-contained homes within the child care institutions, community integration of institutions and institutionalized children, training of  institutional staff, and clear understanding of and adherence to minimal standards of care appear to have a more positive effect on children.

Recommendations from these findings are in the categories of policy, care in institutions and noninstitutional care.

Policy recommendations focus on bringing together ministries for accreditation, supervision, and monitoring. “There is a need to ensure distribution of the revised guidelines and training of management and staff at child care institutions, other local institutions/organizations involved in alternative care or its facilitation (e.g., kebele, idir), and government oversight bodies in the application of the revised guidelines.”

There is a need to ensure distribution of the revised guidelines and training of management and staff at child care institutions, other local institutions/organizations involved in alternative care or its facilitation (e.g., kebele, idir), and government oversight bodies in the application of the revised guidelines.”

Care in institutions recommendations include development of databases;a case plan for every child; public awareness campaigns of the harm of institutions; and “incorporating small homes or rooms suitable for groups; promoting linkages and participation in local communities; ensuring that a child protection policy and accompanying mechanisms are in place; providing appropriate psychosocial support, education, and developmentally appropriate care; and providing support and skills training to facilitate successful transitioning for children exiting care.”

Noninstitutional care recommendations include “In an effort to promote domestic adoption, information as to requirements and procedures should be readily accessible to nationals interested in adopting, as well as more understandable. Public awareness campaigns to promote domestic adoption should be conducted. Minimum standards of care should be developed for each form of alternative care and should be based on the NGAC. The minimum standards should be distributed to all responsible government officials, child care institutions, and local organizations involved in alternative care. They should be translated into Amharic and other local languages, as needed, so as to be understandable by all.”

REFORM Puzzle Piece