Cost Benefit Analysis Results and
Proposed Alternative Child
Protection Policy in Tajikistan
The 2nd Child Protection Forum:
“Building & Reforming Child Care Systems in
Central Asia”
Maastricht Graduate School of Governance
Maastricht University
Bishkek, May 2009
Background
• Tajikistan is a country of children
o
More than 50% of families with 4+ children
• Children have higher poverty risk
• Vulnerable/needy children entitled to social protection
(insurance/assistance/care)
o
o
Complex and inefficient system
9,500 children living in residential care (2008)
• Pilot projects for a comprehensive child protection
system (supported by Unicef)
o
o
o
o
Diversion projects for youth in conflict with law
Pedagogical, medical, psychological consultation
Parent’s education center/Kindergarten Inclusion projects
Child Rights Departments at district level
CBA: Questions to answer
• What are costs and benefits of traditional
versus alternative child protection
services?
• What is the level of potential savings that
can be achieved by transforming existing
institutions?
• Will fiscal space be sufficient for financing
alternative community-based services for
children and their families?
Current child protection system
• Residential care
Boarding schools for vulnerable children (orphans,
children with minor disability, children from poor
families)
o Children’s homes (for children in the first years of life)
o Special school and special vocational school for
children in conflict with law
o Sanatorium for disabled children
o
• Social pension for full orphans
• Cash compensation for poor children
Alternative child protection system:
family-based, with support services
• Child Rights Departments (CRD)
CRDs provide assistance to children with disabilities, deinstitutionalized
children, arrange for guardianship (placement of children in homes of
relatives), adoptions. They also play a gate keeping role to reduce the
number of children placed in residential institutions.
• Psychological, medical, pedagogical consultation
centers (PMPCC)
These units provide diagnosis, referral and therapy for children who have
physical and mental disabilities. The PMPCCs try to integrate children
with disabilities into mainstream kindergartens and schools. They play a
gate keeping role to reduce the number of children placed in residential
institutions.
Alternative child protection system:
family-based, with support services
• Juvenile Justice Alternative Projects
(JJAP)
The JJAP provides rehabilitative services for juveniles who have
committed minor offences, as an alternative to residential placement.
• Not included due to insufficient data:
Parents’ education center/Kindergarten
inclusion projects
o Other pilot projects
o
Costs
• Direct costs
Capital costs (construction, maintenance,
purchase of equipment, etc.)
o Recurrent costs (salaries, food, transfers, etc)
o
• Indirect costs
o
Pressure on social assistance
Issues in data collection and data
analysis
• Financing of current institutions vary
greatly across types and districts (e.g. from
less than 1 somoni per child per day to more than 7
somoni per child per day)
• Contributions in kind to current institutions
are not systematically recorded (e.g.
contributions by local sponsors or families), which
makes it impossible to estimate them
reliably.
Issues in data collection and data
analysis
• Information of costs of alternative
programs is available, but sometimes
without details (e.g. costs of JJAP are recorded in
broad categories)
• It’s too early to document impact of
improved conditions of children on their
adult life (e.g. benefits on their health or productivity)
Remarks about the CBA analysis
• The CBA analysis is based on the comparison of
four policy scenarios: the current policy scenario
and three scenarios that represent policy
alternatives
• The number of children living in boarding schools is
kept constant in the current policy scenario, while
the number of institutionalized children increases
over time
• The alternative scenarios differ from each other
with respect to the rate of de-institutionalization of
children, the number of CRD, JJAP and PMPC
adequately implemented and the level of
Results: estimates of costs of the traditional
versus alternative child protection services
• The current policy is more costly than any of the
alternative policies in the long term mainly because of
the high operation costs of residential institutions.
Results: estimates of costs of the traditional
versus alternative child protection services
• In the scenario of high de-institutionalization, the cost per child of the
alternative policy would be less than half of the cost per child of the current
policy by year 2018. In the scenario of low de-institutionalization, the cost
per child of the alternative policy is still 20 per cent less than the cost per
child of the current system (by the same year).
Benefits of de-institutionalization
• Direct benefits
o
Reduced number of children living in residential care
• Indirect benefits
o
Increased productivity in adult life:
 Institutionalization affects negatively the productivity of children
in the adult age.
 Improved emotional, mental and physical well-being of deinstitutionalized children is expected to have a positive impact
on the children’s future earnings. Children living in family
environment have
 better scores on developmental measures, fewer medical,
cognitive and behavioural problems
 higher enrolment rates and educational achievements
Results: estimates of benefits of the traditional
versus alternative child protection services
• As the alternative programs also focus on improving
skills of children, a long term impact on their productivity
might be observed.
Issues: current financing
• Expenditure on institutional care has
increased significantly in recent years
(from 2006 to 2007, it increased 21 per
cent, reaching 10 MTS).
• Expenditure on social assistance to
children and their families has also
increased considerably
• Still, conditions are precarious
Issues: long-term financing
• Step-wise transformation of the system
gradually creates fiscal space
• Long term: savings from transformed
institutions gives flexibility to policymaking process
• Resources would be sufficient to finance
alternative system, including
o
o
Training of social workers
Guardianship allowance
Results: estimates of sufficiency of fiscal space to finance
alternative social services
• The fiscal space created by closing traditional institutions would cover the
costs of implementing the alternative programs.
Results: estimates of sufficiency of fiscal space to finance
alternative social services
YEAR
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
MODERATE DE-INSTITUTIONALIZATION (ESTIMATES)
ESTIMATED DIFFERENCE
BETWEEN FISCAL SPACE
CREATED AND NEEDED
EACH YEAR (THOUSAND
TS)
-495
2,036
5,991 12,103 21,506 35,614 56,771 89,197 140,196 230,438
HIGH DE-INSTITUTIONALIZATION (ESTIMATES)
ESTIMATED DIFFERENCE
BETWEEN FISCAL SPACE
CREATED AND NEEDED
EACH YEAR (THOUSAND
TS)
-535
3,465
9,493 18,609 32,290 52,364 81,983 126,569 195,541 315,654
LOW DE-INSTITUTIONALIZATION (ESTIMATES)
ESTIMATED DIFFERENCE
BETWEEN FISCAL SPACE
CREATED AND NEEDED
EACH YEAR (THOUSAND
TS)
-609
204
1,570
3,617
6,903 12,076 19,710 32,052
52,882
93,846
• The fiscal space available after covering the costs of implementing the new
programs might be used to strengthen the capacities of the child protection
system (e.g. by training social workers).
Final remarks
• Prior to the de-institutionalization of children, new
components should be introduced to the system (CRD,
PMPC, JJAP, and other services).
• The process of de-institutionalization of children should
be conducted gradually and selectively (i.e. only children
who shouldn’t be at institutions)
• In the short term, additional investments are necessary
to deal with plausible increments in the public
expenditure in child protection.
• The new child protection system should acknowledge
the relation between the well-being of children and the
well-being of their families. In this respect, monitoring
the conditions of children at home is a crucial aspect for
Final remarks
• The current financial crisis puts further pressure on the
government budget, and the funding of existing
institutions for children. In that context, the
establishment of cost-efficient appropriate alternative
services should be given priority.
• The financial planning of alternative child protection
should become part of a broader Medium Term
Expenditure Framework process.
• The reform of the child protection system benefits
should form an integral part of the overall reform of the
social service and social protection system in Tajikistan.
The different components, such as the reform of the
benefit and service system are mutually reinforcing.