Overview of the situation of children in institutions
in Republic of Macedonia
I Overview of the institutions for children without parents and parental care and numbers of children within these institutions In the Republic of Macedonia, the following ministries are dealing with child issues: Ministry of Labor and Social Protection, Ministry of Education, Ministry of Health, Ministry of Interior, and the newly formed Ministry of Youth and Sports.
The social protection system in Macedonia consists of 30 Social Work Centres and Institutions, which are under the authority of the Ministry of Labor and Social Protection, through which social protection is implemented. Children and youth beneficiaries of social protection are divided into several categories such as: children without parents and parental care; children with upbringing and social problems; neglected children and children with disabilities in their development.
Institutions for accommodation of children and youth without parents and parental care are the following: Institution for Babies and Small Children - Bitola that takes in children from 0-3 years of age and the Institution for Children and Youth "11th October"- Skopje, that provides care for children from the age range of 3-18 years. Beside this public institutions, in 2002 was open the first private Institution for children without parents or parental care SOS Children`s village –Skopje.
1. Public institution “Domicile for babies and little kids”-Bitola
This institution is caring only babies and little kids less than 3 years of age. It provides care, food, and clothes for the infants, and this institution is providing conditions these children to be adopted or to be settled in a foster family. In addition, here are temporarily settled single unemployed pregnant mothers one month before their childbirth and single parents with babies younger than three months. In the institution, exist two babies groups, which include babies from 0 to 6 months, and two family groups, which include babies and kids from 6 months to 3 years. The capacity of the institution is 100 babies and kids, and 25 mothers. This institution has 53 employees (data from 2002, according to the report of the Ministry of Labour and Social Politics). There are working a pedagogue, a psychologist, a social worker, an educator, a jurist, administrative-technical personnel, nurses and doctors, cooks, laundry women, tailors and sanitary personnel..
2. Public Institution Child’s Home “11th October”
Child’s Home “11th October” is for children and adolescents without parents and parental care. For the children and adolescent who live in this institution housing, food, clothes, and care are provided, as well as conditions for returning in their family or preparing them for independent lives for those who are without a family. The institution functions in nine educational groups. Every group consists of 12-14 children on different ages that are settled in 4 dormitories (2 for boys and 2 for girls) and have one living room for their daily activities. Children attend the nearest primary school and secondary is chosen by the wish of the child. Those children with disabilities in their mental development attend special schools. The capacity of the institution is 144 children and adolescents. In the Child’s Home “11th October” are working 35 persons (data from 2002, according to the report of the Ministry of Labour and Social Politics). There are social workers, a pedagogue, a psychologist, a jurist, educators, nurses, a defectologist, administrative-technical personnel, cooks, laundry woman, a tailor, and sanitary personnel.
3. Private institution “SOS Children’s Village Skopje”
This is an institution opened on the initiative of SOS Kinderdorf International from Austria. It began with its work on 29th of April 2002. This private institution is caring children without parents and parental care until the age of 18. The whole complex consists of 12 houses in which should live 7 children and a “mother” who lives with them and is responsible for their development. In addition, every house should have an “aunt” who comes every day (4 hours a day) and helps the “mother” with the daily activities in the house. The capacity of the complex is 84 children (data from 2002, according to the report of the Ministry of Labour and Social Politics).
Recently the SOS Children’s Village Skopje has opened his Youth house where are living children above 18 years.
As alternative form of fostering In Republic of Macedonia there are 140 foster families in which are accommodated 219 children without parents and parental care and in same time, there are registered 31 potential foster families. (the information are from April 2009, data provided from Institution for Social activities of Macedonia).
Foster families in the cities
Foster families receive modest assistance from the MoLSP and the current foster care system is considered to offer good prospects for children who would otherwise be without adequate care. However, foster care in Macedonia still lacks a clear framework for accreditation and, most importantly, quality control. (According to Situation analysis – Children in Macedonia, 2008 by UNICEF).
Normative Framework for the foster families
According to Evaluation report – Foster care services, 2008 by UNICEF, The Ministry of Labour and Social Policy (MoLSP) is responsible for developing the normative framework for social protection. However, Institution for Social activities is responsible for carrying out analysis, evaluations, and assessments that guide and inform policy making. Foster care services in the country are regulated by the law on social protection and the rulebook for the criteria for selection of foster family, type and number of beneficiaries that could be placed in a foster family, type and scope of social welfare services provided to the person placed in foster care, and the amount of the placement and care allowance. The law on social protection envisages the right to placement in foster care as a non-residential form of protection to be executed through the CSW. This entitlement is designed for persons with inadequate living conditions or in need of placement when other forms of protection are not available. Foster care placement is regulated through a contract signed between the foster family and the CSW, and outlines key roles, rights and responsibilities for the foster family, as well as regulations concerning contract termination or extension. The CSW is responsible for monitoring and coordinating activities linked to placement and care of a foster child once placed. Foster families are obligated to act according to the contract with the CSW and duly inform the CSW of significant changes or needs of the foster child. The foster care rulebook specifically regulates criteria for selection of foster families, type and number of beneficiaries, and social protection services. The rulebook specifies the exact amount of allowances for placement and foster care and identifies categories of service beneficiaries eligible for foster care protection. The placement of younger children in foster care is usually related to complex problems in the home. The multi-faceted nature of these problems can make it difficult to isolate the primary cause for each individual placement in foster care for younger children. Often, a specific crisis precipitates the need for foster care placement. Evidence indicates that prior to foster care placement, many biological families were surviving at only marginally functional levels, coping with numerous problems and stress. Overlapping challenges make it difficult for child protection agencies to separate categories of children by problem groups to assist in identifying the most appropriate placements. The rulebook, prepared by the MoLSP in cooperation with ISA, provides a legal basis to guide foster care placement and differentiates the following categories of children/persons that may be placed in foster care:
- child without parents and parental care
- child with educational challenges combined with abuse, neglect, and social insecurity
- child with asocial behaviour
- person with mild and moderate intellectual disability
- person with severe intellectual disability
- person with permanent physical disability
- older person
-adult person with physical and intellectual disability who is not in position to take care of him/herself
Small group foster home is new alternative form of fostering home that is functioning as family. The first small group foster home is opened on 20.11.2008 in Berovo and there are accommodated 5 children without parents and parental care. (The information’s are provided by the Institution for Social affairs within the Ministry of Labour and Social Politics of Republic of Macedonia).
FACTS AND FIGURES
(according to the 1994 census and according to the Statistical Yearbook of the Republic of Macedonia for 1997 year and according to the information’s provided by all 30 Institutions for Social work within the Ministry of Labour and Social Politics of Republic of Macedonia, upon our request).
* The mark “/ ” in all tables in this report is indicates that there were no available data, the mark is not indicating absence of the respective cases or categories.
Table 1. Data on children and youth accommodated by social protection forms
Table 2. Data on children and youth accommodated in institutions for children without parents and parental care
Institution for Babies and Small Children – Bitola
Institution for Children and Youth
"11th October" –Skopje
Institution for Babies and Small Children – Bitola
Institution for Children and Youth "11th October" –Skopje
Private institution SOS children’s village
Table 3. Foster families (number of the foster families)
Table 4. Numbers of children separated from their families
Table 5. Number of parents/children who have received interventions to prevent family separation
* The data for the city of Prilep are considering all kind of interventions toward the families (psycho-social support and material support) per year, which by them are seen as aimed toward strengthening the families.
II Overview of other institutions for children care (children with upbringing and social problems; neglected children and children with disabilities in their development)
In Macedonia there are two institutions for accommodation of children and youth with social upbringing problems and problematical behavior, the Institution for Care and Upbringing "25th May"- Skopje, that accommodates children and youth with social upbringing problems from the age range of 7-18 years for both male and female sex, and the Institution "Ranka Milanovic" - Skopje that accommodates neglected male children and youth from 10 -18 years of age.
1. Public Institution for caring, upbringing and educating children and adolescents “Ranka Milanovic” - Skopje
This institution is for male children and adolescents with disturbed behaviour, upbringing and educational problems. These children sometimes need to be separate from their environment, so because of that the Centres for Social Work pursuant the Family Law sends these children in this institution. They attend primary school inside the institution and secondary in one of the regular schools in the city. In the last few years, the number of female children and adolescents with upbringing and educational problems is increasing, but still there is no separate section for females. This institution has 27 employees (data from 2002, according to the report of the Ministry of Labour and Social Politics). There are psychologists, a social worker, pedagogues, a jurist, nurses, defectologists and teachers.
2. Public Institution for children with educational and social problems “25th May” - Skopje
Main reason why children are sent in this institution is their disturbed behavior, because of reduced parental care, begging, wandering, missing school, running away from home, and juvenile prostitution. The aim of this institution is accepting and temporarily caring of these children and adolescents, observation and diagnostic of the juveniles. In this institution are working 21 persons (data from 2002, according to the report of the Ministry of Labour and Social Politics). There are pedagogues, social workers, psychologists, a jurist, a nurse, a defectologist, educators and administrative-technical personnel.
Institutions for persons with physical disabilities capable of rehabilitation in the Republic of Macedonia are the Institute for Rehabilitation of Children and Youth - Skopje and the Institute for Protection and Rehabilitation Banja Bansko.
1. Public institution for rehabilitation of children and adolescents - Skopje
This institution is assigned for rehabilitation of children with moderate and high disabilities in their mental development. There are 55 employees (data from 2002, according to the report of the Ministry of Labour and Social Politics): professional personnel-defectologists, a social worker, a psychologist, educators; health personnel: a doctor, nurses; and administrative-technical personnel.
2. Public institution for protection and rehabilitation - Banja Bansko
This institution provides socio-helpful rehabilitation, health, and upbringing-educational activities for children and adolescents with disabilities in their physical development, but with average intelligence. The capacity is for 73 users, but at this moment. There are 31 employees with different profiles (data from 2002, according to the report of the Ministry of Labour and Social Politics): a defectologist, a sociologist, an orthopedist, a physiotherapeutic, nurses, a massager, a jurist and administrative personnel.
In addition there is the Institution for persons with severe and most severe mental retardation Demir - Kapija.
This institution is assigned for caring, feeding, health protection and educational activities of persons with high disabilities in the mental development. The capacity of the institution is 420 persons (data from 2002 according to the report of the Ministry of Labour and Social Protection).
FACTS AND FIGURES
(according to the 1994 census and according to the Statistical Yearbook of the Republic of Macedonia for 1997 year and according to the information’s are provided by all 30 Institutions for Social work within the Ministry of Labour and Social Politics of Republic of Macedonia, received upon our request)
Table 1. Data on children and youth with social upbringing problems accommodated in institutions.
Institution for care and upbringing
"25th May"- Skopje
Institution "Ranka Milanovic"- Skopje
Institution for care and upbringing "25th May"- Skopje
Public institution for care and education of children and youth - Ranka Milanovik - Skopje
Table 2. Data on persons with physical disabilities capable of rehabilitation
Institution for Rehabilitation of Children and Youth – Skopje
Institution for Protection and Rehabilitation – Banja Bansko
Institution for protection and rehabilitation Banja Bansko - Skopje
Institution for Rehabilitation of Children and Youth – Skopje
Table 3. Data on persons with severe and most severe mental retardation accommodated in the Special Institution - Demir -Kapija
Institution for persons with severe
and most severe mental retardation Demir-Kapija
Institution for persons with severe
and most severe mental retardation Demir-Kapija
II Overview of number of children at risk to lose the parents or parental care
Table1. Children at risk to lose the parent and the parental care (according to the report of the Centre for Social Work – Skopje for the violence July 2008 - data from 2006 year)
Description of the population of children, which are at risk to lose the parents or the parental care
Children from poor families
Children form families with disturbed relationships
Children direct victims of violence
Families with children – witness of family violence (or the mothers are victims)
III Overview of the children care outside of the institutions In terms of non-institutional care 2008 year there are 18 daycare in centers in Macedonia that provide services to some 330 children and young people with special needs. In addition, there are two centers for drug abusers, six for victims of family violence, three for street children and one for homeless people. These centers are in general also understaffed and under-resourced (According to Situation analysis – Children in Macedonia, 2008 by UNICEF).
Also as part of the First Children Embassy in the world MEGJASHI there is one centre for street children, where they have been provided with food, hygiene and education services.
IV Overview of the deinstitutionalization of the institutions for residential protection of children According to Assessment of the reform of the child protection system, December 2007 by UNICEF, the reforms regarding deinstitutionalization of children in Macedonia were for the most part initiated by UNICEF in 2000.
Of the institutions for residential protection of children presented in only the Special Institute "Demir Kapija" in 2007 was undergoing the process of deinstitutionalization. No reforms towards deinstitutionalization were in place for the other institutions. The process of deinstitutionalization of children with disabilities from the Special Institute "Demir Kapija", was initiated in 2000 through the UNICEF support to the project "Educational and Social Activities with Children from the Special Institute Demir Kapija aimed at Deinstitutionalization". The project was welcomed by the MoLSP and implemented by a professional team from the Institute for Defectology, within the Faculty of Philosophy in Skopje. The Project commenced in February 2001, dealing at first with 20 children up to the age of 10. For each of these children an assessment of individual needs was carried out (using the traditional, though functional approach in assessment), and educational and upbringing programs was realized. The assessment of the individual needs of children was carried out by a team of 7 professionals (2 defectologists, 1 speech therapist, 1 physiotherapist, 1 neuropsychiatry, 1 social worker and 1 care-giver). The team also worked on the preparation of children for discharge from the Institute. Until 2006, UNICEF had been covering expenses for their salaries.
The program activities within this project were aimed at stimulation and development of the children's' potential and enabling their self-reliance in meeting daily needs. Already in May 2003, 23 children exited Demir Kapija. At the moment of the assessment, according to the MoLSP data, 30 children have been deinstitutionalized. At the end of 2007 year 29 children with moderate and severe disabilities are still residing in Dемир Kapija, 3 of them already prepared to exit and be placed in the either biological family of in foster care. According to the information from the MoLSP, 330 disabled persons are still in residential care in Demir Kapija. Most significant achievements regarding deinstitutionalization are obviously related to the category of disabled children.
In this direction, in cooperation with UNICEF, a Strategy for Deinstitutionalization and operational plan was developed. It outlines the deinstitutionalization process, the transformation/closure of institutions and development of alternative services. It covers all categories of children without parents and parental care and children in conflict with the law.
Further, in above mentioned report an recommendations were given toward the process of the deinstitutionalization:
“ Extend the current deinstitutionalization reforms (at present directed towards disabled children) towards children without parents and parental care and children in conflict with the law who are already or at risk of being institutionalized
Home-based services as alternative to institutional care and support to non-formal family care should be developed, while the current network of alternative services extended (NGOs, private sector, other
MoLSP should explore the modalities for redirecting the investments in covering rental and maintenance expenses for children coming out of age (assistance in housing), towards more sustainable investments in provision of housing that would be in the ownership of children, and where they could live independently after the age of 26.”
V Evaluation of the foster care in R.M As indicator of the foster care services in Macedonia, are overviewed three official researches and reports who have evaluated the situation of the foster care services in R. Macedonia. Also during the collection of the data by the official Institutions in Macedonia (especially the Centers for Social Work), it can be found that there is lack of mechanisms for collecting and keeping the information, upon which later a statistical analysis could be made.
The first is the Evaluation report FOSTER CARE SERVICES, UNICEF Skopje, August 2008, where the foster families in Macedonia were evaluated. The evaluation was aimed toward several aspects of the foster care within the foster families: SOCIAL PROTECTION SYSTEM IN PROVIDING FOSTER CARE SERVICES, QUALITY AND ADEQUACY OF FOSTER CARE and FOSTER CARE TRAINING. Their conclusions are summarized in continuous (Evaluation report – Foster care services, 2008 by UNICEF, available on http://www.unicef.org/tfyrmacedonia/MK_Evaluation_report_ENG.pdf):
- The Rulebook that serves as a guide to practitioners in the delivery of foster care is functional, but clearer terminology is required and possible changes in regulations to advance foster care practice may be recommended.
- There are neither standards nor extensive monitoring mechanisms in place to assure quality maintenance in the delivery of foster care services. CSWs, currently monitors the foster care practice through visits. These visits are infrequent, at a maximum of once per year.
- There is a lack of supportive services to families facing difficulties that would assist and supplement professional efforts to avoid child separation from the biological family. Preventive social services are seriously limited and often result in the removal of a child from the home as a first, rather than last response.
- The absence of legally recognised kinship care was identified as a weakness in the child protection system in general, and foster care system in particular.
- Professional social work approaches used in current foster care practice are insufficient and outdated. Planning, contracting and participation of service beneficiaries in the development and delivery of social services, monitoring and follow-up practices are missing. Procedures for selection of foster parents and subsequent monitoring are underdeveloped. Selection is usually made based on observations of the family situation and resources, supported by interviews carried out with foster parents and other family members. Monitoring is also largely executed through home visits, rather than in a standardised manner.
- Since the widely organised campaigns by CSWs for promotion of foster care services approximately 5 years ago, continuing promotion to attract new interested families to the foster care system is not taking place. As a result, in some cities, there are foster families on a waiting list to receive placements, and in other cities not a single foster family has been identified.
- Overall, the quality of care is high. Children are well adjusted, accepted and looked after in a caring and warm environment. Still, evaluation revealed certain aspects of the foster care which should be further advanced. Contacts between children and biological parents and the
linkages between them are not always frequently and properly maintained, even in cases when there is obvious evidence of temporary biological family crisis that may be resolved. In short, insufficient attention is paid to preservation of family ties even in cases when that may be beneficial for the child.
- The need for continuing education for developing staff skills is recognised at all levels of the foster care system. Many professionals currently working in the foster care system have not benefitted from any specialised trainings. Development of training programmes, training needs assessment and evaluation are insufficiently carried out and requires further investments. Generalised training on contemporary social work and foster care practice is insufficient and should be improved.
- Training for foster parents is seriously lacking. With the exception of Skopje, Prilep and M. Brod, where CSW staff reported of organised group training to foster parents, training is limited to only informative meetings with foster parents and CSW staff on an individual basis to explain roles, responsibilities and expectations.
The second research was conducted in 2009 by the office of Ombudsman of the R. Macedonia. The research was directed toward physical, psychological and sexual violence against the children in the institutions. 53 children from public institutions for children: “11 Oktomvri”, “25 Maj” and “Ranka Milanovik”. The children were interviewed anonymously. The whole research is available on http://www.ombudsman.mk/default.aspx?cId=132&Lan=MK.
Regarding the knowledge of the child rights, it was concluded that children in the institutions ate not familiar with their rights (73,58% of the interviewed children said that they have no knowledge about the children rights) and about their obligations (81,13% from the children don’t have any or insufficient knowledge regarding their obligations).
In the questionnaire, there were questions about the presence of physical and psychological abuse, if there is what kind of abuse and where the children have looked for help. The data have shown that:
- 20,75% from the interviewed children claimed that often there is a physical violence, and 16,98% claimed that they were often psychologically abused.
- 20,75% from the interviewed children claimed that the physical violence is rare, and 11,32% claimed that they were rarely psychologically abused.
- 50,94% from the interviewed children claimed that they have never been physical abused, and 47,17% children claimed that they have never been psychologically abused.
- 7,55% didn’t answered if they were physically abused and 24,53% didn’t answer if they were psychologically abused.
The children were also asked if they have reported the cases and what was made for their protection. The data have shown that:
- 16,98% from the interviewed children claimed they have reported the case to the employees in the institutions and asked for help.
- 24,53% from the children didn’t ask for help, because they were afraid.
- 7,55 from the children didn’t ask for help, because they didn’t know where to report.
- 50,94% didn’t answered.
When the cases were reported, the data have shown that:
- 33,96% from the interviewed children claimed that no measures were taken against the perpetrators.
- 7,55% from the interviewed children claimed that they were punished, instead the perpetrators.
- 7,55% from the interviewed children claimed that the perpetrators were punished.
- 49,06% didn’t answered.
In the last part of the questionnaire, the children were asked if they were victims of sexual abuse, how and did they ask for help. The data have shown that:
- 66,04% from the interviewed children didn’t answered.
- 18,87% from the interviewed children pointed out that they were victims of verbal sexual aggression.
- 7,55% from the interviewed children claimed that they were coerced to fulfil some “unacceptable” desires of the employees.
- 5,66% from the interviewed children have claimed that the sexual abuse were made by touches of intimate places.
- 1 child have stated that he/she was sexually molested.
The overall conclusions from this overview were:
the biggest number of the children don`t know their rights
in big percentage corporal punishment is present in the institutions
there is a presence of psychological abuse also, but in smaller percentage, even though many children didn`t answered these questions.
Children in the institutions are afraid to report the cases of physical and psychological punishment, further more they don`t know where to report
Children in the institutions are also victims of sexual abuse, and usually they don`t report the cases.
The third source is the Shadow report for the Implementation of the Convention on the rights of the children in Macedonia, which will be submitted to the Committee on the Rights of the Child. The report is still in the phase of preparation and it is prepared by the First Children Embassy in the World MEGJASHI in collaboration with several other NGOs. This report have a very important role, through advocacy and monitoring, in ensuring the UN CRC acts as an effective instrument of protection of the rights of the child. Shadow reports are an important advocacy tool at national level (especially in the cases where civil society is not adequately included in the national reporting process), and should foster open discussion and assessment of progress between the governments, civil society representatives, and other key stakeholders engaged in the national response.
In the Shadow report for the Implementation of the Convention on the rights of the children in Macedonia, the following recommendations will be submitted to the UN CRC regarding the foster care services:
- Increasing of the capacity of the CSW and superiors services in the MoLSP trough organizational reforms and continuous education of the employees. The reforms have to be followed by precise control mechanisms and procedures which will secure the identification and punishment of the child’s rights violation and violators.
- There are some weaknesses in the process of making decisions by the CSW in the process of divorce and custody of the children. The recommendation is to be taken in consideration the right of the opinion of the child, equally as the material and economical conditions of the parents. The children who have more than 6 years have psycho-psychical and emotional maturity to decide with which parent want to live. Also this should be considered when younger children are involved too, and especially when the child is losing both parents and as alternative is should be placed at the closest relatives.
-The parental right to see his/her children when they are living with the other parent or in foster care is often realized without to be guarded by the representatives of the CSW and without observation of the conditions and behaviour of the parents. There were few cases when this parental right was used, the children were sexually molested. More information about this cases could be found at http://www.childrensembassy.org.mk/default-mk.asp?ItemID=B03FCF B256A1004D9F037C2B7E92D9A6.
- Positive remarks are given toward the efforts of the state to provide alternative care for the children without parental care after they leave the institutions by providing them free accommodation with covered expenses, until they are 26 years old.
- The need for increasing the number of foster families is present. In addition, the foster families need previous education and training to provide appropriate care to the children – victims of different kind of child abuse.
- CSW and MoLSP are not providing quality monitoring of the work of the institutions for children. As examples could be taken several cases where children from the institutions have reported child abuse. In one of this cases the Helsinki Committee for Human Rights of the Republic of Macedonia have submit criminal charge and the outcome is still pending. More information about this cases could be found at http://www.childrensembassy.org.mk/default-mk.asp?ItemID=22EAB52B523 0EC41B171A2E402F87058.
- Regarding the adoption in Republic of Macedonia rarely are adopted children with disabilities and Roma Children, and nothing is done to popularize these issues.
- Regarding the adoption of children by foreign citizens is recommended our state to make bilateral agreements for international adoptions and according to them to supervise the condition of the adopted children. Also is recommended one of the parents to be from the state where the child is born or near by, in order the child to be familiar in the future with his/her origin, language and identity.
- CSW has established appropriate criteria for selection of the people who wants to adopt children, but the procedures and the process is very slow. It is recommended the procedures to go faster and the collaboration between the state and the NGOs to be improved.
1. Assessment of the reform of the child protection system in Macedonia, December 2007 by UNICEF.Census report 1994
2. Evaluation report – Foster care services, 2008 by UNICEF,
3. INFORMATION about the physical, psychological, and sexual abuse of the children in the institutions, Ombudsman of R. Macedonia, September 2009
4. Report of the Ministry of Labour and Social Politics of R.M., 2002
5. Report of the Centre for Social Work – Skopje for the violence July 2008
6. Statistical Yearbook of the Republic of Macedonia for 1997 year
7. Situation analysis – Children in Macedonia, 2008 by UNICEF