Deinstitutionalisation – moving from institutions to family and community based care

Our approach in Malaysia involves stakeholders implementing a tried and proven DI model founded on international best practice methods. OrphanCare works closely with Lumos, an international UK-based NGO founded by author J K Rowling that is at the forefront of the push to end the institutionalisation of children around the world. Implementing a system that will allow children to be raised in a safe and loving environment is not straightforward.

DI is not about closing buildings or developing new services. It is a process that gives children the opportunity to reclaim their identities and grow their individuality. The success of DI is not measured by a simple reduction in numbers of children in institutions. What is important is the long term quality of life for children who transition from institutions.

There are 5 areas that need to be addressed in order to turn an outdated and harmful system into one that protects children and gives them a future.

OrphanCare Foundation has worked hard to convince the government that the institutionalisation of children should end. It is focusing on convincing corporations that they should stop supporting orphanages and help fund the alternative family and community based care model instead.

OrphanCare arranges training workshops using trainers who are experts in the field

OrphanCare worked to bring about the recent changes to the Child Act (Amendment) 2016 that will facilitate the implementation of DI

Budgets need to be re-looked. The transition from institutions to family and community based care will require a significant reallocation of funds

By following new models of care we will be able to better help children

Recommendations

What is needed to end the institutionalisation of children in Malaysia

When many remain convinced orphanages are good or necessary moving to a system based on family-care and communities will be strenuously resisted.

We need to know the size and scope of the problem to remedy the situation. There are some official statistics about children in institutions but children in the many institutions that are not registered miss being counted. OrphanCare, the Department of Social Welfare and Lumos are collaborating to compile accurate data.

Closer coordination and collaboration between the private sector, government and NGOs will provide opportunities to harness the funds, strategic thinking, skills and political will needed to accelerate the DI process. OrphanCare is committed to working with all relevant parties.

With actual data and relying on experience from countries that have successfully implemented DI Malaysia can formulate its own DI strategy that would include:

  1. a map of services needed to provide placements for all children currently in institutions
  2. a timetable and action plan for the development of community services and for moving children from institutions to families
  3. a plan for managing the change process, including communications and awareness raising
  4. a workforce development programme and detailed costs to implement the strategy

In most countries, the majority of children in large institutions can be reintegrated with their families if adequate family-strengthening services exist. We need to strengthen and make community based health, education and social services in Malaysia more accessible.

Active work to prevent separation of children from their families as well as intensive work on returning children currently in institutions with their families can solve the problems of most children currently admitted to the care system.

For those children who cannot go home to their families the next best solution is adoption or foster care. Considerable work is needed to develop the foster care system in Malaysia.

The current foster-care system is confused with the system of adoption, which means that people on the list of potential foster carers are those who would really like to become adoptive parents and don’t understand the difference.

In order to establish proper community services that give children the possibility of returning to their families, these two systems must be distinct from each other. In addition, more work is needed to strengthen the process of selecting adoptive parents, matching them with children and preparing everyone for their new life together. This will help minimise breakdowns in adoption.

The government should select one or two institutions to develop a ‘pilot’ or demonstration DI programme. By implementing first on a small scale, lessons can be learned and local expertise in managing DI can be developed. This demonstration will also help others to understand DI and to see the positive benefits for children, families and society.

Significant changes are required in the legislation to facilitate the development of appropriate community services and to end institutionalisation. In particular legislation is required to ensure that State authorities actively support parents to assume their full parental responsibilities and that all decisions taken regarding children respect their rights and are made in their best interests. This should result in significant reduction of the number of children separated from their families, as well as reducing risk of harm and abuse.

Given the role of the private sector in Malaysia’s care system, strong laws regulating the circumstances under which children are placed into private institutions are essential. Quality standards are required that apply in equal measure to institutions run by the State and those run by the private or voluntary sector. Harsh sanctions are needed to reduce the number of institutions that are not registered and therefore are not subject to any regulation.

Any changes to the law must be introduced in parallel to the development of quality alternative care and family and community based services. This will require investments in the short term of resources to effectively enforce and coordinate measures.

One of the main drivers of institutionalisation is the use of misdirected funding to build new institutions or renovate old facilities, instead of providing assistance and access to services for families who want to keep their children at home. A new strategy must work to divert funding away from institutions towards the development of community services that support children to live with their families.

Residential care appears to be the first stop solution of some organisations and individuals who, with the best intentions, provide support and funding to children in orphanages, often unaware of community based care options that are much better for children.

Whenever a DI process is put in place, it is essential to ring-fence the funds in institutions and reinvest them in quality alternative care and support services. At a minimum, these funds should correspond to the amount that was allocated for each child living in the institution.

By reinvesting funds, money is diverted from institutions and into family and community services. This in turn dis-incentivises the admission of more children to institutions.

Although the process of DI requires heavy investment in the short term, it pays significant economic dividends in the medium and long term. It is less expensive to support families to raise their own children to grow up in families than it is for children to live in institutions with much poorer quality care and exposing children to risk of serious harm.

The money saved can be reinvested in high quality services for a minority of children with extremely complex needs.

Accreditation: Ending the institutionalisation of children in Malaysia 2014 Lumos