‘Moving forward’ to implement the Guidelines for the
Alternative Care of Children:
Deinstitutionalising responses to
children with disabilities
Nigel Cantwell
Consultant on Child Protection Policies
International conference on
“Human Rights of persons with disabilities in the Balkans and Turkey”
Istanbul, 9-11 October 2013
Children in the CRPD

The CRPD as a whole
◦ A core HR instrument that approaches children’s rights as
part of human rights while setting out certain additional
targeted issues/rights such as:
 Art 7.3: right to express views, with assistance if
necessary

Reflecting the CRC
◦ Not only CRC Art 23 but the entire treaty, as intimated in
CRPD Art 7.1
 ‘ensure the full enjoyment by children with disabilities of
all human rights’
 Thus including CRC Arts 7, 18(2), 20, 21, 25-28…

Note also CRC Committee’s General Comment # 9
(2006): Rights of children with disabilities
Guidelines for the Alternative Care
of Children [1]
Grounded in the CRC and approved by
consensus at the UNGA in 2009
 Provide policy orientations for ensuring the
appropriate use and conditions of alternative
care for all children
 CRC Committee already uses these Guidelines
systematically in Concluding Observations
 CRPD Committee briefed on the Guidelines by
NGO Working Group in Sept 2012, and likely
will also use them as a reference…

Guidelines for the Alternative Care
of Children [2]
Guidelines are very long: over 160 provisions,
often difficult to navigate
 No drafting history to assist in interpretation
 Hence Handbook on implementing the
Guidelines (‘Moving Forward’) that explains
the main thrusts, analyses key issues, sets out
policy implications and gives examples of
‘promising practice’


www.alternativecareguidelines.org
(English, French, Russian, Spanish)
Establishing ‘necessity’ and
‘suitability’ of alternative care [1]
Is alternative care genuinely needed?
 Prioritise preventing the need for recourse to
alternative care via, e.g. family support (§ 9.a) and
tackling discrimination of all kinds (§ 10)
 Combat practices that encourage parents to place their
children in alternative care
If so, is the care setting appropriate for the child?
 If alternative care is necessary, provide a range of
options, from family-based to residential settings
 All such care options must be suitable – on a general
level (complying with human rights) and for meeting the
specific needs of the child concerned
Establishing ‘necessity’ and
‘suitability’ of alternative care [2]
Promoting the ‘range of options’
The Guidelines:
 Highlight the vital role of gatekeeping
 Emphasise support to informal coping
mechanisms
 Underscore the importance of how alternative
care provision is financed
 Promote family-based options but…
 … also recognise positive roles for ‘suitable’
residential care for some children
 Distinguish residential care from ‘institutions’
 Underline the need for a strategy to
deinstitutionalise the alternative care system
The system, not the children
The key aim of deinstitutionalisation is
not to remove children from institutions
but to remove institutions from the
alternative care system
 Guidelines (§23): ‘alternatives should be
developed in the context of an overall
deinstitutionalisation strategy, with
precise goals and objectives, which will
allow for their progressive elimination’

Children with disabilities in care




In CEE/CIS countries, children with disabilities make
up between 30% and 60% of those in residential
care (UNICEF 2010)
Numbers seem to have barely changed since the
mid-Nineties, despite general efforts to prevent
recourse to alternative care as a whole and to deinstitutionalise the system in particular (UNICEF
2010)
The Guidelines contain several (9) provisions
where children with disability or ‘special needs’ in
general are explicitly mentioned but…
… all provisions apply to all children always.
Deinstitutionalisation strategies for
children with disabilities [1]


Combatting the frequent and high degree of
stigmatisation and marginalisation of children
and adults with disabilities is a pre-requisite
for strategy development and
implementation in their regard
Explain the goals of the exercise to
communities, parents of children with
disabilities and the children themselves, and
solicit their views on their needs as well as
any concerns
Deinstitutionalisation strategies for
children with disabilities [2]
Similarly consult with all levels of current staff of
institutions
 Examine the extent to which staff could be
redeployed within the care system, including with
additional skills-training as required, once there is
no further role for their facility
 Begin by developing alternatives to institutional
placements for children under 3, including family
support, day-care and respite care services, etc.
and then formally banning such placements

Deinstitutionalisation strategies for
children with disabilities [3]
In developing foster-care options, ensure
that there is first a robust support service in
place for carers
 Set acceptable levels of compensation for
specialised foster carers
 Establish an effective multi-disciplinary
gatekeeping mechanism to determine the
most suitable option for each child
 Foresee regular reviews of the need for, and
suitability of, individual placements
 For more details: Handbook, pp 43-46

Finally, need for reliable data

Comprehensive, trustworthy data: an essential
basis for policy-making and strategising
◦ Special importance given to this in CRPD Art 31:
 1. States Parties undertake to collect appropriate information,
including statistical and research data, to enable them to formulate
and implement policies to give effect to the present Convention. […]
 2. The information collected in accordance with this article shall be
disaggregated, as appropriate […]
◦ Also Guidelines § 69: ‘policies should be based on
sound information and statistical data’