Familierapport 2012 by SOS Børnebyerne

Supporting Families through the Economic Crisis: The SOS Children’s Villages Family Report 2012

Contents Preface: For caring families in difficult times

Executive Summary

0. Introduction

0.1. Global challenges require joint responses

0.2. Family in the context of a globalised world

0.3. Children and their families at the centre of response 1. The key importance of state support

13 14

1.1. The Challenge: Families fighting poverty

1.2. The Response: Supporting states and communities in service provision

1.3 Key learnings and recommendations

2. Hard choices: Labour migration, unemployed or working poor

2.1. The Challenge: The emotional costs of labour migration

2.2. The Response: Improving families’ income prospects

2.3 Key learnings and recommendations

3. Health care gaps increase family vulnerability

3.1. The challenge: Preventive health education

3.2. The Response: An integral approach to family health

3.3 Key learnings and recommendations

4. Keeping children in school

4.1 The Challenge: Family income and knowledge

4.2. The Response: Adressing children, families and the system holistically to prevent school-drop

4.3 Key learnings and recommendations

5. Economic pressures impact on parenting

5.1. The Challenge: Child care at risk

5.2. The Response: Supporting quality care among care-givers and communities

5.3. Key learnings and recommendations

The SOS Children’s Villages Family Report 2012

Preface: For caring families in difficult times A child’s healthy development is best realised in a caring family environment. This conviction underpins the SOS Children’s Villages vision that every child belongs to a family and grows with love, respect and security. SOS Children’s Villages works with local communities and partners around the world to strengthen disadvantaged families. We assist them to manage their lives independently and provide adequate care for their children’s holistic development. This includes supporting communities and governments in social, education or health service provision. Families are empowered to become economically independent and strengthen their psycho-social and emotional child care capacities. Alternative care in an SOS family is offered when children have no family or when, despite support, families are still not in a position to care for their children. The starting point of our work is to protect and promote the rights of children. As the UN Convention on the Rights of the Child (UNCRC) recognises, the family is the ‘natural environment for the growth and well-being of children’. Only strong family environments can support children adequately. This report is informed and shaped by a survey among SOS Children’s Villages national associations on what they perceive as major challenges for families today. Their opinions are based on their daily work with over two million vulnerable children and their families in SOS Children’s Villages programmes in the field of family strengthening, care, education, health and emergency relief, and reflect the particular needs of families in difficult and poverty-stricken situations. The survey reflects concerns about how the recent global economic crisis has hit families around the globe, especially those already facing difficulties. The crisis has undermined families’ fundamental human rights, they are deprived of adequate living standards including nutrition, housing, health care and schooling for their children. Families lack social services and other support, and this has consequences for the quality of parental care, even leading to cases of child abandonment. The instinct to nurture children is human, as are families’ goals 1 for child development in all parts of the world. Based on extensive cross-cultural studies, LeVine identified three universal goals of parenting: Assure the physical survival and health of their children; support their children’s development towards economic self-reliance; and transmit cultural and social values and skills. LeVine found a ‘natural hierarchy’ among these goals, in that physical survival was always prioritised. In difficult times, parents may concentrate on the survival of their children at the expense of other concerns, and lack time and resources to dedicate to more holistic development goals. As an organisation, SOS Children’s Villages recognises and embraces the increasing diversity of family life around the globe, and believes that children deserve stable, reliable and caring family environments that provide them with the best possible development opportunities. The UN Convention on the Rights of the Child (UNCRC) 1

LeVine (1977:20) in: Bernhard von Leer Foundation (2010: 2)

The SOS Children’s Villages Family Report 2012

affirms a family environment as ‘an atmosphere of happiness, love and understanding’. Such family environments require decent living standards for a family to live in dignity and for parents to have the time and resources to devote to the full and optimal development of their children as self-reliant, self-confident members of society. The International Day of Families, proclaimed by the UN General Assembly in 1993, is observed annually on the 15th of May and reflects the importance the international community attaches to families. We take this opportunity to join in promoting awareness of the challenges affecting families today, to share our experience of supporting families around the globe and to call for broad attention to the situation and needs of families. Especially in times of economic difficulties, governments and decision-makers everywhere need to take seriously the UNCRC commitment that families receive the support they require to take adequate care of their children. The current crisis must not increase family vulnerability or cut back on past progress in terms of child rights and child development. We have to invest in families to prevent perpetuating the intergenerational cycle of poverty. Richard Pichler Secretary General SOS Children’s Villages International

Executive Summary The understanding of family has been fluid throughout history. Today, many diverse types of family – single parents, same sex, unmarried and remarried couples – are increasingly widely accepted. SOS Children’s Villages warmly embraces a broad understanding of the nature of family, while recognising that changing socio-cultural norms, especially around gender, are causing intergenerational tensions in traditional cultures. Today’s families face many challenges. The effects of globalisation are connecting families in some ways and dividing them in others; meanwhile, the complex nature of poverty is changing along with phenomena such as urbanisation, climate change and the faltering of both informal social protection mechanisms and public support structures. This report explores five themes which emerged from SOS Children’s Villages’ survey of its national member associations and shares insights regarding the work the organisation undertakes in these areas. 1. Families fighting poverty: The key importance of state support A lack of services supporting adequate living conditions, nutrition and healthcare contribute to continued child mortality in developing countries. Governments have a legal duty to support families in areas such as housing, sanitation and infrastructure, food security, healthcare and education. Given that the recent economic crisis is putting pressure on governments’ ability to support families in these areas, there is an even greater need to reinforce adequate social protection measures. Especially the most vulnerable families, those living in poverty, in rural areas, or from an ethnic minority or migrant background are often overlooked by, or excluded from, public service provision.

The SOS Children’s Villages Family Report 2012

The SOS response is to support states and communities in providing family services and assistance, in three main ways: Advocating to influence policy, legislation and service implementation, in partnership with other stakeholders and the community; strengthening existing social service provision and family support systems, contributing to their quality and sustainability; and delivering direct services where immediately necessary and not otherwise available, often in cooperation with specialised partners Key learnings and recommendations (summary)

2. Hard choices: Labour migration, unemployed or working poor With the economic crisis the number of unemployed and working poor has increased, and many parents are resorting to labour migration to provide financial benefits for their families. However, labour migration also comes with emotional costs, as separating family members can have a devastating impact on family life and child development. It is often hard for families to migrate together, especially in cases of undocumented migration. Creating more jobs in migrants’ places of origin would be one important measure to protect family life. The SOS response is to support families towards economic self-reliance, through intervention strategies including: Vocational, practical and social skills training in workshops and training centres; Promoting and supporting income generating activities (IGAs) and the setting up of small family businesses, including the provision of small interest-free loans, micro-credits, technical and business training and follow-up; and Legal and practical counselling, accompaniment and skills training towards finding and maintaining local employment. Key learnings and recommendations (summary)

3. Health care gaps increase family vulnerability: preventive health education Improving preventive education is essential to promoting family health, especially given that public health provision is patchy in many countries and private care remains unaffordable to many families. In particular, many deaths of under-fives are from preventable causes, and greater spending on preventive healthcare could greatly improve maternal and child health and reproductive health. Preventive efforts involving social, cultural and behavioural dimensions, especially when targeting mothers, can have an impact on improving family health. The SOS response is a holistic focus on children’s ‘healthy development’ through supporting access to preventative and curative family-friendly and child-specific health care services, including for families outside the formal health insurance system; conducting training sessions and awareness-raising campaigns and supporting governments in scaling up their preventive health measures and crafting legislation; and supporting the psycho-social and mental component of family and child health through counselling, therapeutic support and promoting positive family relations. Key learnings and recommendations (summary) The SOS Children’s Villages Family Report 2012

4. Keeping children in school: A matter of family income and knowledge Education is also key to breaking the intergenerational cycle of poverty. However, recent gains in access to primary education have not been matched by improvements in quality of schooling or access to secondary and higher education. Many children, especially girls, still drop out of school to work and contribute to family income; girls and children from poor, less educated or marginalised families are over-proportionally affected. The SOS response, in partnership with governments and others, includes building the capacity of educational service providers to develop child-centred, holistic, safe, inclusive and accessible quality educational services; providing formal or non-formal educational services where none is available, though with a clear focus on transferring ownership to the state or community; and helping parents support their children’s learning and claim their educational rights. Key learnings and recommendations (summary)

5. Child care at risk: How economic pressures impact on parenting The economic crisis has also severely impacted on parents’ caring and coping abilities.. Inadequate living conditions and the struggle for economic survival create stress and despair, often furthering conflict, depression, alcoholism or violence. An increasing worklife imbalance is squeezing parents’ abilities to devote time to their children. Labour migration and other factors separate families and weaken their cohesion and resistance. Family poverty makes children vulnerable to violence, abuse, neglect and exploitation. Families in these situations require stronger support through community networks, information, public services and support structures. The SOS response involved strengths-based parental skill-building to develop the attitudes, knowledge, skills and capacity for creating a positive family environment and providing loving quality care for children; activities for children to strengthen their selfconfidence and family communication; and joint family activities to support families in spending time together. Key learnings and recommendations (summary)

The SOS Children’s Villages Family Report 2012

0. Introduction 0.1. Global challenges require joint responses ‘ (…) poverty is so high that government alone cannot address this issue.’ (SOS family survey Gambia)

SOS Children’s Villages works in 133 countries around the globe committed to supporting children by strengthening their families and communities. The rights and wellbeing of children cannot be realized without strong and healthy families able to take adequate care of their children’s development. Families in turn have to be well supported by the surrounding environment, resourceful and child-friendly communities, familyfocused quality services and suitable infrastructure, a supportive legislation. SOS Children’s Villages national associations around the world were asked in a survey on what they perceive as major challenges for families today. The views of national directors and programme advisors from 88 countries in all continents illustrate this report throughout. Their opinions are based on their daily work with over two million vulnerable children and their families in SOS Children’s Villages programmes, and reflect the particular needs of families in difficult and poverty-stricken situations. SOS programmes worldwide reach out to and support 2…  430,500 vulnerable families and their local communities through 607 family strengthening programmes  80,300 children and youth in family-based alternative care (SOS families, foster families, youth programmes)  148,400 children, youth and adults through education or vocational training  455,700 people in 72 medical centres and health programmes  1,137,700 people in 13 emergency relief programmes The survey results have shown that the recent global economic crisis has hit hard on families and communities around the globe and deepened already existing problems around family poverty and social marginalisation. Each of the five chapters of this report addresses specific challenges the survey identified as facing families today. Apparently, in the context of today’s globalised world, the challenges are interlinked and influence each other, which require multi-sectoral and comprehensive responses. Firstly, each chapter describes the current situation and features then examples and case studies from SOS Children’s Villages programmes to share learnings and approaches in tackling the problems identified. The report is also suggesting ways in which different actors can take action to support families. Doing so, the report intends to explore the questions: What problems are the world’s families facing today? And what can make a difference in their lives? Most obviously, the policies of national, local and municipal governments play a major role in shaping the environment for families. Almost all of the world’s governments have ratified the UN Convention on the Rights of the Child (UNCRC), which committed them 2

Figures taken from SOS Children’s Villages Annual Report 2010/2011

The SOS Children’s Villages Family Report 2012

to create adequate legal frameworks and take supportive action to assist families in assuring their children’s comprehensive development (see box B). This commitment to children’s rights reaches into many mutually influencing policy areas affecting family life: Do health and education systems give parents the support they need, from ensuring health through pregnancy to knowing how to help their children’s physical, mental and emotional development? Do economic policies enable parents to find jobs paying a living wage, in decent conditions that do not require extended periods away from their homes? Are there safety nets to ensure that parents who are unable to work, or earn little, can still provide for their children? In deciding how to translate their UNCRC commitments into policies, governments are influenced by many actors. They may face direct obligations from lending institutions such as the World Bank, International Monetary Fund and bi- or multilateral donors, or regional political and economic associations such as the European Union, the Council of Europe, the African Union, the Association of Southeast Asian Nations (ASEAN) or the North American Free Trade Agreement (NAFTA). Supranational structures such as the various United Nations agencies or programmes and the Organisation for Economic Cooperation and Development (OECD) facilitate cooperation or funding and promote human rights policy frameworks that influence governmental legislation and implementation. Governmental policies may be further swayed by the voice of media and by corporations, philanthropic foundations or NGOs’ advocacy, lobbying or offers of funding and technical support. This report describes some of the major challenges to be addressed, shares the respective experience of SOS Children’s Villages and explores the role a multitude of partners in a globalised world play where national approaches and resources are often insufficient to tackle the challenges families face.

0.2. Family in the context of a globalised world Families are changing, as are the challenges they face. Many diverse types of family – single parents, same sex, unmarried and remarried couples – are increasingly widely accepted. Changing socio-cultural norms, especially around gender, are however causing intergenerational tensions in traditional cultures. The effects of globalisation are connecting families in some ways and dividing them in others; meanwhile, the complex nature of poverty is changing along with phenomena such as urbanisation, climate change and the faltering of both informal social protection mechanisms and public support structures. While more than a quarter of the overall population worldwide is affected, poverty disproportionally concerns children and youth.

The SOS Children’s Villages Family Report 2012

Figure 1: Overview of poverty in general and affecting population below 18 and population below 5 years. (Source: http://www.unicef.org/sowc2011/statistics.php, download December 8, 2011)

Graphic text: Poverty remains a strong issue. While more than a quarter of the overall population worldwide is affected, poverty concerns almost a third of the population below 18. In response to social, cultural and economic transformation, the concept of family around the globe has always been, and remains, rather diverse. Humans have always gathered in small kin groups, and these family and community forms have throughout history been constantly impacted by the social, economic and cultural conditions around them, as they tried to adapt for best possible survival and protection of themselves and their children. Demographic shifts, cultural changes, globalisation, economic recession, and the uneven pace at which states are addressing development issues are among the global trends shaping family life today. The mixed impacts of globalisation Today, the acceleration of globalisation both interconnects and fragments the lives of families. Families profit from opportunities such as growing mobility and access to information, but also suffer consequences over which they can exert little influence. While liberalisation and global trade have brought economic growth, inequality in access to resources excludes poor and disadvantaged families and constrains their potential contribution 3. Mobile phones and television increasingly connect even remote and rural areas, but disparity in access remains stark and creates new forms of inequality: While 72 per cent people in the developed regions use the internet, only 21 per cent in developing countries do 4.

3 4

UNRISD (2010: 4-6) Figures from end-2010, United Nations (2011b: 63)

The SOS Childrenâ&#x20AC;&#x2122;s Villages Family Report 2012

Figure 2: New forms of communication as a driver for inequality

Many families are struggling against the impact of unemployment and poverty. Despite progress made in tackling the Millennium Development Goals (MDGs), close to half the population of developing countries live on less than two dollars a day, nearly a quarter lack access to electricity, and one in six lack access to clean water 5. The economic crisis that began in 2008 reduced growth, trade and investment, and led to higher prices and fewer jobs 6 . Agriculture and industry in many developing countries are stagnating. Spiking food prices put families in poverty at increased risk of malnutrition, with women and children being especially vulnerable. A recent UN report states that ‘the devastating impact of the crisis on so many people underscores the dynamic and multidimensional nature of poverty’ 7. Urbanisation and climate change drive migration and deepen poverty Over half of the world’s population live in cities and this proportion is growing fast 8. For families, urbanisation is a mixed blessing. On the one hand, families living in cities have on average more access to resources than rural families; on the other hand, poorly managed urbanisation is likely to increase family vulnerability. Large urban populations put more pressure on ecosystems and increase competition for resources and demand for energy. Climate change is also having a growing impact on developing countries, with millions of families suffering the effects of floods, storms and droughts 9. Natural disasters destroy settlements and food resources; they contaminate water, cause various diseases, and draw away resources from development. Changed sowing and harvesting rhythms also imperil the livelihoods of rural families. The consequences of these trends include more migration and deeper poverty. As shown in Figure 3, West and Central Africa currently has the highest incidence of extreme poverty at 55%, followed by 51% in Eastern and Southern Africa and 40% of South Asia. It has been estimated that there will be around 200 million ‘climate refugees’ by 2050, with a greater risk of children being separated from their families 10 . Additionally,

United Nations (2010: 39) United Nations (2011b: 6-8) United Nations (2011: 9) 8 UNFPA (2011: ii) 9 World Bank (2010:37) 10 Save the Children, ‘Legacy of disaster’ in: Reale (2008: 9) 6 7

The SOS Children’s Villages Family Report 2012

humanitarian conflicts and persecution displaced globally around 43 million people by the end of 2010, about half a million more than the year before 11.

Figure 3: Overview of poverty in general and affecting population below 18 and population below 5 years, divided by regions (Source: http://www.unicef.org/sowc2011/statistics.php, download December 8, 2011

Socio-cultural transformations in the understanding of family Across the worldâ&#x20AC;&#x2122;s 49 least developed countries, almost half the population is under the age of 18 12, and many of these children and youth live in poverty-affected households: 67% of children and youth under 24 live in the 60% households which receive only 19.2% of the global income 13. In poorer parts of the world where birth rates remain high, 25.2% of children and youth live in the poorest families, who receive only 3.2% of global income 14. In other countries, slowing population growth rates are decreasing average family size. This is causing a shift in family structure from the traditional extended family more typical of human history and developing countries to the nuclear family which now dominates in the industrialised world 15.

Figure 4: 67% Children and youth under 24 who are living in the 60% households which receive only 19,2% of the global income

United Nations (2011b: 15) UNICEF (2010a: 7) Figures from 2007, Ortiz and Cummins (2011), UNICEF; in: Ortiz (2011) 14 ibid 15 UNESCAP (2009: 7) 12

The SOS Childrenâ&#x20AC;&#x2122;s Villages Family Report 2012

The modern concept of nuclear family evolved in a Western context with industrialisation and technological progress. Characterised by strong emotional bonds and intimate individual relationships between couples and between parents and children, it brought a new and diverse understanding of living together and raising children. However, many diverse types of family – including single parents, same sex couples, unmarried and remarried couples – are now widely accepted as normal and unremarkable across the industrialised world 16. This transition is also happening, though more slowly, in many emerging and developing countries as concepts of individual freedom, social and gender equality spread through globalisation and the mass media. Across Latin America, there is ‘a higher number of incomplete families, patchwork families and single homes than in the past’ 17. The Asia Pacific region witnesses the ‘appearance of new and diverse forms of living arrangements such as co-habitation and living-apart-together’ 18. The shift in the socio-cultural understanding of family values is causing generational clashes in many traditional cultures, where it is often seen as a threat to long-standing customs, ethics, belief-systems and roles. Changes in gender roles around the world In particular, one consequence of social change affecting families all around the world is the increasing acceptance of women taking paid employment. This can be seen as a welcome liberation from ‘the burden of complying with traditional social expectations’ 19 and a chance to increase family income. It can also be seen as a ‘diminishing of traditional care-giving functions of the family’ 20. Women’s growing participation in the labour market is changing family structures through contributing to delaying marriages and reducing fertility rates, and through questioning the traditional social gender identity of men as sole breadwinner. Data from many countries shows increasing rates of marital breakdown, single parenthood and female-headed households 21. Men, meanwhile, are progressively becoming more involved in care-giving, especially in urban settings and among educated couples. The recent International Men and Gender Equality Survey shows that even beyond high-income countries, both men and women value greater participation by men in the lives of their children 22. However, gender inequality persists and women are far from having an equal share in income, economic activity, assets or social participation 23 . Globally, women earn on average 22 per cent less than men 24 and spend 2 to 10 times more time on unpaid care work than men 25. 16

Trask (2011: 2) Marcela Cerrutti, Georgina Binstock (2009: 51) UNESCAP (2009: ix) 19 Marcela Cerrutti, Georgina Binstock (2009: 51) 20 UNESCAP (2009: ix) 21 UN DESA, (2011: 16); UNESCAP (2009: 8-9); Marcela Cerrutti, Georgina Binstock (2009: 26, 30) 22 UN DESA (2011: 15-16) 23 The World Bank (2011: 13) 24 World Bank (2007), in: UN DESA (2011: 11) 25 Budlender (2008), in: UN DESA (2011: 11) 17 18

The SOS Children’s Villages Family Report 2012

Families face a lack of support networks Family poverty has complex causes and manifestations. Deficits in housing, income, health, education and nutrition intertwine with a lack of social and cultural resources, support networks and services offered by neighbourhoods, communities and states. Poverty impacts on the psychological and emotional well-being of families, leading to feelings of powerlessness, shame and failure, particularly in a globalised world where the capacity of individual families is strongly determined by external circumstances. Traditionally, informal social protection mechanisms have supported family life in developing countries. However, community and extended families support networks are increasingly being eroded through economic hardship and the trends towards the nuclear family, urbanisation and labour migration 26 (see chapter 2). Rising public debts and fiscal austerity measures in response to the current economic crisis are threatening governments’ public social spending 27 , increasing the risk of breaking their legal obligations towards supporting families (see Box B). Based on the results of the SOS Children’s Villages family survey, the following chapters look in depth at five major challenges poverty-stricken families are facing in relation to basic human rights: • The lack of adequate public support • The increase in labour migration spurred by unemployment • The inadequacy of preventive health services • The insufficiency of education services and income resulting in school drop-out • The negative impact on parental care quality Box A. The notion of family in this report Throughout history, understanding of family has always been evolving and fluid. With today’s global context and challenges, the concept of family is especially complex and pluralistic. Its increasingly diverse composition varies across and within societies and is progressively codified in national legislation. The understanding of family today varies with social and economic class, location, cultural belonging and personal choices. A clear or universal definition of what a family constitutes is therefore neither possible nor suitable. Family remains a fundamental social group in society, playing a central role in socialising the next generation. The UN Convention on the Rights of the Child (UNCRC) recognises the family as ‘the fundamental group of society and natural environment for the growth and well-being of (…) children’. However, formerly widespread criteria are no longer a must, such as a family sharing a biological lineage, common identity or place of residence, or assuming jointly functions such as reproduction, child-rearing and economic cooperation. The desire of human beings to relate and belong is creating new forms of family, and SOS Children’s Villages welcomes the broad social acceptance of diverse forms of family. As an organisation focusing on child development, SOS Children’s Villages uses 26 27

ODI/UNICEF (2009b: 30); UN DESA (2011: 19, 51); UNESCAP (2009: 7) United Nations (2011: 78)

The SOS Children’s Villages Family Report 2012

“family” in this report to mean a social group with a commitment to the loving upbringing and socialisation of children. As the development of attachment is not based on genetics but on sensitive interactions with any caregiver, it extends beyond biological parents 28. This wide understanding of family includes amongst others those with or without marriage bond, nuclear families or extended family networks comprising relatives or community members, monogamous or polygamous families, hetero- or homosexual families, patchwork families, divorced families, co-parenting, families providing alternative care e.g. as kinship carers, guardians, SOS parents or foster parents or others, families where members are living in different locations, single-headed or siblingheaded families, child-headed families, community-based family care arrangements, and many more. The word “family” comes with respect attached to it. In the view of SOS Children’s Villages, whoever decides to live as a family and takes responsibility for each other deserves the respect that is inherent to the word and concept.

0.3. Children and their families at the centre of response Enabling the child’s healthy development within a caring family environment has been, and continues to be, the driving force for development of the SOS Children’s Village idea. (SOS Children’s Villages Programme Policy) ‘The challenges for society are also our challenges!’ (SOS family survey Panama)

Each of the five main chapters will include an exploration of how the SOS Children’s Villages programme responds to the challenges families face. This introduction intends to briefly give a general context to these programme responses. The overall aim of SOS Children’s Villages is to create a positive framework for maximising the developmental chances of the most vulnerable children – those who have lost, or are at risk of losing, the care of their parents. As SOS Children’s Villages firmly believes in a caring family as the best possible environment for a child, the primary focus of the organisation’s child development programmes is strengthening different forms of families providing care for children. The SOS Children’s Villages programmes work jointly with local families, communities and states, developing various support measures to prevent children from losing the care of their family due to such reasons as financial difficulties, HIV/AIDS, stress or social marginalization. For children who have already lost family care, or when it is in the child’s best interests, individualized solutions are found with the participation of the child to grow up in foster families or in an SOS family, where children are supported, protected and cared for in a loving family environment. Communities with a high number of families at risk are assisted to develop strong social support networks and strengthen their caring, coping and protection capacities. SOS Children’s Villages programmes strive to empower communities to give families access 28

according to Bowlby, the pioneer of attachment research, in: Bowlby (1969)

The SOS Children’s Villages Family Report 2012

to the full range of services required for the holistic development of children. To fulfil children’s rights to survival, protection, development and participation, programmes address various dimensions of community, family and child development and offer interventions in areas such as education, health, work or psycho-social care. Programmes also offer child-centred emergency relief in cases of natural disaster or armed conflicts. SOS Children’s Villages develops programme interventions jointly with local communities and partners based on a child rights situation analysis. The programmes further aim to sensitise decision-makers to families’ concerns and influence them to make sustainable changes in policies and practices that affect the economic and sociocultural environment. This includes partnering with governments and reminding them of their responsibilities under the UNCRC. Alongside many other organisations, SOS Children’s Villages supports local and national bodies in providing direct services to families and reaches out to other potentially influential actors such as the private sector (to e.g. improve working practices or support fair trade). The UNCRC and the UN Guidelines for the Alternative Care of Children guide the programmes. They are paramount as it regards the provision of quality care, with essential reference to the primary responsibility of the parents for the child’s upbringing and development; the role of the child in his/her own development; and community, state and other service providers as duty bearer in promoting and protecting children’s rights.

1. The key importance of state support 1.1. The Challenge: Families fighting poverty A lack of services supporting adequate living conditions, nutrition and healthcare contribute to continued child mortality in developing countries. Governments have a legal duty to support families in areas such as housing, sanitation and infrastructure, food security, healthcare and education. Given that the recent economic crisis is putting pressure on governments’ ability to support families in these areas, there is an even greater need to reinforce adequate social protection measures. Especially the most vulnerable families, those living in poverty, in rural areas, or from an ethnic minority or migrant background are often overlooked by, or excluded from, public service provision. The available services are not sufficient to provide necessary support to all vulnerable families, therefore children do not receive adequate support and many rights are violated. Municipalities have limited resources to provide material aid and social services. (SOS family survey Latvia)

Social services and support schemes are essential for families to be able to ensure the basic well-being of themselves and their children. Supporting families should be a priority for all states. A recent UN report highlights the ‘critical importance of social protection for reducing vulnerability’ and affirms that ‘universal access to basic social protection and

The SOS Children’s Villages Family Report 2012

social services is necessary to break the cycle of poverty and reduce inequality and social exclusion’. 29 Besides the provision of basic services in the area of infrastructure, health or education, state support consists of social protection measures including social insurance, pension schemes and social assistance, which is especially important for vulnerable groups without or with very low incomes, including many poor families. Box B. Governments have a commitment to help and support families “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services”, affirms the Universal Declaration of Human Rights. While international law makes clear that parents have the main responsibility for the upbringing and development of their child, it does not leave parents alone in this care responsibility. The UN Convention on the Rights of the Child (UNCRC) has achieved near-universal acceptance, having been ratified by 193 parties since being adopted by the UN General Assembly in 1989. It stipulates that parents ‘have the primary responsibility for the upbringing and development of the child’ (Art 18) and that states have to ‘respect the responsibilities, rights and duties of parents’ (Art 5). It affirms that every family “should be afforded the necessary protection and assistance so that it can fully assume its responsibilities within the community”. The UN Guidelines for the Alternative Care of Children, officially welcomed by the UN General Assembly in 2009, give further guidance to national governments about obligations towards children who do not have parents, or whose parents are finding it difficult to look after them. They provide a universal framework for the provision of quality care and contribute to improving and harmonising alternative care provision and family support systems. SOS Children’s Villages was among the organisations supporting the United Nations to draft these guidelines and to disseminate them. When a national government ratifies the UNCRC, it accepts legally binding responsibilities. In many countries this has led to far-reaching legal reforms to recognise and protect the rights of children and provide services in areas such as child protection, health care, education or social support. When governments fall short of these responsibilities – as, unfortunately, still happens – they are failing to follow through on their commitments under international law. Every government should provide appropriate support to parents in their child-rearing responsibilities. This includes setting a family-friendly policy framework which enables a family to benefit from resources, services, training and information. States are also obliged to assure that educational facilities, health services and treatment, care provision, institutions and social programmes are accessible to all families and stick to certain quality standards. For families in poverty, governments should render “material assistance and support programmes, particularly with regard to nutrition, clothing and housing”. The UNCRC commits governments to ensure that the rights of a child are realised regardless of 29

United Nations (2011: 9-10)

The SOS Children’s Villages Family Report 2012

circumstances, including when parents work, when families move to another country, or when a child is from an ethnic minority or disabled and requires particular support. The UN Guidelines for the Alternative Care of Children 30 specify measures states should set to prevent child abandonment and family separation. They call for social policies and protection measures, empowering and supportive social programmes and family strengthening services. Examples mentioned include parenting courses, the promotion of positive parent-child relationships, conflict resolution and mediation, employment and income generation opportunities, day care, or social and financial assistance, As well as taking legislative, administrative, social and educational measures to protect children and families, states have a duty to make sure that other actors in society respect childrenâ&#x20AC;&#x2122;s needs and rights, such as media, service providers, courts or institutions.

Poor housing, sanitation and infrastructure weaken families Outside the main cities, there is no running water, and even in cities where there is running water, less than 20% of families have access. This intensifies the water-borne diseases such as diarrhoea, cholera, dysentery ... (SOS family survey Burkina Faso) The government needs effective programme for the construction of social housing in the country to allow accommodation of urban and rural families living in precarious housing conditions, giving them back their dignity (SOS family survey Angola)

Every day, thousands more rural people arrive in big cities. With the rise in urban populations, an estimated 828 million people now live in urban slums, compared to 657 million in 1990, as shown in Figure 5.

Figure 5: Trend of number of people living in urban slums (millions) from 1990 to 2011 (add source)

Living in a slum means inadequate access to safe water, sanitation and other infrastructure, poor quality of housing, overcrowding, insecurity and a low socioeconomic status 31 . Accumulated rubbish becomes more and more difficult to clear, worsening sanitary conditions. Slum living conditions exacerbate the impacts of natural disasters 30 31

SOS Childrenâ&#x20AC;&#x2122;s Villages International, International Social Service (2010:12) UN-HABITAT (2003)

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such as landslides, earthquakes and storms. Urban renewal programmes which replace slums with modern housing in some cases fail to address the underlying social problems and merely redistribute poverty. Despite improvements, 884 million people worldwide continue to lack access to clean drinking water, 84 per cent of them in rural areas. Access to proper sanitation facilities is increasing slowly, averaging 76% in urban and 45% in rural areas 32. In Sub-Saharan Africa, around 45% of the population still does not access or use improved drinkingwater sources and more than 60% remain without access to improved sanitation facilities 33. In Southern Asia, improvements have mainly benefited the wealthy; sanitation coverage for the poorest 40% of families has hardly increased, and 64% of the population lacks access to improved sanitation. 34

Figure 6: In regions with better access to clean water, child mortality is lower. Distinction between access to water in rural and urban areas. (Source: http://www.unicef.org/sowc2011/statistics.php, download: Dec. 8, 2011)

More than any other group, young children are especially vulnerable to the risks posed by contaminated water, poor sanitation and hygiene 35. Every year, 1.9 million children under five die from diarrhoeal diseases (see chapter 1.3.); 1.5 million of these deaths are related to unsafe drinking water, inadequate availability of water for washing and cooking and lack of access to sanitation 36. As shown in figure 6, regions with better access to clean water have lower rates of child mortality. Box C: Regional trends in poverty and extreme poverty The current United Nations definition of extreme poverty, an income less than 1.25 Dollar a day, affects around 20% of the worldâ&#x20AC;&#x2122;s population. The UN and the World Bank estimate that the recent economic crisis has driven an additional 47 to 84 million people into extreme poverty 37.

UNICEF (2010a: 8) UNICEF (2008: 9-10) United Nation (2011b: 55-56) 35 Haines, Andy, et al., The Lancet (2007), in: UNICEF (2008: 31-32) 36 Powell-Jackson, Timothy, et al., The Lancet (2006), in: UNICEF (2008: 31-32) 37 World Bank and International Monetary Fund (2010), United Nations (2010a), in United Nation (2011: 1) 33 34

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Kommentar [SI1]: Explanations on right hand side got lost and will be recovered. Blue: Child mortality. Red: Water total.

There are big differences among regions, and figures on extreme poverty in many developing countries are still extremely high: According to 2005 estimates 38, in SubSaharan Africa, 51% of the population lived on less than 1.25 dollars a day, 39% in Southern Asia, and 26% in the Caribbean. In South-Eastern Asia, Eastern Asia and Central Asia and the Caucasus, extreme poverty afflicted 19% of the population – a rate that is falling in South-Eastern Asia, but reflects an increase of around two-thirds since 1990 in the Central Asia & Caucasus. Many countries in sub-Saharan Africa, West Asia and parts of Eastern Europe and Central Asia have also seen increases in poverty 39. The situation looks better in Latin America (7%), Western Asia (6%) and Northern Africa (3%).

Figure 7. Percentage of population living on less than 1.25 US$

Broadening the definition from “extreme poverty” to “poverty” – officially defined as two dollars per day – brings a dramatic rise in poverty rates in developing countries 40. Even this measure, however, understates the difficulty of achieving a decent living on a few dollars per day – and measuring poverty only through income fails to capture its numerous other dimensions. The ‘Multidimensional Poverty Index’ introduced by UNDP in 2010 includes such measures as living standards and access to nutrition, health and education, and better reflects the vulnerability of household members. There is no commonly agreed measure of poverty across OECD countries. Many classify people as poor when their household income is less than half of the national median. Based on these definitions, the average OECD country poverty rate is 11%. The at-risk-of-poverty rate for households with dependent children in 2009 was 17.6% in the European Union, and poverty risks have shifted towards families with children 41. In the United States of America, poverty rates have been on the rise: 21% of children lived in poor families in 2009 (15.3 million children), meaning their family income was less than $22,050 a year for four children; and 9% of children lived in extreme poverty. There are tremendous differences among states and a greater poverty likelihood for black, American Indian, Hispanic and migrant families 42.

United Nations (2011b: 6-7) United Nation (2011: 49) United Nations (2009: 10) 41 OECD doing better for families, in: Eurochild (2011: 1) 39 40

National Centre for Children in Poverty, Columbia University, http://nccp.org

The SOS Children’s Villages Family Report 2012

As shown in Figure 8, Western and Central Asia saw an increase in poverty from 1990 to 2005, with reductions in every other region – most significantly in East Asia.

Figure 8. Poverty figures including regional trends and comparison with UNDP database (Source. MDG Report 2011)

The consequences of malnutrition and food insecurity are severe Malnutrition is the biggest contributor to child mortality. It inhibits educational performance and is a key impediment to economic growth through its consequences on health, the ability to learn and labour productivity. (SOS Family survey Tanzania)

Developing countries, where agriculture is the main source of living, were hardest hit by the food crisis. While expenditure on farming was increased in response to the crisis – including food subsidies, cash transfer and feeding programmes (e.g. in schools, or food for work) – the available funds were limited and they did not reach all groups in need 43. Around 178 million young children, about one-third of all children under age five, still suffer malnutrition, measured by severe or moderate stunting – that is, being short for their age 44. 80 percent of them live in twenty-four countries in Africa and Asia 45. Each year, about 19 million children in developing countries are born underweight because of their mother’s poor nutrition during pregnancy 46. Children who go to bed hungry or whose parents cannot afford to give them a balanced diet face severe long-term consequences: Delayed growth impairs brain and motor 43

United Nation (2011: 83-88) Stunting (height for age) is a common measurement in assessing the nutritional status of children, UNESCO (2010: 44) 45 UNICEF (2009b: 11) 46 UNICEF (2009b: 22) 44

The SOS Children’s Villages Family Report 2012

development, undermines the learning capacity of the child and might lead, later in life, to low work productivity. Under-nutrition of mother or child contributes to more than 30% of child deaths 47. Figure 10 shows the correlation between child mortality, stunting and being underweight in various parts of the world â&#x20AC;&#x201C; regions with higher rates of stunting and being underweight as the African countries or Southern Asia also have higher child mortality rates. Nutrition problems are often invisible, in the sense that they go unnoticed until undernourished children fall sick 48 (see chapter 3), and hence remain a low priority on national development agendas. Low-cost measures proven to be effective in the critical period of early childhood include promotion of breastfeeding for the first 6 months, assuring complementary feeding and micronutrient intake, vitamin A supplementation and universal salt iodization.

Figure 10 Overview of child mortality, stunting and underweight in comparison per region â&#x20AC;&#x201C; regions with higher rates of underweight and stunting tend to have higher rates of child mortality (Source: http://www.unicef.org/sowc2011/statistics.phpDownloaded Dec 8, 2011)

Families fall through gaps in public healthcare Families are poor, and medicines and healthcare are too expensive for the incomes of nearly every household. At least 70% of households do not benefit from full or partial medical insurance. (SOS family survey Senegal) There is a lack of access to services in rural areas, and a lack of coordination and cooperation of services for families, families receive services too late or they are lost in the system, and developmental delays of children are detected too late (SOS family survey Hungary)

Economic problems and poor living conditions increase the likelihood of health problems, including infectious diseases: Poor families have fewer resources to spend on balanced nutritious food, preventive measures or sufficient hygiene. Many governmental health services introduced user fees in the 1990s, but they are often still of poor quality or

47 48

WHO and UNICEF (2010: 11) UNICEF (2009: 11)

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inaccessible countries 50

, and public health insurance does not exist in many developing

Globally, 80% of health care spending is focused on the 18% of the world’s population who live in OECD countries 51. 64 WHO member states do not meet the target of 35 US$ minimum annual health spending per person, and in 30 developing countries the spending is below 20 US$ 52. Disparities exist also within countries: A UN survey in 38 of the poorest countries showed that health intervention coverage is much higher among mothers and children from wealthier households than among those from poor ones 53. Those families who can afford it rely on private care, but out-of-pocket expenditure on health care tends to fall during economic crises; and as families cut back, diseases can go undiagnosed or untreated. Families in poverty are often unable to afford costly medical support. Box D: Facts and figures around child mortality During 2010, 7.6 million children worldwide died before their fifth birthday – six out of 100 children born globally – of whom more than 40% were younger than one month 54. Nearly 21,000 children under five die every day, 82% in sub-Saharan Africa and South Asia 55, often in remote regions affected by conflict and disasters. There is progress, as this number has declined by a third since 1990 56. But this global average hides disparities: While most regions have seen reductions of at least 50 per cent, less progress has been made in Southern Asia, Oceania and especially subSaharan Africa, here one in eight children die before the age of five 57. This is nearly twice the average of developing regions overall, and around 18 times the average of developed regions. According to household data from 80 countries, children in rural areas are more at risk of dying than those born in urban areas, even in regions where child mortality is low 58. Children from the poorest households are two to three times more likely to die before the age of five than children from the richest households 59. The biggest rural-urban and wealthy-poor disparities are found in Latin America, the Caribbean and Eastern Asia, where overall child mortality is relatively low.

UNESCAP (2008: 17-18) Blas and Kurup (2011: 67) 51 WHO fact sheets http://www.who.int/mediacentre/factsheets/fs319/en/index.html 52 According to WHO estimates 53 WHO & UNICEF (2010: 31) 54 WHO and UNICEF (2010: 11) 55 UN Inter-agency Group (2011:5) 56 UNICEF (2009a: 4) 57 United Nations (2011b: 25) 58 Survey countries accounting for 73 per cent of total births in developing regions in 2008, in: United Nations (2011b: 25) 59 Analysis based on 66 developing countries, accounting for 71 per cent of total births in developing regions in 2008; in: United Nations (2011b: 26) 50

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Figure 12. Global and regional trends in child mortality under 5 (Source:

Kommentar [SI2]: Copy/paste problem: trend shows: Blue:/1970. Red/1990, Yellow/2000, green/2009

http://www.unicef.org/sowc2011/statistics.php; downloaded Dec 8, 2011)

Diarrhoea, malaria and pneumonia are responsible for more than half the deaths of children under five (see Chapter 3), and child mortality could be radically reduced if state authorities devoted as many resources to preventing and treating them as have previously been successful in reducing rates of malaria and tuberculosis. Immunisation campaigns, knowledge about and access to diagnosis and treatment need to reach even the poorest, most marginalised families and children in remote areas. The economic crisis undermines education spending Low-income families do not have the resources to provide for educational support of their children and for building children's capacities (SOS family survey Israel)

Education is a key investment in families as it contributes to social cohesion and economic growth as much as to the self-realisation of individuals. Education is important from birth on: Research has shown that consistent quality care in a stimulating learning environment during the early years is crucial for a child’s later development 60. As early as age two, children from poor families are more likely to have a reduced educational and cognitive performance 61. The crisis is, however, threatening education spending. Monitoring by the UNESCO Education for All Initiative (EFA) shows that seven out of eighteen low-income countries cut education spending in 2009 62. A recent United Nations report quotes examples of governments delaying access to free education or calling for re-introducing user fees to combat their funding crisis 63.

Woodhead, and Siraj‐Blatchford (2009:6) Grantham-McGregor et al. (2007) in: Woodhead, and Siraj‐Blatchford (2009:6) 62 UNESCO (2011a: 101) 63 United Nations (2011a: 79-80) 61

The SOS Children’s Villages Family Report 2012

Insufficient funding has a direct impact on vulnerable families’ access to education, as they are often the last to benefit from educational services. Even where basic education is free, the costs associated with schooling – such as books, school uniforms or bus fares – might present an obstacle. However, when government spending grows, poorer households’ access to education also improves 64. Challenges for public service provision There is a social crisis weakening our welfare state system which needs to be overcome, there are not enough services for children. A child has different opportunities related to the place where he/she is born, due to strong differences between the north and the south, there is a need to eliminate such discrimination (SOS family survey Italy)

Developing countries increasingly recognise social safety nets as vital for maintaining parental care-giving capacity, and many governments have implemented or expanded programmes with positive impact. However, whilst in developed countries social protection tends to be well established and easily scaled-up in moments of crisis, weakly institutionalised protection networks in developing countries are more easily destabilised or overwhelmed. The combination of the global economic slowdown with Structural Adjustment Policies is putting intense pressure on governments’ ability to provide adequate social safety nets 65. While the impact of the crisis on social provision is difficult to estimate, there is a fear that progress in reaching the UN Millennium Development Goals might have slowed 66. Research in 28 low-income countries shows that government spending on social protection declined from 2008 to 2010 from 1.9 to 1.6. % of GDP (in Sub-Saharan Africa, from 1 to 0.6 per cent) 67. External aid is also coming under pressure: Economic crises tend to cause OECD countries to cut their development aid budgets, and the World Bank anticipates that development aid may fall by nearly one quarter 68. Preliminary evidence suggests that social spending has suffered most in Eastern Europe and Central Asia, whereas in Latin America it has been more or less maintained 69. In sub-Saharan Africa, while public health spending rose between 2008 and 2010 from 1.6 to 1.86 % of GDP 70, there are projections that the crisis may result in a cumulative loss of about 30 billion US Dollars in public spending on education till 2013 71. When states are struggling to assume their social protection responsibility, there is greater likelihood of them handing over this responsibility to under-resourced NGOs or the private sector. Privatisation of public social and infrastructural services has in many cases made them unaffordable for poorer families through introducing user fees or higher tariffs 72.

World Bank (2004: 116) Trask (2011: 2) 66 United Nations (2011: 55) 67 Kyrili and Martin (2010), in: United Nations (2011: 8) 68 The World Bank (2010b), in: United Nations (2011: 23) 69 United Nations (2011: 78) 70 United Nations (2011: 81) 71 UNESCO (2010), in: United Nations (2011: 79) 72 United Nations (2009: 108-110) 65

The SOS Children’s Villages Family Report 2012

In developing countries, the number of poor households receiving employment-based social insurance is usually very small. As the Child Rights Situation Analysis of SOS Children’s Villages Benin says: ‘Only two per cent of the total population is covered by the National Office of Social Security because they service workers who earn a salary and the members of their families. The extension of these services to other individuals encounters many problems because most of active population works in the informal sector that is characterised by low wages and precariousness 73. One reason for problems of access and inequality related to social protection is the extensiveness of informal labour markets (see chapter 2). Another is that around half of the children under five years old in the developing world are not officially registered at birth 74 , meaning they can be excluded from benefits. Reasons for children going unregistered include their parents being unaware of this service, afraid of costs or unable to access it in remote rural areas. Children born in the poorest fifth of families or of ethnic minority backgrounds are less likely to be registered 75. More broadly, the latest review of MDG progress has shown that people living in poverty, in rural areas, or from an ethnic minority background are most vulnerable and hardest to reach through programmes and service provision 76. Problems of access however also concern countries in the developed world, with regional disparities in availability of services 77. Tackling family poverty through public services There is a need to improve the health and education systems. The state plays a key role, and while associations and civil society can provide support, they cannot replace the state. (SOS family survey Morocco)

Besides service provision in basic infrastructure, social support, health and education, poor families require support in areas such as transport, communication, recreational facilities, cultural and political participation, psycho-social or legal counselling, and parental skill-building. Some also require specialised services tackling particular needs, such as families with disabilities, migrants, ethnic minorities or others. In service provision for families in poverty, it is especially important to empower and mobilise them instead of viewing them as recipients of social aid. Service provision and social security packages are a key investment to help break the inter-generational poverty cycle. Especially in moments of economic and social crisis when those systems are most under strain, they are important ‘safety nets’ for povertystricken and vulnerable families.

Children Rights Situation Analysis Benin (2008:11) UNICEF (2010a: 44) UNICEF (2010a: 44) 76 United Nations (2011b: 5-6) 77 UNRISD (2010: 82) 74 75

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1.2. The Response: Supporting states and communities in service provision Our advocacy activities also contribute to change of duty bearers in the area of social protection, and we are constantly engaged to support them in provision of basic social services. (SOS family survey Bosnia and Herzegovina)

By signing the UNCRC, governments have committed themselves to provide rightsbased quality social protection and support systems and services. However, to do so, they need both knowledge and capacity. SOS Children’s Villages seeks to support communities and states in building these safety nets for families and becoming ‘childcompetent’ through: 

advocating to influence policy, legislation and service implementation, in partnership with other stakeholders and the community;



strengthening existing social service provision and family support systems, contributing to their quality and sustainability;



delivering direct services where immediately necessary and not otherwise available, often in cooperation with specialised partners.

On health, for example, SOS Children’s Villages programmes facilitate families’ access to services including preventive and curative health, sexual education, maternal and preor postnatal health, mental health, disability, counselling, psychological support, and work with public health services on quality service delivery. SOS medical centres and clinics provide services directly where needed, and many programmes include both preventive and curative health components ranging from workshops on hygiene or breast-feeding practices to delivering vaccines or vitamins. On education, SOS Children’s Villages programmes support families in accessing public schooling and educational services for their children, from early childhood development programs and informal activities through to formal schooling and vocational training. Programmes provide SOS crèches, kindergartens, primary and secondary schools or vocational training centres, but only where they are not available in the community. SOS programmes especially concentrate on the psycho-social and care dimensions of family support, seeking to create a stimulating environment for child development. This includes supporting alternative care systems such as family-based care in foster families or SOS families, or short-term placements in cases where children can return to their family. The organisation develops alliances for the protection and promotion of child rights, and communities and governments are supported to improve child care legislation, de-institutionalisation and quality care provision. The type of support and services families need is as diverse as their life-stories. Some might need basic short-term emergency aid in terms of food parcels, safe drinking water or temporary shelter. Others require access to long-term social support or child welfare schemes, legal advice, individual home-visits of social workers, specialised support services for coping with disability or integration in the community, or family-centred recreational facilities. Some require financial resources for starting a business, affording medical consultation or school fees, or buying school uniforms or books. The SOS Children’s Villages Family Report 2012

In some parts of the developing world especially, support can also be provided through engaging and strengthening community development committees, home-based care groups and community-run initiatives; these strategies are particularly important to support the sustainability of responses, in line with the belief that strong and caring communities are best placed to organise themselves and address their own problems. In other, especially urban areas and industrialised regions, SOS Children’s Villages works with partners who have been nominated to take responsibility for social protection and welfare, such as local municipalities, government departments and NGOs, institutions and international agencies. Case study 1: Supporting community-based Foster Care in South Africa ‘It is very encouraging to see such an enthusiastic group, taking ownership of the challenges in their own community and working hard to protect and care for orphaned and vulnerable children’ (QwaQwa trainer on family development).

QwaQwa, in the East of South Africa, is a densely populated and impoverished area highly affected by HIV/AIDS. Census and foster placement data show a high prevalence of vulnerable children who have lost, or are at risk of losing, the care of their families. In the village of Makeneng, the community showed a strong desire to respond but had limited resources. While basic health and educational services were available, there was only one under-resourced, government-run children’s home. In 2004, an SOS programme piloted in QwaQwa an in that time innovative communitybased form of foster care in which volunteer foster mothers would give local children a new family, allowing them to stay in their community of origin. Local authorities provided land for four community family homes, and strong partnerships were forged with the traditional leadership, the local municipal council, the Department of Social Development, the local clinic and local schools. All supported the four foster families, each caring for six children, to become a full part of the community. The programme assisted the foster mothers to organise themselves into a communitybased organisation (CBO) called Ipopeng Young Women’s Organisation, which shares offices at the SOS Community Social Centre. This CBO is supported through training, organisational development, allowances for volunteers and the provision of a homebased care kit including medical and hygiene articles. The programme assisted Ipopeng to become more independent by accessing government funding. The programme also supports the community family homes through day-to-day social work supervision and monitoring the quality of care provided. Programme evaluation showed a need to do even more to promote community rooting for the foster families, and that the organisational support structure suffered from high staff turnover in the QwaQwa Community Social Centre. With a huge demand for social workers in urban areas of South Africa, recruiting and retaining quality staff in remote rural areas is difficult. With support of the QwaQwa Community Social Centre, families develop their own personalised family development plan, where they set their own goals for family life and child development and discuss how they can reach them. The trainers for family

The SOS Children’s Villages Family Report 2012

development planning supporting them were excited about the families’ self-reliance efforts promoted by these tools. A great strength of the QwaQwa Community Social Centre is that the family-based care component, in the form of the community family homes, is incorporated with general measures of supporting other families in the community. Sharing of resources and infrastructure is cost-effective, ‘anchored’ within the community, and the tailored responses enable the children to grow within their community of origin. The challenging partnership with governments The recent economic crisis has increased the pressure on non-profit organizations by overstretching the capacities of government. For example, when the Greek government cut public expenditure by about a fifth 78, progressively deregulated the public welfare system and cut public workers’ salaries, the number of families supported by SOS programmes increased from 210 to 1,230 within a year 79 . More and more, SOS Children’s Villages in Greece receives inquiries, over 1,000 during 2011, from caregivers who want their children to be admitted to an SOS family, simply because they cannot afford to care for them. This problem is especially big in Athens, where traditional family and neighborhood ties are weaker than in the countryside. Meanwhile, Greece became the first country in the world to introduce taxes on donations to aid organisations, exacerbating the decline in contributions from the general population due to the economic crisis. This is putting additional pressure on non-profits’ work in the country. Any non-profit organisation faces a number of challenges when supporting states in service provision for families and providing their own services. In general, there are limits to what services non-profits can offer, so it is important to constantly stress the state’s responsibility for providing infrastructure and basic services to families. Bad quality of public service provision can undermine a programme’s objectives and efforts. For example, a programme evaluation in Peru found that SOS-supported families continued suffering from absence of basic services and polluted water 80, so claims were made to public authorities to improve infrastructure and service provision. Non-profit programmes have to manage a dual role of being a partner to governments in service provision and capacity-building, while at the same time exerting independent advocacy pressure for improving public support. One way of exercising this advocacy role is the creation of advocacy networks amongst non-profits, community-based organisations and other local stakeholders which then jointly establish regular interaction with their local and national governmental partners.

Malaga presentation https://intranet.soskd.org/Aboutus/Organisation/GeneralSecretariat/EUNA/SOSDocuments/Greece%20in%20CrisisLV.ppt (exact reference: EUNA) 79 interview with George Protopapas, director of SOS Children's Villages in Greece, http://www.soschildrensvillages.org/news-and-stories/news/pages/they-are-taking-the-air-we-breathe.aspx 80 Impact evaluation Peru p.10

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Case Study 2: Supporting De-Institutionalisation of child care and preventing family break-down in Central and Eastern Europe ‘This is a strongly-rooted culture that has been created gradually throughout the years. Generations were raised this way, and so it was passed on… They truly believe that it is better to live in an institution, and many years this faith was encouraged.’ (Representative of a central 81 institution, Bulgaria) .

As early as the 1960s and 1970s, the USA and Europe began to move from large-scale residential educational and care facilities for children towards small group homes and family-based forms of care such as foster families. After the fall of the communist regimes in Central and Eastern Europe and the former Soviet Union, the extent of poor living conditions and cases of violence in these countries’ child care institutions became visible. Over the past 20 years the region has also embarked on de-institutionalisation; it was among the criteria for admission to the European Union for Bulgaria and Romania. However, due to a lack of consistent research and data gathering, it is difficult to obtain a clear overview on the situation. In 2010, around 5698 children in Bulgaria 82, 8400 in Czech Republic 83 and 32951 in Poland 84 still lived in residential institutions, and many more children in foster and kinship care arrangements, which are often little supported, remunerated and regulated. In Bosnia Herzegovina 85, data indicates that the number of children placed in residential care has actually increased over the past few years. A considerable number of children in care in the region still have living parents and are placed in care for reasons of poverty, ethnicity or labour migration. These reasons account for the majority of children in institutions in some countries, and have been exacerbated by the recent economic crisis. For example, almost all institutional child placement in Bulgaria is poverty-related; according to the State Agency for Child Protection, in 2010, 46.7 % of the children placed in specialized institutions were there due to parental unemployment, and another 38.8% came from large families or families with low care capacity 86 . Children with disabilities or of Roma origin are also overproportionally represented in institutions in the former communist systems; indeed, even babies under the age of three are found in various specialised institutions. The whole social service system requires improvement to assure that families at risk are identified and supported to prevent the need for alternative care. In particular singleheaded households, teenage mothers and families with disabled children lack support. Re-integration of children from the care system into their families of origin is often poorly prepared and managed, leading to these children suffering from social stigma, lack of life skills and psycho-social problems. Legally, in many countries, children in care lose support after the age of 18. Child protection continues to be a concern as few mechanisms for complaint and response exist. 81

Bulgaria CRSA p.15 Annual report of the Bulgaria State Agency for Child Protection (2010) (www.sacp.government.bg) 83 Ministry of Labour and Social Affairs (http://www.mpsv.cz), Institute for Information on Education (http://www.uiv.cz), Institute of Health Information and Statistics of the Czech Republic (http://www.uzis.cz) 84 Ministry of Labour and Social Policy (http://www.mpips.gov.pl ) 85 (Country briefing): https://intranet.soskd.org/areasofwork/PD/Content/Programmeinterventions/Improvepolicy/EUCB/SOSDocuments/1109_CB_Bi H_.pdf p.3 (official source to check) 86 Annual report of the Bulgaria State Agency for Child Protection (2010) (www.sacp.government.bg) 82

The SOS Children’s Villages Family Report 2012

While social services largely remain centrally financed and governed, their implementation is increasingly devolved to local authority structures which lack knowledge, financial and human resources. Both legislative frameworks and bureaucracies are often fragemented, meaning accountability and coordination remains weak. As processes in many countries are taking place under pressure and deadlines from donor agencies and international partners, planning is often poor; this leads to excessively quick family re-integration, shortcomings in the selection, training and monitoring of foster families and a focus on statistics instead of child protection. More generally, a change of mind-set is still needed among officials and the wider population. In response to this situation, SOS Children’s Villages national associations in the region work in close partnership with local and national governments on capacity-building and training of social workers to support families in at-risk situations – for example, through provision of day care and enhancing parental care-giving skills and psycho-social care, and addressing stress factors such as poverty, illness, divorce, conflict or violence. In a region-wide ‘leaving care’ campaign, SOS Children’ Villages is supporting young people leaving alternative child care to integrate into society and raises awareness for their situation and needs. SOS programmes also support foster family networks through training and monitoring. On a policy level, SOS Children’s Villages national associations participate in networks and working groups which are initiated by governments, and organise awareness-raising activities for the population and decision-makers. SOS Children’s Villages is among the organisations which supported the development of the United Nations Guidelines on the alternative care of children, now a key resource in supporting governments in their deinstitutionalisation efforts. ‘Quality4Children’ standards for alternative care were developed by SOS Children’s Villages in cooperation with partners and based on the experience of children and care providers in the region. Learn from families what they really need While states provide generalised services, non-profit organisations can develop targeted services depending on a community’s situation and its families’ needs. This requires not only partnership with both private and public specialists to assure services are complementary, but also ongoing consultation with community members to learn what families really need. For example, when a programme in Zimbabwe supported HIV/AIDS-affected families to renovate their houses, the community made them aware that they had overlooked the housing situation of families living in rented accommodation, who often faced eviction; their needs were consequently addressed by establishing community social support mechanisms. 87 Careful analysis is required to see if service provision is really accessible, as access can be hampered by factors such as bus fares to the hospital are being higher than the hospital fee 88 , or schools being several hours away on foot 89 . Families’ access to services is further often limited by their lack of information about the services provided and their legal rights. Programmes need therefore to disseminate information, using 87

Impact evaluation Zimbabwe p. 22-24 Impact evaluation Zimbabwe p. 20-22 89 Zambia, Uganda, Mozambique, p.23-26 88

The SOS Children’s Villages Family Report 2012

channels which reach the most excluded in an accessible language, for example community volunteers, schools, counselling centres, clinics and kindergartens. A programme evaluation in Latvia found that on average 30% of clients had joined at the suggestion of social workers at school, kindergarten or doctors; the rate was much higher, over 90%, among high-risk families, which often require personal encouragement to admit the need for outside help 90. Increasing families’ autonomy and strengthening their citizenship capacity often includes legal education and counselling, to provide information and address fears and stress about issues such as social entitlements, insurances and protection schemes, registration and documentation, property or inheritance. One effective way of bringing this information to at-risk families is home visits of social workers or community-based volunteers. A careful approach to material and financial assistance Where service provision includes food aid or material assistance, this might raise issues of fair distribution and family conflict and need well-defined criteria and the accompaniment of community representatives or social workers 91. Food aid is organised best by the community itself. In general, “family finances are a sensitive issue, where they are ashamed to talk about and interference is easily perceived as threatening their independence” 92. There is also a danger of creating dependency if such assistance continues in the long run or is not adequately incorporated with other measures encouraging autonomy, so it is important to clarify the temporary nature of this support 93 and embed material aid in measures to promote families’ self-governance. Material aid often raises the further question of who defines the needs of families, so their active participation is useful for increasing sustainability of impact. For example, a programme in Romania used ‘social tickets’ which had a material value which families could use instead of money for their purchases. It proved a customised possibility to support families in determining their own material needs, accompanying them in decision-making and developing their budget and household management abilities 94. Case Study 3: An integral approach to service provision in Lilongwe, Malawi ‘The reduction in water borne diseases is not just by accident .We are taking the lessons we learnt seriously and implement them at home. That is why the diseases have reduced’ (village 95 development committee member)

In Malawi, 50% of households living below the poverty line and 48% of children under the age of five years are nutritionally stunted 96. Causes of the severe food crisis include irregular rainfall, inflated prices and high HIV prevalence. Many children orphaned by 90

Impact evaluation Latvia 15 Impact evaluation Malawi p. 14-16; Impact evaluation South Africa p. 41- 42, Impact evaluation Rumenia p.27-30 92 Latvia 32 93 Impact evaluation Nepal p. 14-17, imact evaluation Ukraine p.10,11 94 Impact evaluation Rumenia p.27-30 95 Impact evaluation Malawi p. 39-44 96 Malawi Demography and Health Survey 2004, p. xxiii. See http://www.measuredhs.com/pubs/pdf/FR175/FR-175-MW04.pdf - check most recent data 91

The SOS Children’s Villages Family Report 2012

AIDS are raised by grandparents or other family members, exerting social and economic pressure on the most vulnerable children and their families. In 2002, SOS launched a family strengthening programme in the Tsabango area in Malawiâ&#x20AC;&#x2122;s capital Lilongwe, covering 12 rural and peri-urban villages with 806 households, caring for 1718 mainly orphaned and vulnerable children. The programme aims to complement existing state and community support and works in close cooperation with the Ministries of Health, Agriculture, Education, Women and Child Welfare, as well as local authorities, village development committees, local clinics and other community based organizations and service providers. It identifies households in collaboration with community committees. Responding to the food crisis, the programme collaborated with the Ministry of Agriculture to support 370 households with farm inputs such as seed, fertilizer and chickens. As 21% of households are landless, the programme also provided land for community gardens to grow maize, managed by the village development committees. Sustainability is addressed by providing training and continued support over a number of years. As a complementary short-term measure, monthly supplementary food packs for children were distributed, reaching its peak in 2004 with around 1,600 children per month. Distribution is frequently re-visited and adjusted, though a number of families especially affected by sickness rely on food aid in the long term. Support for income diversification into non-farm economic activities is also provided. The programme also addresses access to essential services and facilities, including safe drinking water. 22.4% of the households rely on boreholes; the programme built new boreholes and provided training in borehole maintenance and water management. The communities have set up 12 water committees which developed fundraising programmes for maintaining the boreholes themselves. Incidence of water-borne diseases in the three areas has reduced. Another health component of the programme focuses on the costs of medications and the lack of transport to get to public health clinics which are up to 10 or 15 km away from the villages. The programme complements the governmentâ&#x20AC;&#x2122;s efforts by operating mobile health clinics, training home-based care volunteers and providing free medicines to the vulnerable in co-operation with community-based organisations such as Paradiso. In addition, the programme raises awareness on HIV/AIDS, the need to visit health clinics when sick, proper waste disposal and adequate feeding practices. Medical personnel have noted that there is a need for more surveillance and follow-up visits, as capacities are easily overstretched. Next to the food security, water and health and programmes, 1177 primary school pupils are provided with writing materials, school uniforms and food packs. In a 2008 programme evaluation, 92.5% of respondents were satisfied or very satisfied with the programme. Involving the local communities at all levels of the programme, including the planning process, has ensured that the programme is tailored to the specific needs of the families and that it is fully accepted by the communities. However, it also showed a need for persistent support.

The SOS Childrenâ&#x20AC;&#x2122;s Villages Family Report 2012

1.3 Key learnings and recommendations Any social and economic progress is impossible without the access to basic social services: education, health, sanitation, clean drinking water, and family planning (SOS family survey Mali)

With political will, poverty can be tackled; the UN observe that “transformative social policies, (…) which were holistic, inclusive and universalistic, can provide lessons to developing countries struggling to overcome poverty. Many of the major social transformations were achieved despite low average income levels.” 97

•

Families’ social and economic security has to be guaranteed through for example appropriate social insurance, pension and social assistance schemes which should be a priority for all states, with a particular attention to also reaching those families falling through the systems due to parental unemployment, lack of documents or ethnic belonging.

•

State signatories to the UNCRC should take their obligations in supporting parents and care providers seriously, and pay heed to a progressive implementation of the UN Guidelines for the Alternative Care of Children.

•

Communities should be supported in the creation of local advocacy networks, in building social safety nets for families and in finding tailor-made local solutions in supporting families and children in their communities of origin.

•

Priority has to be given to improve the provision of well-functioning public infrastructure and services related to quality drinking and cooking water, adequate sewage systems and latrines, which severely impact on child development and family health, with a particular attention to the situation in poor overcrowded urban and remote rural areas

•

Public spending on education and health care should be improved, and efforts put in developing accessible and free quality health and education services for families, servicing also families most at risk, and those having specialised support needs.

•

For combating malnutrition and child mortality, effort should be put into promotion of breastfeeding for the first six months, assuring complementary feeding and micronutrient or vitamin supplementation. Food and material aid measures should be developed in consultation with local communities and families.

•

Service provision shall be developed in consultation with the families concerned, assuring that information reaches also the most excluded through appropriate and accessible channels, and that barriers to access are addressed and removed.

•

Service provision has to be implemented with a view to strengthening citizenship capacity and increasing families’ autonomy.

United Nations (2009: 10-11)

The SOS Children’s Villages Family Report 2012

2. Hard choices: Labour migration, unemployed or working poor 2.1. The Challenge: The emotional costs of labour migration With the economic crisis the number of unemployed and working poor has increased, and many parents are turning to labour migration to provide financial benefits for their families. However, labour migration also comes with emotional costs, as separating family members can have a devastating impact on family life and child development. It is often hard for families to migrate together, especially in cases of undocumented migration. Creating more jobs in migrants’ places of origin would be the one important measure to protect family life. Low incomes generate a lot of stress on fathers and mothers. (…) Employment opportunities are limited, there is no unemployment insurance. Hiring schemes do not offer parents or caregivers benefits such as social security, childcare or housing loans (…) income is limited, families are forced to migrate. (SOS family survey Mexico) Having or having not a job is an indicator for stability or instability of families (SOS family survey Austria)

Employment is vital for securing a family’s survival. The number of unemployed globally rose by 27 million, to 205 million, from 2007 to 2009 98. The crisis hit all parts of the world: Around half of this increase took place in developed economies, which account for only 15 per cent of the world’s labour force. East Asia recorded 6 million unemployed, Central and South-Eastern Europe 18.5 million 99 . The number of people in long-term unemployment increased in all countries 100. Widespread unemployment has catastrophic consequences for the dignity and self-esteem of both men and women and for family solidarity. An increasing number of women are working outside the home. Most married women are unemployed or in the informal sector (SOS family survey Uganda)

Even those who are employed do not necessarily earn a decent income. According to the International Labour Organization, one in five workers and their families worldwide were living as ‘working poor’ in extreme poverty during 2009, the economic crisis increased this number by 40 million 101, who are more likely to be found in agricultural and informal employment. In 2009, half of the world’s workers, nearly 1.53 billion people, were in a form of vulnerable employment 102. The UN state that unless employment and social protection goals are put at the centre of economic and social policies, “working poverty is likely to increase in most developing countries” 103 with “adverse impacts… for 98

International Labour Organization (2011), in: United Nations (2011a: 27) United Nations (2011a: 28-29) United Nations (2011a: 30) 101 United Nations (2011b: 10) 102 United Nations (2011a: 32) 103 United Nations (2011a: 46) 99

100

The SOS Children’s Villages Family Report 2012

example, on levels unemployment.” 104

malnutrition,

school

dropout

rates

and

long-term

Globalised markets, which promised to increase flexibility and bring new opportunities, have instead increased labour market inequalities and worsened working conditions in many countries. More and more employment is informal, temporary and precarious 105, with a lack of adequate social protection, no benefits or job security, low wages, and difficult or even hazardous working conditions. Parents often do not have any other choice but to accept these difficult working conditions. The informal labour sector is wide-spread in parts of Africa and Asia, but also found in many Latin American and other middle-income countries (e.g. around half of the working population in Brazil, around 90% in India) 106 . In developing countries, the informal economy employs overall up to 60 per cent of the workforce and produces close to 40 per cent of GDP 107. Women face particular challenges in the labour market. Female labour force participation varies between 26 percent in the Middle East and North Africa, 35 percent in South Asia, 64 percent in East Asia and 61 percent in Sub-Saharan Africa 108 . Women’s unemployment rates exceed those of men, and they benefit less from growth in employment; 60% of women’s paid work globally is limited to the agricultural sector 109. Also, self-employed women generate lower income than men 110.

Figure 15. Trends of Female unemployment rates per region. Indication in percentage.The division in regions follows United Nations (Ed.) (2011a): The Global Social Crisis. Report on the World Social Situation 2011. New York: United Nations, Seite xiii, f(Source: Global Employment Trends 2011 – The challenge of a jobs recovery, Geneva

Kommentar [SI3]: Same procedure as before. Blue: 2007. Red: 2008. Yellow 2009. Green: 2010. Figure 15 and 16 to be merged and simplified

104

United Nations (2011a: 9) UNRISD (2010:10) UNRISD (2010: 40-44) 107 United Nations (2011a: 31) 108 The World Bank (2011: 199 ) 109 United Nations (2011b: 21-22) 110 The World Bank (2011: 201) 105 106

The SOS Children’s Villages Family Report 2012

Figure 16. Trends of male unemployment rates per region. Indication in percentage. The division in regions follows United Nations (Ed.) (2011a): The Global Social Crisis. Report on the World Social Situation 2011. New York: United Nations, Seite xiii, f (Source: Global Employment Trends 2011 – The challenge of a jobs recovery, Geneva

Unemployment spurs labour migration Able-bodied workers leave their villages, leaving behind their wives and children to face all kinds of problems, notably illness, poor hygiene and poverty in general. (SOS family survey Niger)

It is against this devastating background that the trend towards labour migration has to be viewed. Lack of decent working opportunities close to home and the desire for a better future for their families often force parents to migrate. However, in high-income countries, migrants are mainly found in work which is low-paid, temporary, precarious and sometimes exploitative, beyond the reach of labour regulations – ironically, reminiscent of the forms of living they wanted to escape 111. Successful labour migration is often viewed as a solution to improving families’ economic well-being, as the income of labour migrants substantially contributes to household welfare, nutrition, food, health and living conditions in their places of origin 112. However, these financial benefits for families must be weighed against the huge emotional and psychological toll - as a UNDP report notes: ‘separation is typically a painful decision incurring high emotional costs for both the mover and those left behind’ 113. Graphic to be inserted: labour migration per continent and world wide Labour migration’s effects on family life Parents have no job or incomes (because of unemployment) and migrate abroad, children stays with one caregiver, alone or with grandparents or in care institutions. Trauma and behavioural disorders start, families break up because of labour migration (SOS family survey Lithuania) Problems include that mothers are going for foreign employment, contributing to a gap in childparent relations (SOS family survey Sri Lanka)

111

UNRISD (2010: 36) UNRISD (2010: 36); UNDP (2009: 72) 113 UNDP (2009: 71-72) 112

The SOS Children’s Villages Family Report 2012

Even with one or both of their parents absent, families often decide that it makes more sense for children to remain in their places of origin with other family members. Various research shows how this can fundamentally disturb family life: 

Research in Europe found that, despite accruing material benefits when their parents’ migration goes well, children separated from their parents through migration experience double the rate of emotional distress 114.



A Save the Children study shows that almost half of Sri Lankan mothers working in the Middle East have left behind children under the age of six in Sri Lanka, in the most critical development period of their lives. Often, young girls are pulled out of school to become heads of household and care for the family 115.



Children are sometimes forced to live extended periods of time without at least one of their parents: A UNICEF 2007 study found that as many as 126,000 Romanian children were estimated to have been left behind by both parents, 16% of them for at least one year and 3% for more than four years 116.



Children of migrating parents are at great risk of experiencing violations of their rights: In Vietnam, where an estimated 500,000 parents work abroad and 3-4 million migrate internally, the SOS Child Rights Situation Analysis links migration to a higher risk of children being abandoned to live as street children or trafficked to work in sweat shops and in the sex trade 117.

As women are increasingly migrating to be their family’s main income earner, rather than as an accompanying spouse 118, the care responsibility is often passed on to remaining female relatives or low-income domestic care workers 119 . Ironically, many female migrants leave their own children behind to look after other women’s children – ‘an international network system of care-giving stratified by class and, often, ethnicity’ 120. The effects of this form of ‘transnational mothering’ 121 on a whole generation of children living apart from and only irregularly seeing their mothers, require more in-depth study. The loss of family life also impacts the migrating family members. Migrants report feeling less social support than the locally-born population as their social networks, such as the extended family, are fragile 122. BOX E: Who migrates? Rural-urban and south-south migration In the search for opportunities parents often migrate from rural areas to cities or to other countries while grandparents or others take care of their children. (SOS family survey Peru)

114

Swärd and Bruun (2007: 12) Save the Children, in: CRSA Sri Lanka: 13 116 UNICEF (2008), in: CRSA Romania: 14 117 CRSA Vietnam: 1 118 WIDE (2010: 14) 119 WIDE (2010: 40-41) 120 WIDE (2010: 40-41) 121 Trask (2011: 6) 122 Development Research Centre on Migration (2009: 24) 115

The SOS Children’s Villages Family Report 2012

Though often overlooked in international policy debates, labour migration within and between low-income countries is significantly more widespread than migration from lower-income countries to higher-income countries: Approximately 740 million people are internal migrants, almost four times as many as those who have moved internationally 123. 130 million internal migrant workers are found in China alone 124. A major cause of internal migration is the rapid urbanisation being experienced in all corners of the developing world. Workers are pulled in from the countryside, seasonally or permanently, as earnings from informal urban employment are on average still higher than those from agriculture 125. Among people who have moved across national borders, just over a third moved from a developing to a developed country – fewer than 70 million people. Most of the world’s 200 million international migrants moved from one developing country to another or between developed countries 126. Approximately half (48 percent) of all international migrants are women 127 , a proportion largely unchanged over the last half century. Recent pressures by the economic crisis and cut-backs in social programmes 128 however give rise to female migration. While labour migration is often seen as primarily an Asian and African issue, it presents an increasing challenge to family life also in Latin America and Central and Eastern Europe. Why few people migrate with their families One potential way to lessen the negative impact of migration on families is to make it easier for migrants’ families to follow them. Article 10 of the UNCRC states that a child whose parents reside in different states has the right to maintain on a regular basis direct contacts with both parents, and that their applications to enter or leave a country for the purpose of family reunification shall be dealt with in a positive, humane and quick manner. Migrants who wish for their families to join them, however, face formidable legal difficulties. The UNDP found that about two-thirds of developed countries allow family members of temporary workers to join them and work, in comparison to about half of developing countries. 129 In most countries temporary migrants are not allowed to access state assistance schemes which are available to families of national citizens and permanent migrants 130 When the migrant’s country of origin offers social protection schemes, these are often not transferable across borders 131. Partly for this reason, migrant families in high-income countries are likely to be poorer than locally-born families 132.

123

UNDP (2009: 1-2) United Nations (2011a: 29) UNRISD (2010: 34) 126 UNDP (2009: 1-2) 127 UNDP (2009: 25-26) 128 WIDE (2010: 19) 129 UNDP (2009: 36-37) 130 UNDP (2009: 53) 131 Development Research Centre on Migration (2009: 3) 132 UNDP (2009: 53) 124 125

The SOS Children’s Villages Family Report 2012

Even migrants who have been granted nationality of their new country often still find that difficulties with social inclusion affect prospects for their families, notably in terms of unemployment, insecurity of income, denial of rights at work, discrimination and lack of social mobility. 133 Undocumented migration breaks family ties Migrants who cross borders in search of employment without having the required documents are especially likely to find it difficult to maintain family ties. As they themselves lack legal rights to be in a country, they are unable legally to have their families join them – and as they would need to re-enter the country illegally to resume employment, they find it difficult to leave in order to visit their families. An estimated 50 million people today are in this situation 134, which is often exacerbated by the punitive fees charged by black-market middle men to facilitate undocumented migration 135. When undocumented migrants start a family in the country to which they have migrated, they face the problem of accessing services. Children of undocumented migrants are not admitted to school in a third of developed countries and over half of developing countries. Even if they have the legal right to send their children to school, undocumented migrants are often deterred by fears that their status will be reported to authorities 136 . Most research in Europe found that the educational achievements of ‘second generation’ children of immigrant parents is below that of native children with comparable family background, and that they are more often unemployed 137.

2.2. The Response: Improving families’ income prospects Strategies should be created letting families integrate in the labour market according to their abilities and with a salary that allows them to meet their basic needs. We motivate through trainings for job placement, we offer support and follow up to the unemployed so that they can seize opportunities. (SOS Family Survey Dominican Republic)

No family should be forced to choose between unemployment and separation. One way of avoiding that families face this decision is to support job creation and job availability in countries. The increasing need of many families for basic economic and job-related support has lead SOS programmes to form partnerships with various specialists in the field to address this issue. SOS Children’s Villages wants to prevent family-break up through job-related migration, and builds the capacity of families and communities to have a decent standard of living through economic self-reliance. The programmes are intended to help family heads to learn ‘how to fish’ 138 so they are able to take care of themselves and their families in the future. Intervention strategies SOS programmes use in this regard include: 133

Stalker, 2000; International Organization for Migration 2008; Taran and others (2009); in: UN (2009: 78) UNDP (2009: 2) Development Research Centre on Migration (2009: 18) 136 UNDP (2009: 58) 137 United Nations (2009: 78-79) 138 Impact evaluation Malawi p. 56-61 134 135

The SOS Children’s Villages Family Report 2012

  

Vocational, practical and social skills training in workshops and training centres Promoting and supporting income generating activities (IGAs) and the setting up of small family businesses, including the provision of small interest-free loans, microcredits, technical and business training and follow-up Legal and practical counselling, accompaniment and skills training towards finding and maintaining local employment

To this end, SOS Children’s Villages national associations and programmes establish partnerships with local and national ministries, city councils, local and national business companies, community-based organisations and initiatives, training and educational institutes, employment services and job placement agencies, trusts and banks, microcredit institutions, business and vocational specialists and others. From unemployment to a decent and life-fulfilling job Many unemployed caregivers are not aware of their rights. For example, a programme evaluation in Belarus found 50% of low-income single mothers did not know that they needed to register with the employment center to receive child welfare payments 139. At the same time, the evaluation found that many mothers were difficult to motivate towards self-reliance because the country’s legislation would ‘punish’ the acquisition of income immediately with a decrease of state financial aid 140 . The situation of unemployed caregivers thus needs to be carefully looked at to find appropriate support strategies. Employment training and support is best built on existing capacities, skills and interests of parents and caregivers. An itinerant might be helped to get additional training and find a fixed position, a market vendor could upgrade his business skills and receive help running a formal shop, or a former domestic servant could get qualified as community carer. When looking at people’s individual skills, it is also important to respond to needs of local and national markets and to support and initiate new business areas to diversify and strengthen markets. In developing countries, this could include such areas as traditional crafts and trades (e.g. tailoring, beadwork, bag-making, brick-making, carpentry, welding, etc.), or service-sector professions (hairdressing, designer, computer engineering, nursing, etc.) Basic literacy and numeric skills are also covered in training. The professional side of training should be accompanied by social skill-building to enhance employability, cope with challenges of the labour market and inspire entrepreneurship. Such skills include critical thinking, active problem-solving, autonomy, realistic self-assessment and self-esteem. This is especially important for people who have been out of formal employment for a long time or constantly struggle with issues of basic survival. Once people have received training, SOS programmes use partnerships to follow up and support their transition to the labour market. Social workers and trained community volunteers can help in giving advice, writing applications, preparing documents and preparing for interviews, and mediating relations with potential employers.

139 140

Impact Evaluation Belarus, p.27 Impact Evaluation Belarus, p. 16,17

The SOS Children’s Villages Family Report 2012

An evaluation of programmes in six Latin American countries 141 indicates that this is a long-term project: after six months of participating in a programme, women had an employment rate of 60%, which progressively increased to nearly 90% after five years. It seems that women who adhere to the program for a longer time succeed in getting work 142 ; the number of families with higher income also increases with programme duration, as seen in studies in Brazil, Colombia and Chile 143. Earning an income is not just a matter of improving the economic situation of families; programme evaluations have shown that a job and income empowers parents and raises their self-confidence 144. They feel they contribute to society, form part of social networks, and gain self-esteem about their skills and achievements. Such increased independence and empowerment might also bring new challenges for a family. The evaluation of programmes in six Latin American countries 145 revealed a higher frequency of domestic conflicts among families with longer programme participation, as the empowerment of women was resisted by their partner or family. Educating and empowering women to find a job requires addressing such potential points of conflict. Case Study 4: Empowering women to prevent labour migration in Columbia ‘After having felt that life was too challenging, the people participating in the workshops feel that they are valuable. They are encouraged to go on. I started to see that I can work not only for me but for other women in a similar situation.’ (Testimony of a participant in the Cazucá Social Centre)

SOS Children’s Villages runs three social programmes in Colombia in vulnerable areas of Soacha (‘Cazucá’), Santa Fe and La Candelaria (‘Nueva Vida’).. These areas are all characterized by insufficient availability of basic health and education services and problems of malnutrition and a lack of sanitation infrastructure or services such as garbage collection. School drop-out rates and unemployment rates are very high, and most people subsist on informal jobs. Around 70% of the population are below the medium income line 146. The densely populated and socially diverse environment triggers frequent violence, including sexual violence. The surroundings of Soacha also have a high concentration of people who have been internally displaced by violence between the government and paramilitary groups. The family strengthening and community development efforts of these programmes are based on four main components: The protection and integral development of children and the development and empowerment of women, family and community. Self-organised day care – provided in community houses by trained and remunerated community mothers, supported by the Social Centres – give children quality care and a 141

Brasil, Bolivia Chile, Columbia, Peru; Venezuela SOS Children’ Villages Continental Office Latin America (2007: 4) 143 SOS Children’ Villages Continental Office Latin America (2007: 7, 8) 144 Impact Evaluation Albania p 17 145 SOS Children’ Villages Continental Office Latin America (2007), El Impacto de los Programas de Fortalecimiento Familiar en Sudamérica, Brasil, Bolivia Chile, Columbia, Peru; Venezuela, , p 5-6 146 socio-economical layers 2 and 3 out of 6 according to the National Statistics Department, in: Colombia Impact and Evaluation Report 2007 Page 14 142

The SOS Children’s Villages Family Report 2012

safe space while parents attend training or work. Also, through programme components improving the general life quality of families, mothers are able to concentrate on getting education and a job. For example, about 70% of the families gained access to the Social Security System and 90% of the parents consider that the nutritional state of their children has improved 147. Literacy and job seeking workshops develop the professional skills of mothers and micro-credit enables them to start small business such as shops. Some mothers started or continued academic education; others are trained in a trade. The programme has improved the participation of women in the labour market, as well as entrepreneurship on the part of families and communities. After two years of programme participation, the rate of women in paid employment in Nueva Vida had increased from 67% to 82% 148. Women are engaged predominately as shop-sellers, micro-entrepreneurs and community carers. Through personal development workshops and training sessions, physical violence against women has been reduced and families deal more constructively with their conflicts; the use of dialogue to resolve family conflicts has increased from 25% to 65% after two years 149. The programme increased representation of women in school boards, in community life associations and in the church 150, improving their leadership skills by engaging them in local development processes, .By increasing womenâ&#x20AC;&#x2122;s opportunities in local labour markets, the programme reduces their incentive to take part in labour migration. Such results in terms of employability, empowerment, community participation and employment opportunities contribute to the well being and stability of vulnerable families. Income generation and self-employment: a complex matter Programmes which aim at creating self-employment through small businesses and IGAs require the people to be trained by specialists in business and technical skills. Families also need tools and infrastructure for their businesses, e.g. for cultivation of crops or production of crafts. Programme evaluations reveal that entrepreneurship is not for everyone: some people lack commitment or see loans as a kind of assistance and do not take their business and financial responsibilities seriously enough 151. Comprehensive follow-up support and monitoring is needed to guarantee long-term accomplishment, for example to ensure markets are being accessed, money is not being wasted on alcohol consumption, or the stigma for having an HIV-positive family member is not negatively impacting on business success. 152 The success of any small business venture depends on the development of local and national markets, the technical suitability of a business to the local situation and proper risk assessment. It is important to enhance and complement existing strategies of a local community and address local realities. For example, the promotion of agriculture for food security will have a greater impact among farming communities in rural villages with land 147

Colombia Impact and Evaluation Report 2007 Page 5 - 6 Colombia Impact and Evaluation Report 2007 Page 58 Colombia Impact and Evaluation Report 2007 Page 57 150 Colombia Impact and Evaluation Report 2007 Page 60 151 Impact evaluation Zambia p. 42-43 152 South Africa, p.44-45 148 149

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resources and a tradition of agriculture, but limited impact among land-constrained urban communities 153. However, IGAs in rural areas should not be limited to farming activities, as families’ vulnerability can be reduced by diversifying income sources – for example, many rural families rely on supplementing agricultural income with casual labour, remittances of migrant family members, or the selling of bread, beer, charcoal, fish or firewood 154. Often, a country’s macro-economic or socio-political situation hinders efforts towards community self-reliance. A poor harvest season, floods or droughts, earthquakes, political upheavals or armed conflict can suddenly eliminate a programme’s gains. This happened for example in Zimbabwe, as a programme in which grandparent- and sibling headed households had started successfully to run businesses was severely affected by a governments clampdown on informal trade 155. Case study 5: Strengthening skills and labour market integration of families in Sri Lanka Now I feel stronger and I devote my time to the welfare of my family. When my children attend extra classes at the SOS centre in the afternoon, I am fully assured that they are 100% safe. I am selling ready made dresses and the profits are deposited as savings for my daughter. I am now reconstructing our house to make it habitable.’ (single mother, programme participant Sri 156 Lanka )

Since the end of Sri Lanka’s three decade-old civil war, the government has committed its support to reconstruction, poverty reduction and the development of small enterprises 157 . Nevertheless, 14% of the Sri Lankan population still live below the poverty line 158, and the declining official unemployment rate of 4.9% in 2010 159 obscures the fact that 66% of people work informally, often under precarious conditions and without permanent income 160. Many rural people leave for the city or migrate abroad in search of work. Estimates suggest that 20 percent of all jobs held by Sri Lankans are abroad and more than 600 workers leave Sri Lanka every day for the Middle East, East Asia or Europe, typically as construction workers or domestic labourers 161. Programmes in Pilyandala and Monaragala have supported around 267 families that are at risk of being separated or unable to provide for their children since 2003. Single mothers are especially vulnerable. More than two thirds of the supported families do not have enough money to meet their daily needs; 37% are unemployed and dependent on others, while another third are self-employed; many are day labourers working in precarious conditions 162.

153 154

155 156

Impact evaluation Malawi 14-16 Impact evaluation Malawi 56-61

Impact evaluation Zimbabwe p. 24-25

FSP Programme and Impact Evaluation Sri Lanka (2008: 35) 157 CIA World Factbook (2011) https://www.cia.gov/library/publications/the-world-factbook/geos/ce.html 158 United Nations Development Programme (2011: 143) 159 Central Bank of Sri Lanka, et al. (2011: 1) 160 International Labour Organization (2008: iii) 161 Shaw (2010: 2) 162 FSP Programme and Impact Evaluation Sri Lanka (2008: 26)

The SOS Children’s Villages Family Report 2012

The programme offers temporary economic support to reduce the need for caregivers to leave their children in search of work in the cities and abroad. Free nutrition, health and education services are provided including lunches, stationery, bags and shoes for school children, extra classes for university entrance examinations, and free medical check-ups and medical aid in special cases. This subsidized economic support is offered for a defined period of time until the families become financially self-reliant, typically between three and seven years. The programme offers training on IGAs and links the caregivers with other service providers and CBOs that offer micro-credits or saving schemes. SOS Childrenâ&#x20AC;&#x2122;s Villages helped found seven CBOs in different locations in Sri Lanka which are legally entitled to handle financial transactions. For example, the Devinuwara Small and Medium Industrialist Co-operative Society in Gandara, established in 2009, has 96 members and the power to raise funds, engage in business activities and issue loans; it now handles all financial assistance to the supported families. Primarily, economic support is given in the form of microcredit. After an assessment of the caregivers situation, a basic loan of up to Rs. 20, 000 (EUR 140) is given at an interest rate of 2% per month. A loan plan is set up that includes how the money will be invested and how the loan will be repaid. The loans are used by caregivers to start or expand businesses and improve their living conditions. To date the CBO has loaned a total of Rs. 605,000 to 81 members, with 46 of them already having paid back the full amount. The CBO uses the interest earned to finance other activities that strengthen the community, such as running a grocery shop where supported families sell their products and can also purchase items. The CBO in Gandara has become a strong organisation with a stable financial position, which indicates that the caregivers are progressively taking ownership of the programme. The programmes also offer trainings on IGAs and skills such as making dresses or door mats and book-keeping. Youth from the supported families may be enrolled in vocational training in fields such as welding, carpentry, electricity or plumbing, basic computer skills, bakery, and eco-tourism, either through partners or at the SOS vocational training institute at Monaragala. The impact of economic assistance on the supported families is visible through their increased self-reliance, as they have proportionally higher savings, higher disposable income and depend less on commercial banks for loans. Labour migration for economic reasons has gone down. 97 percent of children have balanced nutrition and are supported by informal education, 80 percent access health services, and basic school enrolment has improved to 99% 163. The programmes also enhanced positive attitudes of caregivers towards child care, reduced their levels of stress and improved their mental stability and confidence, strongly improving family relations.

163

FSP Programme and Impact Evaluation Sri Lanka (2008: 21)

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2.3 Key learnings and recommendations Quite simply, we have to create jobs for young people, allowing them to stay with their families. (SOS family survey Niger)

No family should be forced to choose between unemployment and separation, between finding work and living with their children. •

Governments should prioritise ensuring a greater availability of decently paid and socially secure jobs in families’ places of origin, reducing the incentive for parents to leave their children in search of work; and provide appropriate social security schemes

•

Companies and the profit sector have to lift up to their responsibility in creating fair labour conditions and partner with governments, institutions and non-profit organisations towards reaching equitable employment and work for all

•

Self-employment of family heads and the setting up of small businesses shall be promoted to assist family self-reliance through support to income generating activities (IGAs) and the provision of loans. Micro-credits should be assisted through comprehensive assessment, training and follow-up

•

Employment training and support measures shall be developed in response to needs of local and national markets, promoting the innovative and creative potential of people and considering their individual capacities, skills and interests

•

Economic skill-building to enhance employability shall adopt an integral approach, including a social dimension, towards empowering potential employees as human beings and building their citizenship and self-esteem.

•

Governments should work together on the portability of state benefits and in facilitating family visits and reunification for migrant families in accordance with the UNCRC

•

Children should never be excluded from access to services because of their parents’ undocumented status and awareness need to be raised to avoid the exclusion of migrants and their families in the countries they work in.

•

Particular attention should be paid to the emotional costs of family separation and ‘transnational mothering’ for labour migrants and their families, and support measures set for allowing these children to receive quality care and remain in regular touch with their parents. In-depths research on their situation and needs should be conducted to guide further programme interventions.

The SOS Children’s Villages Family Report 2012

3. Health care gaps increase family vulnerability 3.1. The challenge: Preventive health education Improving preventive education is essential to promoting family health, especially given that public health provision is patchy and private care remains unaffordable to many families. In particular, many deaths of under-fives are from preventable causes, and greater spending on preventive healthcare could greatly improve maternal and child health and reproductive health. Preventive efforts involving social, cultural and behavioural dimensions, especially when targeting mothers, can have an impact on improving family health. Professional services should be strengthened for raising parentsâ&#x20AC;&#x2122; consciousness on different issues around diseases and HIV/AIDS (SOS family survey Kosovo)

Prevention is a key issue in health care, especially for poor families, who tend to be more vulnerable to health problems (see also chapter 1.1.). Besides lacking resources, poor families often also lack access to basic knowledge on disease prevention or psycho-social care. The UN reports that most health spending is dedicated to hospitalbased curative care 164, disproportionately benefiting the better-off. The situation of poor families could be significantly improved by shifting the focus to boost preventive efforts. Many child deaths can be prevented The first challenge for families in Burkina is the survival of children, because childhood diseases are very numerous, compounded by endemic malaria, all of which are favoured by the country's poverty. (SOS family survey Burkina Faso)

Pneumonia, influenza and other respiratory diseases are the largest cause of death among children, accounting for 18 per cent of all under-five deaths (see Box D). The risk of transmission increases with over-crowding of living conditions and indoor air pollution caused by wood, coal or dung cooking stoves, which affect an estimated 3 billion people 165, mainly in developing countries. The second largest cause of death among under-fives, at 15 per cent, is diarrhoea. Malaria is the third largest cause of death, accounting for 8%.

164 165

United Nations (2009: 126) WHO fact sheets http://www.who.int/mediacentre/factsheets/fs292/en/index.html

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Figure 17: Largest causes of deaths among under 5s (Source: WHO fact sheets

http://www.who.int/mediacentre/factsheets/fs292/en/index.html; download Dec 8 2011)

Many of these child deaths are preventable. It is estimated that improvements in hygiene and the quality of drinking and cooking water, sewage systems and latrines could prevent around 1.5 million deaths from the underlying bacterial, viral and parasitic infections causing diarrhoea 166 . If combined with hygiene awareness and behaviour change, diarrhoea-related morbidity could be reduced by two thirds 167. Malaria can be tackled effectively through insecticide-treated mosquito nets. Safe cooking stoves can help to reduce respiratory disease. More generally, adequate nutrition (particularly for pregnant mothers, as their feeding habits impact on a newborn’s immune system and disease resistance), vaccines and timely health care could ensure that most of these children’s lives are saved (see chapter one). Preventive education can play an important role in preventing child mortality, including basic knowledge about symptoms of diseases, regular and balanced feeding, hygiene habits such as hand-washing and proper faecal disposal, and the importance of breastfeeding: In developing countries, breastfed children are at least 6 times more likely to survive their first months than non-breastfed children 168 . Figure 18 illustrates the correlation between child mortality and breastfeeding. In regions with a high rate of breastfeeding, child mortality rates are lower. Even in developed countries there is an issue of information and knowledge not penetrating to the poorest in society – for example, a study in the UK 169 found that the poor had a lower rate of healthy life expectancy due to making worse choices about diet, smoking, sports and so on.

166

Powell-Jackson, Timothy et al (2006) in: UNICEF (2008: 31-32). Cairncross and Valdmanis (2006), in: UNICEF (2006: 3) 168 UNICEF (2009a: 13) 169 Marmot, Michael, et al (2010) 167

The SOS Children’s Villages Family Report 2012

Figure 18: UNICEF, (Source: http://www.unicef.org/sowc2011/statistics.php, downloadDec 8, 2011)

The need for more spending on maternal and child health Although access to health services is free and maternal health services are first world degree, there has been a worsening of the servicesâ&#x20AC;&#x2122; efficiency. Access to national health services and early intervention is becoming more difficult and slower. Families' debts have forced many to neglect their health. (SOS family survey Portugal)

As with many child deaths, the vast majority of maternal deaths are avoidable through education and improving basic maternal health and reproductive health care. According to UN estimates, 536,000 women died in developing countries from causes related to pregnancy and childbirth during 2005. Half of these deaths took place in sub-Saharan Africa and another third in South Asia, with 22 per cent of the global total in India alone 170. However, while overseas development assistance (ODA) for health in developing countries almost doubled in the six years following the adoption of the MDGs, according to OECD figures, maternal and child health is relatively under-funded. Most of the 16.7 billion dollar spending focuses on specific diseases such as malaria or HIV/AIDS 171 . While governments in developing countries dedicate half or more of their total health resources to reproductive and child health 172, only around a third of all ODA in 2007 was dedicated to this area. In particular, ODA spending for family planning has declined constantly, making up only 2.6 per cent of the total ODA spending in 2009 173. UN analysis shows that countries with the lowest GDP per-capita and highest mortality rates benefit least from ODA spending

170

UNICEF (2009a: 5-6) OECD, WHO, The World Bank (2008). in: London International Development Centre et al (2010: 6) 172 WHO and UNICEF (2010: 36) 173 United Nations (2011b: 35) 171

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on maternal and child health 174. Among all MDGs, improvement of maternal health is the goal which is most under-funded 175 and making least progress. Maternal health and the power of knowledge Illiteracy, women's low status in the society and under-utilization of currently available services are challenges to improving maternal health in Nepal. (SOS family survey Nepal)

Good pre- and post-natal care – including birth planning, skilled birth attendants, early immunisation and counselling on breastfeeding – can significantly increase the survival chances of both mothers and newborns 176 . These can be improved through simple, community-based strategies, providing mothers with basic skills and knowledge for safe motherhood and newborn care 177 , particularly where they lack access to affordable health facilities. 

50 million women give birth each year at home without any trained support 178 , predominantly those who lack education or live in rural areas 179.



A further estimated 10 million women annually experience complications such as pregnancy-related illnesses or post-natal problems 180.



100 to 140 million girls and women 181 in parts of Africa, Asia, the Middle East and among immigrant communities suffer the consequences of female genital mutilation (FGM), a cultural practice which involves the removal of the external female genitals. FGM severely affects the health of women, and increases the risks to both mothers and babies for complications before, during and after birth.



Many women still do not use contraceptives; around 25 per cent in Latin America, approximately 45 per cent in Southern and Western Asia, up to nearly 80 per cent in Sub-Saharan Africa 182.



Globally, more than 120 million women aged 15 to 49 cannot delay or avoid pregnancy due to a lack of contraceptives 183; 40 per cent of all pregnancies are unintended, with higher rates among poor, young and uneducated women, and those with an ethnic minority background 184 . Figure 19 illustrates the correlation between female literacy and family planning; regions with a higher rate of educated women tend to also have a higher use of contraception.

174

Greco et al (2010), in: WHO and UNICEF (2010:37) UNFPA (2011: 63) Mills et.al (2006); in: UNICEF (2008: 30) 177 UNICEF (2008: 30) 178 Save the Children (2010: 23) 179 Save the Children (2010: 12) 180 UNICEF (2009a: 4) 181 WHO fact sheets http://www.who.int/mediacentre/factsheets/fs241/en/ 182 United Nations (2011b: 32) 183 United Nations (2011b: 33) 184 Blas and Kurup (2011: 178) 175 176

The SOS Children’s Villages Family Report 2012

Figure 19: Correlation between female literacy and unmet needs for family planning (Source: The Millennium Development Goals Report, Statistical Annex, 2011)

Box F: Young girls are especially at risk Every year the number of teenage pregnancies increases, endangering the life of the mother and of the child and leading to school dropout of the mother. Promotion of sexual education policies is needed. (SOS family survey Peru)

Progress towards the Millennium Development Goal of improving maternal health, including reducing teenage pregnancies, is in danger of being reversed. The highest rates are found in Sub-Saharan Africa, where more than 10 per cent of girls give birth before their 19th birthday; in Latin America, it is around 8 per cent 185 . Adolescent pregnancies remain relatively high even in regions where overall fertility has dropped. A WHO-UNICEF analysis of 18 Sub- Saharan African countries showed that teenage pregnancies dropped by 10 per cent since 2000, but mostly among more educated girls in urban areas 186. Girls who give birth before the age of 15 are five times more likely to die during childbirth than women in their twenties. 70,000 girls die each year 187 during labour. Teenage mothers have also a 60 per cent higher risk of their child dying, or suffering problems such as under-nutrition or development delays 188. Rates of unsafe abortion are highest among young women, with greater likelihood of complications and mortality when they have a low socioeconomic background 189. Timely and comprehensive sexual education and family planning not only helps to prevent unwanted pregnancies and sexually transmitted infections such as HIV/AIDS, it also addresses equitable gender norms and cultural habits, supports communication 185

United Nations (2011b: 31) WHO and UNICEF (2010: 17) World Health Organization (2006), in UNICEF (2009a: 32) 188 UNICEF (2009a: 32) 189 WHO (2011: 182) 186 187

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among couples and empowers young women to make their own decisions 190. Lack of such services contributes to keeping women out of school and out of the labour market, and increases the health risk for themselves and their children. Educating mothers supports family health and survival in many ways, through better decision-making in the family, better use of existing social services, better childcare provision and higher contribution to the family’s income 191. Women with some formal education are more likely to ensure that their children are immunised and are better informed about their own and their children’s nutritional requirements 192 . Children of mothers with secondary or higher education are three times more likely to survive to age five than those of mothers with no education 193 . Figure 20 illustrates this correlation between female literacy and child mortality; most regions with the highest child mortality rates (Sub-Saharan Africa, South West-Asia, Caribbean, Arab States) have also comparable lower rates of literate women.

Figure 20: Correlation between female literacy and child mortality: (Source: UNESCO Institute for Statistics database (UIS, 2010).

Box G: HIV/AIDS prevention – what remains to be done despite progress The high prevalence is mainly because of the existing socio economic and cultural factors relating to HIV transmission and prevention (SOS family survey Mozambique)

190

UNFPA (2011: 22) Blas and Kurup (2011: 56) 192 UNICEF (2008: 18) 193 UN Inter-agency Group (2011:11) 191

The SOS Children’s Villages Family Report 2012

The impact of HIV/AIDS on families was recognised from the very beginning of preventive efforts 194. HIV is often transmitted among family members, who also carry the burden of care responsibility for ill relatives; and they suffer social stigma, trauma and economic hardship through the loss of income-earners. In high-prevalence areas, the extended family network is unravelling. The UN estimates that in 2009, about 16.6 million children had lost one or both parents to AIDS, 14.8 million of them in subSaharan Africa 195. The example of HIV/AIDS has shown, however, that concerted investment in preventive health measures can have an impact. The rate of new HIV infections declined by nearly 25 per cent worldwide between 2001 and 2009 196, predominantly in sub-Saharan Africa, (the most affected region, with 69 per cent of global infections), where many preventive programmes focused. There is a decline of new HIV infections among young people aged 15–24, from 5.7 million in 2001 to 5 million at the end of 2009, with a clear link to safer sexual behaviour. 197 Other regions have, however, seen less progress, and a number of issues around prevention efforts remain to be addressed: 

Use of condoms remains very low, especially among girls 198.



On average, only 33 per cent of young men and 20 per cent of young women in developing regions have correct knowledge about HIV 199, and many adolescents are uninformed about their HIV status because they were never tested.



Women are especially vulnerable, and in sub-Saharan Africa, 9 per cent of maternal mortality is still due to the disease 200 . However, most programmes preventing mother-to-child-transmission of HIV/AIDS focus primarily on HIV testing and the provision of anti-retroviral drugs, and neglect the essential role of family planning and preventing new HIV infections 201.



Men’s role in educating and shaping their children’s attitudes and behaviours through example and communication is often under-estimated 202.



HIV/AIDS programmes disproportionately reach the wealthy, well-educated and urban over the poor, uneducated, and rural 203 . Condom use is also much less common among young people in poorer households and living in rural areas 204.

194

Global Crisis—Global Action, United Nations General Assembly Special Session on HIV/AIDS, Declaration of Commitment on HIV/AIDS: New York, August 2001; http://www.unaids.org/UNGASS/index.html 195 United Nations (2011b: 40) 196 United Nations (2011b: 37) 197 UNICEF (2010b: 16) 198 UNICEF (2010b: 20) 199 United Nations (2011b: 38) 200 World Health Organization and London School of Hygiene & Tropical Medicine (2010), in: UNICEF (2010b: 4; 5) 201 UNICEF (2010b: 6) 202 UN DESA (2011: 174-179) 203 UNICEF (2010b: 3) 204 United Nations (2011b: 39)

The SOS Children’s Villages Family Report 2012

Improving family health through preventive education In particular, training workshops are required with local communities on children’s rights, 205 HIV/AIDS, healthy life style, prevention of early pregnancy and so forth (SOS Children’ Villages Belarus)

Often, health interventions reach only those families who already have access 206. To achieve lasting change in health-related habits and attitudes, community members need to become involved in spreading information, motivating peers and reaching the most impoverished, isolated or excluded. As health problems result from numerous interlinked factors, preventive efforts require a cross-cutting approach, addressing and exploring linkages between poverty, nutrition, infrastructure, education, culture, gender and environment. Prevention efforts are most effective where a combination of social, cultural and behavioural dimensions is addressed. Basic health care services need to include more preventive information with a focus on the needs and perceptions of all family members. Besides the often mentioned ‘continuum of care’, a ‘continuum of prevention’ is required to connect the various prevention issues and improve health services’ cooperation.

3.2. The Response: An integral approach to family health National efforts to address (preventive) factors should be scaled-up, such as health services for pregnant women or the coverage of insecticide-treated nets to prevent malaria. Our medical centre in Zanzibar addresses this challenge through family planning and counselling, provision of antenatal and postnatal care, addressing STD’s and HIV (SOS family survey Tanzania)

Healthy development for children is on the core of SOS Children’s Villages work. The term ‘healthy development’ encompasses a holistic approach to child development and well-being, including physical, mental, psycho-social, emotional and spiritual dimensions. Health within SOS programmes is addressed in a comprehensive manner: 

 

Supporting access to preventative and curative family-friendly and child-specific health care services, including for families outside the formal health insurance system; Conducting training sessions and awareness-raising campaigns and supporting governments in scaling up their preventive health measures and crafting legislation; Supporting the psycho-social and mental component of family and child health through counselling, therapeutic support and promoting positive family relations.

SOS Children’s Villages’ programmes promote attention to preventive family health as a key to increasing a child’s chances for a healthy development in the long run. In particular, the organisation’s inclusion policy promotes the active participation of children with disability by strengthening the capacities of families and communities to protect and care for them. The policy on HIV/AIDS ensures that effective measures to prevent infection among children, young people and caregivers are integral to all programmes, 205 206

CRSA Belarus, p. 24 London International Development Centre et al (2010: 8)

The SOS Children’s Villages Family Report 2012

including age-appropriate and youth-friendly information and education on sexual and reproductive health, life skills training, prevention of mother-to-child transmission, support for voluntary counselling-and-testing, safe maternal health services or breastfeeding counselling. Programmes also provide forums where children can speak openly about the impact of HIV and AIDS on their lives. Finally, the child protection policy intends to support a caring and protective environment in which violence, child abuse and exploitation can be openly addressed and prevented (see case study 12). Poor people typically consult health services only when there are already signs of sickness, especially where health care is costly or services not within reach 207. Health prevention therefore often starts with enabling children and caregivers to have regular and easy access to a family doctor they trust for routine health check-ups, monitoring their health condition and explaining matters in an easy-to-understand way without the barriers of excessive costs and bureaucracy. Case Study 6: Supporting comprehensive health for vulnerable families in Bucharest, Romania ‚Some refused from the very beginning to use a birth control method. They used to say: “No, no, no, I do not want, I won’t have other children” - until a new pregnancy occurs. I told them at least to go at a medical consult, and they accepted. This was a first step. They were informed what they could do, what methods, what alternatives they have - at least now they know where to 208 go…’ . (National SOS Programme Coordinator Bucharest)

Despite reforms, economic growth and accession to the European Union in 2007, Romania still suffers the consequences of social and economic policies pursued under the Ceausescu regime. When the former dictator was overthrown in 1990, children living in state orphanages were found to be malnourished and living in terrible conditions. Still today, Romania has low levels of employment and wages, a large rural sector and widening regional disparities in social and health service coverage. 13.8 percent of the population live below the poverty line 209 and health expenditure per citizen is the lowest in the European Union 210. SOS Children’s Villages Romania initiated a programme in 1999 in line with the government strategy to prevent poverty-related placement of children in state orphanages. It addresses poor and socially vulnerable families who are at high risk of being separated from their children. The programme runs a social centre in Bucharest, which supported a total of 236 children and their parents in 2009. Nine-tenths of the participating families have an income below the minimum wage 211. The social centre supports the families to improve their living conditions and increase their access to social, educational and medical services in the community, with a view to 207

Impact evaluation South Africa p. 43-44; Impact evaluation Peru p.10 Impact Evaluation Romania (2007: 32-34) World Bank (2007), http://data.un.org 210 UNICEF Romania, http://www.unicef.org/romania/overview_1610.html 211 Impact Evaluation Romania (2007: 15) 208 209

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developing their capacities to independently access services after leaving the programme. Material and financial support is given according to needs, parents are offered training in parenting skills, children can participate in social activities to build their social-emotional skills, and the families receive social and psychological counselling. The social workers also help to prevent discrimination against participating families in public institutions such as hospitals, schools or kindergartens, for example due to their poverty or Roma ethnicity. Health conditions are specifically supported. Social workers assist families in accessing medical services and registering to a family doctor. During house visits and counselling sessions, social workers encourage the parents and children to go for periodical health checks and help them to understand medical diagnoses, vaccinations and treatment. The centre provides financial help where necessary to acquire medicines that are not paid by the state, for both children and parents. The centre partners with facilities that offer family planning and birth control education. Approximately 60% of the mothers who accessed the family planning and birth control services started to use birth control methods 212, which for some was a sensitive issue to overcome their resistances and fears due to for example their religious backgrounds. SOS Childrenâ&#x20AC;&#x2122;s Villages has established an efficient partnership with the child protection department, with mutual case referrals and complementarity of services. The work in partnership with public institutions and other NGOs is important to guarantee support for the families when the social centre involvement ends. The programme sometimes, however, faces difficulties related to the high staff turnover in public service partners. For the future, a day-care centre for children is needed to help mothers find work. The programme has been a success. As a result of counselling and support, familiesâ&#x20AC;&#x2122; health conditions have improved and great progress has been made in family planning. Home visits have motivated parents to take better care of their health and improve hygiene. All families who leave the programme are registered to a family doctor, benefit from free medical services, regularly visit preventive health check-ups and take their children to the doctor independently when medical problems occur. Free care fails without preventive efforts Programme experience has shown that the provision of free medical care alone is not enough; aspects of prevention related to the daily habits and socio-economic circumstances of families also need to be addressed. For example, an SOS clinic in Burundi found that a third of the 12,000 patients it treated during 2009 had symptoms of malnutrition 213. A review of programmes in three African countries showed that about one third of children with sufficient access to medical care fell sick relatively often, reporting symptoms related to malnutrition and inadequate housing, issues which required being tackled through preventive measures 214 . An initial programme 212

Impact Evaluation Romania p. 32-34 Impact evaluation Burundi, p 12-13 214 Impact evalution Zambia, Uganda, Mozambique, p26 ,27 213

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assessment in Nepal found that 80% of families were unaware of the health risks of contaminated water and their homes were full of dirt and mud, with insufficient ventilation for smoke from fire logs and unsanitary toilets 215. In many programmes, information, counselling and awareness-raising on balanced nutrition, breastfeeding, hygiene and sanitary conditions are basic issues to be addressed by programme staff, social workers or community volunteers. Many components of health prevention programmes can be easily run by well-trained community members. They have high credibility among families, guarantee the sustainability of the programme and can contribute strongly to diminishing discrimination in cases of stigma and taboo such as disability, sexuality or HIV/AIDS. Wherever possible, caregivers and children themselves can be trained as peer educators. However, programme experience shows that consistent support is essential to ensure that the volunteers do not neglect problems which they feel they are not competent to handle 216. Preventive health care empowers people to change their lives Many decisions are still mainly made by men in most communities. Education can encourage men to break away from bad cultural practices against women and become more involved and supportive of women's needs, choices, and rights as regards maternal health, and can also improve women's positions in relation to decision making (SOS family survey Uganda)

The psycho-social components of preventive health services can have a far-reaching impact in empowering individuals and communities to gain the knowledge and skills to take better care of them. For example, HIV/AIDS prevention for children and youth can include sessions to help them deal with bereavement and grief when they have lost care-givers, so that they are able to share their despair, re-gain hope and find the strength to build up their self-reliance. Especially girls and women need safe spaces to discuss issues such as abuse, HIV and unwanted pregnancy. Preventive health efforts require empowering women, but they need in addition to increasingly tackle men. Men tend often to be less reached through programme activities, and much change depend on them being sensitised in their role as fathers, husbands, and in many contexts, family heads or community leaders. Life skills trainings or child rights workshops support children and youth in understanding their own development and rights and building their competence, communication and conflict resolution skills to protect them from abusive or destructive behaviours of adults and peers, for example related to alcoholism, drugs or sexuality. Cultural, religious or sport leisure time activities contribute to childrenâ&#x20AC;&#x2122;s physiological, mental, creative or spiritual health, dimensions which are often overlooked for the healthy development of children in impoverished families who focus on issues of daily survival. Stimulating joint child-parent undertakings and mediating family conflicts supports emotional well-being, resilience and stress reduction for caregivers and children.

215 216

Impact evalution Nepal, p. 36-40 Impact evaluation Malawi p. 44- 49

The SOS Childrenâ&#x20AC;&#x2122;s Villages Family Report 2012

At the community level, preventive health can be supported through raising general awareness and disseminating information in a community-appropriate way, for example using theatre, images or traditional stories. In addition, it is important to involve others with influence depending on the issues involved, including the police around violence prevention, teachers or shop-owners related to drug issues, city planners and infrastructure companies regarding safe water or sanitation systems, or churches and schools for addressing safe sexuality and motherhood. Case Study 7: Supporting a HEALing process for vulnerable communities in Zimbabwe ‘It is becoming increasingly harder to ensure children’s access to basic services. The little available is eroded by inflation.’ (SOS family survey Zimbabwe)

Since the late 1990s, the economy of Zimbabwe has been in constant crisis, affected by successive droughts, continuous inflation and low foreign investment. A UNICEF study suggests that approximately 55% of the population in Zimbabwe live in extreme poverty, including 3.5 million children who are chronically hungry and deprived 217. The HIV/AIDS pandemic has orphaned large numbers of children. The government’s social welfare services have a very low coverage, while water and sanitation services have also deteriorated. UNICEF estimates that 250,000 households live in extreme poverty because caregivers have died or are unable to earn a living, mainly due to HIV/AIDS 218. Zimbabwe now has one of the lowest life expectancies worldwide, around 46 years 219. Both infant and maternal mortality have increased; only 60% of births are attended by skilled health personnel 220. Glen View and Glen Norah are two high-density suburbs of the capital Harare, which were selected as an SOS Children’s Villages programme location in cooperation with the municipality and other partners. These suburbs lack services and have a high number of poor households with terminally ill parents, where grand-parents or older siblings are looking after children. The admission rates at the local clinic for TB treatment are high. The programme was initially set up for the period 2002 till 2005 as an emergency response during the droughts, and then extended. It particularly targets children who have sick caregivers or who have already lost one or both parents. The programme works together with the community and participating families to plan activities and identify vulnerable children. Under the acronym HEAL (health – education – accommodation – livelihood), it supports a healing process for the most bereaved and distressed community members. It offers a combination of immediate material support (food packs, school fees) with long-term training and capacity-building of children, families, community structures and service providers such as schools. The programme supports children and families to access health services provided by the local municipal clinic and government hospital, and covers medical expenses where necessary in partnership with pharmacies. Additionally, the programme raises awareness on preventive health issues and conducts workshops on topics including life 217

UNICEF ‘Child-Sensitive Social Protection in Zimbabwe’ (2010: 23) UNICEF ‘Child-Sensitive Social Protection in Zimbabwe’ (2010: 21) 219 UNICEF (2009) http://www.unicef.org/infobycountry/zimbabwe_statistics.html 220 WHO (2009), Zimbabwe country statistics at http://www.who.int 218

The SOS Children’s Villages Family Report 2012

skills, reproductive health, safe sexual behavior, HIV/AIDS counseling, and hygienic living conditions. The psycho-social dimension of health is particularly supported; children and youth are trained in peer counseling to widen the support systems in the community. Workshops focus on relationships and conflict-solving in the family, at school and with peers, on rights and responsibilities of children or physical and emotional development changes. Bereavement sessions are held with both children and adults to help them to resolve the grief caused by loss of parents, children and family members. Staff are trained on working with children in distress. The life quality and health of children have improved tremendously as a result of these activities, with improved nutrition, healthier lifestyles and greater emotional stability. Issues surrounding HIV/AIDS were demystified and discussed openly and knowledge of preventive health was increased. 1,486 children and youth were successfully supported by the programme during 2005. As government services have been weak and underresourced, the programme had to rely a lot on individual support and cooperation with the local community. Currently, the programme is working on building lasting social protection mechanisms in the community and building the capacity of community-based organisations to support the families as needed.

The SOS Childrenâ&#x20AC;&#x2122;s Villages Family Report 2012

3.3 Key learnings and recommendations The challenge for maternal health should be viewed as a continuum that encompasses reproductive health, family planning, pregnancy, childbirth and infant and maternal mortality. Education can also enlighten on how maternal health impacts on women, children's well-being and society as well. (SOS family survey Uganda)

Preventive education is key to family health, especially where health care is costly and inaccessible and living standards are low. •

Governments and health care providers need to pay more attention to aligning curative and preventive health care efforts, address cross-cutting issues related to health, understand health in an integral manner and improve synergy and efficiency in a ‘continuum of health care and prevention’ approach

•

Governments and donors shall target more spending to preventive health care, as well as to maternal and child health, especially to family planning

•

Prevention programmes shall address the complexity of interlinked social, cultural and behavioural dimensions and in particular address the psycho-social and emotional needs of children and adults in home-based support, trainings and awareness-raising, with a focus on the needs and perceptions of all family members.

•

Barriers need to be removed for poor families to access regular health care services for prevention and to reaching them through targeted, timely and accessible communication channels

•

Preventive health programmes shall invest in adequate training and support of community members as peer educators, and reach out to all community stakeholders influencing family health

•

For combating pneumonia, diarrhoea and malaria as the main diseases causing child mortality, preventive efforts in concerned countries shall be boosted disseminating knowledge and targeting awareness and behaviour change around hygiene, safe water and cooking habits, the use of insecticide-treated mosquito nets, adequate child nutrition, knowledge on signs and symptoms, and the importance of breastfeeding

•

Community-based strategies shall be implemented providing mothers with skills and knowledge for safe motherhood and newborn care, including the safe use of contraception, prevention of HIV and sexually transmitted diseases, birth planning and attendance, early immunisation and breastfeeding, with special attention to illiterate women, those in rural areas or from ethnics minority backgrounds. In particular measures are required to sensitise and support young women in preventing HIV/AIDS infection and early pregnancy.

•

Preventive health efforts must be strongly coupled with educating and empowering women as well as sensitising and educating men in their role and responsibilities in family and community

The SOS Children’s Villages Family Report 2012

4. Keeping children in school 4.1 The Challenge: Family income and knowledge Education is a key to breaking the intergenerational cycle of transmission of poverty. However, recent gains in access to primary education have not been matched by improvements in quality of schooling or access to secondary and higher education. Many children, especially girls, still drop out of school to work and contribute to family income; girls and children from poor, less educated or marginalised families are over-proportionally affected. Many parents are not educated, they are not aware of the importance of education and skill training that could shape the future of their children. They rather prefer to use the labour of the children to support the families in the effort to generate income. (SOS family survey Ethiopia)

As figure 21 shows, The Millennium Development Goal on universal primary education has greatly improved school enrolment rates in all regions, with the elimination of school fees driving rapid progress in many countries. Before the recent economic crisis, the number of children out of school fell from 106 million to 67 million between 1999 and 2009 221 . Sub-Saharan Africa remains the weakest region, but has made the biggest progress and achieved a primary school net enrolment ratio of 76% in 2009. Most other developing regions have already well exceeded the 90% mark 222. However, there were still 67 million children out of school in 2009, 32 million, almost half of them, in sub-Saharan Africa and a quarter, 16 million, in Southern Asia, as shown in figure 21 223. More than 20 per cent of primary-age children in least developed countries were excluded from education 224 . West and Central Africa has the lowest school enrolment ratios in the world 225. Only 87 out of 100 children in developing regions complete primary school; in half of the least developed countries, at least two out of five children drop out before reaching the last grade 226. According to UNESCO estimates, in sub-Saharan Africa alone, around 10 million children drop out of primary school each year 227.

221

United Nations (2011b: 16-17) United Nations (2011b: 16) United Nations (2011b: 16-17) 224 United Nations (2011b: 17) 225 UNICEF (2009c: 22) 226 United Nations (2011b: 17) 227 UNESCO (2011a: 47) 222 223

The SOS Childrenâ&#x20AC;&#x2122;s Villages Family Report 2012

Figure 21. Number of children out of school (source to complement)

Which children are most likely to miss school? Guatemala is characterized by a mainly indigenous population with a high percentage living in rural areas where population is concentrated in poverty and extreme poverty. This situation causes that children engage at an early age in informal labour activities, causing dropouts of school, absenteeism and repetition of the school year. (SOS family survey Guatemala)

Children who are poor and deprived, live in remote areas or come from an ethnic or otherwise marginalised background are at a higher risk of not completing schooling. Of the total number of primary-age children in the world who are not enrolled in school, 42 per cent or 28 million live in poor countries affected by conflict 228. Some children are specifically vulnerable to missing out on education or dropping out of school: 

The principal reasons given for children not attending schooling in rural areas are costs, difficulty of access, and low expectations of the utility of education 229. The schooling rate in rural areas is much lower than in urban ones, and rural zones record the highest number of drop outs. Some of their main problems are transport to school, especially in remote areas, and the limited availability of qualified education (see Box H).



Children with specific learning needs due to retarded development or a disability require higher efforts for integrating and keeping in school. The often lack adequate learning environments in response to their specific needs; face discrimination, or their situation might be exacerbated by a lack of parental means for providing adequate care or learning support.



Children from socially marginalised or difficult backgrounds often lack the financial means to afford school material or fees; they rarely have a favourable learning environment at home, and/or face bullying or discrimination at school. This often includes orphaned children or children from an ethnic minority background, and children living in family settings which are outside of local social norms. Children who are taken in by relatives or foster families are also sometimes not treated equally in terms of school attendance. The SOS Children’s Villages Child Rights Situation Analysis Albania shares national study results according to which, in 2007, only 50% of Roma children attended pre-school and compulsory education 230. However, this also includes children coming from families influenced by parental

228

United Nations (2011b: 17) ODI/UNICEF (2009a: 26) 230 Human Development Centre (2007), in: CRSA Albania (15) 229

The SOS Children’s Villages Family Report 2012

alcoholism, drug abuse or domestic violence. The SOS Child Rights Situation Analysis Nepal highlights that these children are at high risk of school drop-out 231 (see box J). In times of financial difficulties, there is also a greater likelihood that integrative special needs programmes are cut. This means children with disabilities or from ethnic minorities face problems attending school, risking further social marginalisation. 

Children from households with less educated or illiterate parents face a higher risk of not attending or dropping out of school. Parents’ education level has an important influence on the educational achievement of children, especially when economic constraints impact on family priorities; parents without education are less likely to value the importance of education for the future of their children. They are also less likely to have the necessary information and knowledge to support their children adequately in their school success, already during the crucial years of early childhood development and especially in the sensitive transition from primary to secondary schooling 232.

The following figures 22 und 23 illustrate how the correlation between adult literacy and school attendance rates implies a self-reinforcing circle, in which less literate caregivers are less likely to send their children to school. Interestingly, South Asia – with relatively low adult literacy but relatively high school enrolment – shows that this vicious circle can be broken.

Figure 22: Correlation between adult literacy and primary school attendance (Source: UNICEF, http://www.unicef.org/sowc2011/statistics.php, download: Dec 8, 2011)

231 232

CRSA Nepal (6) Save the Children (2009: 24)

The SOS Children’s Villages Family Report 2012

Figure 23: Correlation between adult literacy and secondary school attendance (Source: UNICEF, http://www.unicef.org/sowc2011/statistics.php, download: Dec 8, 2011)

In every region of Niger outside the capital Niamey, the educational level of girls is too low in comparison with boys. The reason for this situation lies in the view that the woman’s place is in the home (SOS family survey Niger)



Girls are more likely to not attend or drop out of school than boys for a number of reasons. When poor families have to make a choice between sending a boy or girl to school, studies have shown that parents often choose to invest in the education of their sons, especially as daughters’ household contributions are considered more significant 233. Where girls are in school and work, they often carry a ‘triple burden’ of housework, schoolwork and paid or unpaid work outside the home, which unavoidably impacts negatively on their educational achievement. Further, girls who get pregnant early (see box F) are often forced to leave school to overtake family responsibility or because of discrimination.

Gender parity in school access has improved, with the proportion of girls out of school declining from 58 to 53% worldwide between 1998 and 2008 234 . However, in 28 countries in South and West Asia and sub-Saharan Africa, there are still fewer than nine girls in primary school for every ten boys 235 and in many countries the gender gap is much wider. (insert graphic boy/girl school attendance and/or drop-out rates) 

School attendance rates are lower and drop-out rates higher in secondary education than in primary. Secondary education is even more costly for families, due to typically greater distances to school, higher school fees and costs of materials. Though the Millennium Development Goals have advocated for primary education to be free, secondary education still lacks this support. For many families

233

United Nations (2011a: 45) United Nations (2011b: 17) 235 UNESCO (2010: 6) 234

The SOS Children’s Villages Family Report 2012

in developing countries, secondary or higher education for their children remains unaffordable. 

Finally but from utmost importance, children engaging in child labour presents a main reason for school-drop out. A common response from families facing poverty is to send their children to work rather than school to support family income. Child labour affects an estimated 150 million children aged 5-14, and is most common in sub-Saharan Africa, where more than a third of children work 236.

Child labour plays a major role for school drop out Millions of children in Pakistan suffer under a system of bonded labour. They also remain uneducated, 42% never having attended school and 58 % having dropped out. (SOS family survey Pakistan)

The International Labour Organisation estimates that more than two thirds of all child labour is in the agricultural sector. It has found that many children in rural areas – and girls in particular – begin agricultural labour as young as 5–7 years old 237. The SOS Child Rights Situation Analysis Indonesia quotes a 2006 national study in which more than half of school drop-outs mention lack of money as a main factor for not attending school 238; even more may not have mentioned their poverty due to shame. Parents’ struggle for survival undermines the importance of education. Data from household surveys indicate that children from poorer households are more likely to be engaged in child labour than children from richer households 239 . Children from disadvantaged backgrounds and rural areas are also more likely to be pulled into informal labour markets. As the SOS Children’s Villages Child Rights Situation Analysis Malawi states, ‘Children from marginalised families or communities are at increased risk of being caught up in child labour due to the difficulties they and their families face in meeting their basic needs and accessing essential services’. 240 Especially older children with many siblings often work to contribute to family income and care for their younger siblings; at the expense of their own schooling. Children who live with only one care-giver (see chapter 5) or those who have lost their parents, for example due to war or HIV/AIDS, or where parents are sick, might drop-out to work and assume financial and care responsibilities for younger siblings, grand-parents or sick relatives. As a boy in a focus group discussion in Sierra Leone stated, ‘When my dad died I had to quit school so that I could help my mom and grandmother. I started to sell in the market so that we could eat. If I don’t make money, we don’t eat. I like being out all day with my friends at the market, but I miss school more’ 241. Early entry into the labour force makes children more likely to delay school admission, fail to complete basic education or never attend school at all. While the child contributes to solving the family’s financial problems in the short term, child labour perpetuates the inter-generational cycle of poverty by keeping the child out of school. 236

UNICEF (2009c: 15) ILO (2006: 37–38) PMSK (2006), in: CRSA Indonesia (16) 239 UNICEF (2009c: 30) 240 CRSA Malawi (p. 20) 241 CRSA Sierra Leone (42) 237 238

The SOS Children’s Villages Family Report 2012

Figure 24 illustrates the correlation between poverty, child labour and school drop outs: Regions with higher poverty rates are also likely to have higher rates of child labour and school-drop out.

Figure 24: Correlation between poverty, child labour and school drop outs (Source: Global Initiative on Out-of-School Children, UNICEF and the UNESCO Institute for Statistics, Flyer August 2011)

While increased access to education through the abolition of school fees is regarded as contributing to recent declines in child labour 242 , there is already concern that the economic crisis might trigger another rise in child labour, with negative impact on school attendance.

Box H: A lack of well-trained teachers undermines education quality The challenges of quality education at primary, secondary and advanced levels are reflected in declining pass rates at all levels, dropping year after year, owing to the general poor infrastructure, overcrowded classrooms, inadequate textbooks and teachers at all levels of school. (SOS Family survey Tanzania)

Alongside issues of access and retention, efforts to improve the quality of education are also essential. The 2010 UNESCO Education for All (EFA) report indicates that in South and West Asia and in sub-Saharan Africa, many children fail to master basic literacy and numeric skills, even when they complete primary education 243. Many countries lack sufficient numbers of well-qualified teachers. UNESCO estimates that the poorest countries needed to recruit almost two million teachers by 2015 244, again with a focus on eliminating disparities for rural areas and disadvantaged 242

United Nations (2011a: 45) UNESCO (2010: 7) 244 UNESCO (2010: 7) 243

The SOS Childrenâ&#x20AC;&#x2122;s Villages Family Report 2012

neighbourhoods. The SOS Children’s Villages Child Rights Situation Analysis Central African Republic notes that “Because of budget constraint, the educational system has adopted the practice of the employment of untrained parents as school masters. They nearly represent half of the total number of school teachers in class today 245’. Graphic: Drop-out rates in primary school (by gender and region) With globalisation and the spread of new technologies, knowledge and skills become ever more important to both individuals and national economies. However, where the right to education is not fully guaranteed and children drop out of school due to the financial situation of their families, their transition to the labour market is extremely difficult. This leads to young people finding themselves unemployed or in unqualified, low paid or informal jobs.

4.2. The Response: Adressing children, families and the system holistically to prevent school-drop Our educational system is creating issues because class sizes are well beyond what can be reasonably managed and children with special needs are falling through the cracks. We currently run a homework club for vulnerable youth who need support to achieve basic expectations in school. (SOS family survey Canada)

‘SOS Children’s Villages strongly believes in quality education as the means to break the cycle of marginalisation, poverty, violence and family breakdown’. This introductory statement of the organisation’s education policy stresses the important place education has for a child’s full development. The organisation takes the following steps to make child-centred education accessible for vulnerable children whose right to education is violated:  

  

245

Working in partnership with governments, as the primary duty bearers for formal education, to ensure sustainability, accessibility and quality of educational systems; Assisting educational service providers to develop the capacities, resources and systems necessary to provide child-centred, holistic, safe, inclusive and accessible quality educational services (e.g. teacher training, curricula development, provision of equipment); Providing formal education where otherwise not provided, though with a clear focus on formal educational facilities being in the long run in the ownership of the state, community or recognised local educational service providers; Offering non-formal education for families and children to support comprehensive child and family development; Helping parents to fulfil their primary responsibility for the education of their children, and building their capacity to support their children’s learning and claim their educational rights. Educational activities are provided to strengthen and develop families’ related attitudes, knowledge and skills.

CRSA Central African Republic: 11

The SOS Children’s Villages Family Report 2012

Integrative and holistic child-centred education SOS Children’s Villages programmes always give attention to the full cycle of formal education, from early childhood development, crèches and kindergartens through to primary and secondary schools, vocational training, higher education and adult learning, as well as the many forms of non-formal and informal education opportunities. Formal education today often focuses predominantly on academic achievements and professional qualifications. SOS Children’s Villages promotes a more holistic, rightsbased and child-centred approach to children and youth education. Education which respects the individual child as a resourceful, unique human being actively participating in her/his own development process will keep children self-motivated in school and prepare them for life. Education which individually supports children to develop their innate abilities and skills will make a lasting difference, especially for children from a disadvantaged or marginalised background or with specific learning needs. Today’s society and labour market require attitudes, values, knowledge and skills that go beyond traditional curricula and which address human dignity, empowerment, inequality, child rights and active citizenship. Learning environments need to guide curiosity, create individual learning options, and allow children to express feelings, gain self-confidence, research and experiment. They have to stimulate children to take on responsibility for themselves and others, to be flexible, deal with uncertainty, understand and question a complex reality, take informed decisions and encourage them to participate actively in social and economic life. Case Study 8: Supporting the schooling of children in marginalised communities in Bhubaneswar and Kochi, India Through constant and continuous efforts one can change the life of young people with low academic performance to become successful in society (Youth social worker in Cochin)

Despite two decades of high economic growth, over a third of India’s population live below the poverty line and half of India's women are considered poor 246. About half the country’s 350 million children are chronically malnourished 247. 8.1 million children were out of school in India in 2009 248, most of them from marginalized social groups. Just 40% of Indian adolescents attend secondary school 249. Even though literacy rates are rising, 283 million adults are illiterate 250 . 12% of children under 14 are engaged in child labour 251. Challenges for the educational system include improving access, equity and quality, curricula and teaching practices require improvements. Regional and ethnic disparities need to be reduced. In 2003, SOS Children’s Villages India set up two Family Strengthening Programmes (FSPs) in India, one in Bhubaneswar in the East and another one in Kochi in the South. Both programmes mainly serve socially and economically disadvantaged families living in 15 villages and slums around the cities, the majority coming from castes or tribes 246

UNDP Human Development Report (2011), http://www.undp.org.in/whatwedo/poverty_reduction UNESCO EFA global monitoring report (2011:5) World bank (2009), http://www.worldbank.org.in 249 World bank, http://www.worldbank.org.in 250 UNESCO EFA global monitoring report (2011:66), period 2005-2008 251 UNICEF (2009), www.childinfo.org 247 248

The SOS Children’s Villages Family Report 2012

which are discriminated against. The illiteracy rate among supported families in Bhubaneswar is 43%, and more than 60% live below the poverty line. 80% of caregivers supported in Bhubaneswar and 75% in Kochi are socially marginalized widows 252. The programmes aim at empowering families to become self-reliant in the care of their children, through access to basic services, capacity-building of parents and children, creating good playing and learning environments and helping the community to be responsive to children’s needs. During 2007, 50 families with 103 children were supported in Bhubaneswar, and 214 families with 375 children in Kochi. To support the education of children, caregivers receive financial assistance for purchasing educational material and books, paying school fees or tutors. Children and parents receive advice on school attendance, career choices, admission and other related matters. Non-formal education for school drop-outs and extra tuition for weak learners is provided. 82% and 94% of interviewed children 253 participating in Bhubaneswar and Kochi, respectively, were satisfied with the quality of educational support. The programme further includes subsidised health care and counselling for participating families through collaboration with hospitals, the formation of self-help groups for parents to generate income, and counselling sessions on various issues including nutrition, parental skills and child rights. In Kochi, caregivers started with cash support to provide milk and other food items to their children. This holistic approach furthers children’s school success through adequate nutrition, medical care, respect of their rights and improving the knowledge of their caregivers. Socio-economic factors including the general situation of poverty, poor health and hygiene conditions, along with a low rate of participation in nutrition counselling sessions, are challenges for the programme in Bhubaneswar. However, the educational programmes have been successful in terms of children’s enrolment, attendance and performance. In Bhubaneswar, with a high number of illiterate caregivers, the FSP has been particularly critical in preventing school dropouts, and 94% of the children on the programme regularly attend school. In Kochi, where educational levels have been more positive from the start, 60% of the participating children indicate having improved their educational performance 254. The programmes have been able to ensure children’s access to basic services such as education, nutrition and health. The challenge now is to build the capacity of participating families to access the social security schemes and other entitlements and to empower the whole community for better child safety and the promotion of child rights. Individualised and substantial support for families in need The socio-economic circumstances and living conditions of families need to be addressed to create positive conditions for learning and studying. Children sleeping on banana fibres instead of proper beds and getting soaked overnight in houses with

252

Impact evaluation India p. 20-21 Impact evaluation India p. 30-31 254 Impact evaluation India p. 31 253

The SOS Children’s Villages Family Report 2012

leaking roofs or missing windows 255 – as found in Zambia, Uganda and Mozambique – will not be able to focus on their education. Children who are hungry or overworked will not have the capacity to concentrate on their school-work. Irregular school attendance, which often precedes school-drop out, can depend on many factors. In a programme in Sri Lanka, where school expenses were covered and children were reported to be happy at school, as many as half attended class irregularly 256 . Children in programmes in three African countries indicated that they stayed home from school for reasons such as health problems, a lack of proper material or washed clothes, theft of shoes or uncut hair 257. Around 20% of children and youth in these programmes dropped out of school for reasons ranging from work to pregnancy, bullying at school or transport problems. A programme evaluation in Latvia indicates a strong and mutually reinforcing link between general learning difficulties and frequent absence from school among children from high-risk families 258. There are many ways to attend to the needs of children most at risk of school-drop out and increase their chances from an early age. Early childhood education programmes support especially poorer and illiterate parents to reduce the inequality gap for their children 259, they set a foundation for later school performance and are essential support instruments for children from disadvantaged households. Unfortunately, evidence shows that children from poorer, less educated and rural areas have 25-50% less access to these services 260. For example, a programme evaluation in Peru noted that children starting school who had benefited from early childhood development programmes displayed better reading and writing competence and psycho-motor abilities 261. Once children attend school, individual case-by-case follow-up through home visits by social workers or community members is helpful and can contribute to encouraging and monitoring school attendance 262 . Children without parents or from child-headed, impoverished and marginalised families might stand out because they lack the ability to afford extra-curricular activities, uniforms, books or stationery. Providing these things can help them to become more integrated and accepted in the community. A survey among such children in Zimbabwe confirmed that stigma was reduced and self-esteem increased, in contrast to previous patterns of aggressiveness or withdrawal 263. Working with the whole system to prevent school-drop out ‘The school can say no we have had enough of these at-risk kids, the school is not suitable for 264 helping them’. (school specialist in a programme in Latvia) ‘There is one teacher who likes telling us that we are orphans. It makes me sad.’ 265 (school child enrolled in a programme in Nelspruit) 255

Impact evalution Zambia, Uganda, Mozambique, p.29 Impact evaluation Sri Lanka p 13-17 Impact evaluation Zambia, Uganda, Mozambique, p.23-26 258 Impact evaluation Latvia p 20 259 UNICEF Innocenti (2010: 28); Walker et al. (2007), Engle et al (2007) in: Woodhead, and Siraj‐Blatchford (2009: 6). 260 Woodhead, and Siraj‐Blatchford (2009: 34) 261 Impact evaluation Peru p. 94 262 Impact evaluation South Africa, p. 42-43, Romania 5 263 Impact evaluation Zimbabwe p. 17-20; 33 264 Impact evaluation Latvia 22 256 257

The SOS Children’s Villages Family Report 2012

Unfortunately, the school system often tends to promote a critical attitude towards at-risk children from socially vulnerable families, and educators can also significantly contribute to discrimination against these children. Programmes found that teachers often lacked awareness of the particular needs of vulnerable children, labelled them as unmotivated or problematic, physically punished them or made fun of them 266. Programmes that work on improving the learning environment in schools also address relationships between students, teachers and parents. Training of school representatives and teachers builds skills for working with distressed children, abuse prevention, counselling and child participation, and gives pupils more opportunities to share their concerns and receive emotional support. Regular meetings between parents and school authorities contribute to increasing the schools’ responsibility towards parents and the parents’ knowledge of the school success of their children. Such programmes have achieved considerable impact in committing parents, improving school attendance and even encouraging those who had dropped out to go back to school. 267 As peer pressure is one factor which sometimes motivates students to leave school, it is encouraging to see that it can also work in the other direction. Raising parents’ awareness about the importance of schooling can include advice on school admission and legal issues, career guidance, provision of information, counselling or engaging them in adult learning. Parents’ increased interest in the schooling of their children has been found in programmes on all continents to be an essential success factor for children’s school attendance 268 . It increased not only the emotional encouragement parents provide to their children, but also their willingness to contribute to related costs. Some programmes establish a policy of cost-sharing which involves families paying part of the school fees or materials, which is challenging but also allows them to develop ownership and commitment 269. The progressive abolition of school fees and provision of free primary education by many governments, particularly in Africa, has allowed SOS programmes to re-allocate resources more towards supporting families and children community who are most at need, and introducing tailor-made support systems. Case Study 9: Reducing school drop-out through family strengthening in Sauk, Albania ‘I would like to emphasize the importance of individual educational assistance that is offered to our children. Due to this and other kinds of support, my children have progressed a lot.’ (parent participating in the Sauk family strengthening programme)

Albania is one of the poorest countries in Europe with about 12.4% 270 of the population living in poverty, but also one of the youngest, with 40% of its population under 25. 265

Impact evaluation South Africa, p. 42-43 Impact evaluation South Africa, p. 42-43, Zambia, Uganda, Mozambique, p.23-26, Impact evaluation Latvia p 22-25 267 Impact evaluation Zimbabwe p. 17-20; Zambia, Uganda, Mozambique, p.23-26 268 Impact evaluation Albania 26, Impact evaluation Sri Lanka 43, Impact evaluation India 30-31, Impact evaluation Zimbabwe p. 17-20 269 Zambia, Uganda, Mozambique, p.23-26 270 World Bank (2008) http://data.un.org 266

The SOS Children’s Villages Family Report 2012

Migration is a popular option – 20% of the population has migrated to work abroad – especially among the young 271. Since the end of the communist regime, Albania has endured a difficult socio-economic and political transition. Social and political unrest in 1991 destroyed a lot of infrastructure, including schools. Public expenditure in education is the lowest in Southeastern Europe, at 3.25 percent 272. The difficulties faced by poor families in taking care of their children are compounded by the lack of basic educational and health care services. Albania’s school system suffers from ailing infrastructure, rural-urban disparities, outdated curricula and poorly-qualified teachers, The overburdened and under-resourced system contributes to school drop-out, especially among children with learning difficulties. Enrolment is particularly low among marginalized groups such as Roma and children with disabilities. 12% of children under 14 are engaged in child labour 273, mainly in the agricultural sector. SOS Children’s Villages runs three programmes in Albania to support socially disadvantaged families whose children are at risk of being abandoned. The programme in Sauk, a small community south east of the capital Tirana, started in 2003 and supported 170 parents with 232 children during 2009. One of the main programme aims is to support children’s schooling and prevent drop-out. Vulnerable children are identified in cooperation with social services and community schools. The programme provides not only material and financial support, but also educational assistance for children with learning difficulties according to their specific needs, developed in cooperation with the children, teachers and parents. The programme closely follows and supports the progress of children’s school achievements as well as their health and emotional status. It offers training courses on parenting skills and child rights as well as individual family counselling, and organises joint child-parent leisure activities. Parents have learned more about their roles and responsibilities, their children’s needs and the importance of their children’s education, and send them regularly to school. Parents, children, teachers are more aware of children’s rights. 63% of children say that their parents have stopped the use of violent disciplinary measures. 274 A remaining challenge is to involve more fathers in the activities. Families’ income and economic independence has improved through the programme providing material support, vocational training for women and employment assistance in cooperation with the regional employment office. 95% of participating parents reported that their housing and living conditions have improved 275, and this in turn contributes to keep children in school. The school drop-out rate of children in the programme has decreased. 95% of surveyed children attend school regularly and receive help from family members and educational assistants, and 60% have improved their school results 276.

271

UNICEF; http://www.unicef.org/albania/overview.html United Nations (2007), MDGs in Albania, http://www.un.org.al UNICEF (2005), http://www.childinfo.org/labour_countrydata.php 274 Impact evaluation Albania (2009:17) 275 Impact evaluation Albania (2009:39) 276 Impact evaluation Albania (2009:17) 272 273

The SOS Children’s Villages Family Report 2012

The local government is a strong programme partner and values the programme’s professionalism and way of working. Its comprehensive approach in supporting the various dimensions of family life and empowering parents and teachers has led to sustainable success in children’s psychological and educational situation. Offering proper and comprehensive learning environments Not all households provide optimal learning environments, giving children sufficient time and support for learning – an important factor in pupils’ attendance and performance. With the assistance of SOS Children’s Villages, schools in Africa and Central Eastern Europe created community-based resource centres which offer both students and community members a comfortable atmosphere and resources for studying and homework. These centres might include a library and tutor support, and they raise awareness on education among the whole community. Assistance through trained tutors or peer educators especially supports children with learning difficulties or whose parents have low educational levels and cannot help them 277 . Such centres provide group tutorials and child-friendly study groups, which are more efficient than individual consultations, and teenagers have been shown to be more willing to participate 278. SOS programmes have successfully partnered with public schools in introducing psychosocial issues into curricula, such as HIV/AIDS prevention, social skills, communication and conflict resolution or life skills training. Non-formal education programmes can also complement education where curricula are not able to be adapted. For effectively addressing school-drop out, it is important to analyse the gaps in the formal educational system and to provide alternative methods to those who are socially vulnerable and left out. For example, SOS programmes provide training on child rights and participation, life skills and social competences, and encourage the formation of “Children’s Clubs” which organise trainings, events and awareness-raising activities around issues such as child protection, sexuality, emotions, health and hygiene. Again, particular attention is required to support the participation of the most marginalised children. For example, a programme evaluation in Sri Lanka found that some children did not attend extracurricular activities because they were worried about lacking identity cards 279 Finally, it is important for educational programmes to prepare children for the labour market. SOS programmes therefore seek partnership with tertiary education and vocational training institutions, public departments and private companies to make sure that children from poorer and marginalised families have access to professional education after school graduation. In some countries, SOS Vocational Training Centres are run to help children acquire skills in different trades and professions such as brick laying, electrical installation, tailoring, carpentry, agriculture, information technology, hotel work and catering.

277

Impact evaluation Romania p 5; Impact evaluation Malawi p 64- 73 Impact evaluation Latvia p 20 279 Impact evaluation Sri Lanka p 13-17 278

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4.3 Key learnings and recommendations We need to raise awareness, as well as having binding measures for families that fail to send their children to school, and at the same time, supportive steps by public authorities such as free schooling, school uniforms, and free notebooks in particular. (SOS family survey Burundi)

For the cycle of poverty to be broken, the provision of affordable education and enabling children to remain in school is a must: •

Stakeholders responsible for education have to dedicate more resources and pay special attention to ensuring the quality of schooling, access to schooling and preventing drop-out among socially marginalised children such as those from poor families, rural areas, with special learning needs or disabilities or from ethnic minorities. Particular attention shall be paid to the situation of girls.

•

Targeted investments in early childhood education programmes are essential as a foundation for school performance and improving the life chances of children from disadvantaged households.

•

An adequate policy framework is needed to approach education beyond academic qualifications as a way to motivate children to see themselves as resourceful and unique human beings who can shape their own destiny.

•

Measures should be set to allow the whole school system to attend to the particular needs of at-risk children from vulnerable families, including training of school representatives and teachers, and encouraging the participation of children and parents in school affairs.

•

States should undertake a careful analysis of their formal educational system should identify gaps to improve existing curricula and providing additional nonformal education programmes to achieve a holistic and inclusive approach to education especially reaching out to vulnerable and left out children

•

Governments, educational institutions, companies and other stakeholders concerned shall develop targeted measures to end child labour and allow children involved in child labour to concentrate on their learning and development, including creating income opportunities for parents and supporting child-headed or other vulnerable households to keep children in school.

•

It is essential to support families and communities in creating optimal, childfriendly and well-supported learning environments, especially for children with learning difficulties lacking adequate support at home. Tailor-made programmes shall be developed to raise awareness on the importance of schooling and enable parents with low educational background to support their children adequately in their school success

The SOS Children’s Villages Family Report 2012

5. Economic pressures impact on parenting 5.1. The Challenge: Child care at risk The economic crisis has also severely impacted on parents’ caring and coping abilities. Inadequate living conditions and the struggle for economic survival create stress and despair, often furthering conflict, depression, alcoholism or violence. An increasing work-life imbalance is squeezing parents’ abilities to devote time to their children. Labour migration and other factors separate families and weaken their cohesion and resistance. Family poverty makes children vulnerable to violence, abuse, neglect and exploitation. Families in these situations require stronger support through community networks, information, public services and support structures. Poverty is reducing the adult’s capacity to take care of children (SOS family survey Angola)

Struggling for the basics with inadequate support puts pressure on families and undermines parents’ caring and coping abilities. Governments have a clear responsibility to support parents in their care-giving responsibility and to guarantee the rights of their children (see box B). If this support is not given, many structural and personal factors combine to weaken the abilities, particularly in poorer families, to provide quality care (see box I). How family poverty makes children vulnerable Limited access to information and low literacy result in a weak capacity of families on key child development issues. They lack appropriate knowledge on how to protect children and respect their rights. (SOS family survey Mozambique)

Families are main places of protection for children, and the loss of their family environment leads children to experience insecurity and makes them highly vulnerable towards all forms of violence, abuse, neglect or exploitation. Economic pressure on families however also increases the risks for child well-being within the family context, e.g. for being exposed to child trafficking and child labour (see chapter 4). Children who become victims of trafficking or live on the streets often report inadequate living conditions and parental violence as important factors for running away from home 280. A UN report associated the economic crisis and resulting deteriorating living conditions with cases of child abandonment and increased referrals to child protection services, both in developed and developing countries 281. 57% of girls who marry early come from the poorest households, in comparison only 16% from the richest 282. Early marriage increases their vulnerability, as they are less likely to receive formal education, and more likely to become teenage mothers or experience sexual abuse. The SOS Child Rights Situation Analysis Zimbabwe describes 280

Dottridge (2008: 12–13.); SOS-RELAF (2010: 11-12) Hossain (2009) and Eurochild (2009), in: United Nations (2011: 57) 282 UNICEF (2009c: 10, 26) 281

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some of the pressures on parents: ‘particularly in times of economic hardship parents marry off their daughters in exchange for food (kuzvarira).’ 283 Several studies indicate that poverty and the related inability to provide for their children might lead poor parents to place their children in alternative care 284. Despite a lack of data, the link between poverty and alternative care placement of children is evident in many countries; in Azerbaijan, Georgia, Liberia, Sri Lanka and Zimbabwe, assessments found up to 30-40% of care admissions were due to parental poverty 285. Box I: The importance of quality care in a family context Why is it so important to support positive parenting and a family’s care-giving capacity? A compelling body of research points to how children as agents of their own development learn in dynamic interaction with their family environment through identification, association, imitation, communication and repetition 286, in ways that can be self-reinforcing: For example, a highly verbal 2-year-old might encourage his/her parents to spend more time reading to him/her, which in turn supports the child to further expand his/her vocabulary 287. Attachment theory 288 affirms that children desire from the beginning proximity and a bond with their parents or primary caregivers. Evidence shows that the nature of this relationship forms a working model of the world which guides the child’s behaviour. Children whose relationships with their caregivers are ones of comfort, encouragement, support and cooperation tend to develop secure attachment, curious and open personalities, greater social competence, empathy and the ability to build relationships 289. Such relationships build resilience in adversity 290; they can protect children in situations of vulnerability and risk such as chronic disease or poverty 291, and reduce the impact of external stress factors 292. Studies show that the same effects are seen across different cultural contexts: Childrearing styles characterised by affection, shared time, responsiveness and reasoning instead of punishment, empathy and sensory stimulation all support a child’s growth and cognitive development 293. The consistent presence of at least one caring adult – not necessarily a parent, but also potentially a mentor or caregiver – is the most powerful predictor of resilience in children. 294

283

CRSA Zimbabwe: 27 Pinheiro (2006: 185), sub-chapter ‘violence against children in care and justice institutions’; SOS-RELAF (2010: 17); ATD Fourth World (2004: 138) 285 Williamson and Greenberg (2010: 8) 286 Bronfenbrenner & Morris (2006) 287 Harwood et al. (2008) 288 Developed by John Bowlby, Mary Ainsworth and others, Bowlby, J. (1969). 289 Bowlby (1973), longitudinal Minnesota study, which started in the mid-1970s (Sroufe, 2005) 290 Masten & Coatsworth (1998) 291 Laucht et al. (2000); Werner & Smith (1992) 292 Patterson (2002) in: Bernhard von Leer Foundation (2009) 292 Zeitlin, M. F. et al (tterson (2002) in: Bernhard von Leer Foundation (2009) 293 Zeitlin, M. F. et al (1995) 294 The best known and biggest longitudinal study on resilience is the Kauai Study, conducted by Emmy Werner and Ruth Smith, which documents the lives of 505 men and women, who were born in 1955 on the Hawaiian island of Kauai, from peri-natal period through early adulthood. (Werner & Smith, 1992). 284

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Poverty is linked to stress and depression Lack of good quality social services where families get additional support in difficult circumstances and crisis bring the families to situations where they do not know how to tackle the problems faced. As consequence, the situation in the family can deteriorate and often causes family breakdown. (SOS family survey Uzbekistan)

In both developed and developing countries, chronic poverty, economic uncertainty and the struggle to cover basic needs exposes parents to stress while reducing their access to the resources necessary to deal with this stress. Stress affects poor families in all kinds of ways: The struggle to assure decent housing and nutrition for their children, worries about being able to pay bills, the search for income and the worry of losing a job, social pressure to perform, chronic health problems due to insufficient nutrition, hygiene or healthcare. They can descend into a constant state of emergency and crisis, which undermines their stability. Poor families with many children often live in overcrowded and inadequate conditions, which increase tension: Insufficient privacy, space and quiet fuel child-parent conflicts and lead to social-emotional, behavioural and school adjustment problems in children 295. Such stress erodes the psycho-social capacity of parents to deal with their family situation. Studies found, for example, an increased risk of maternal depression in poor families 296, which in turn leads mothers to neglect children’s nutrition or healthcare needs or apply insensitive and punitive parenting practice. A parent participating in an SOS programme in Florida, Uruguay, expresses these tensions and pressures in the following way: ‘Always on the alert, we live a nervous life... sometimes we are angry at them (the children), I say... but... it is because of the life we have, isn’t it? If suddenly we could live economically better, we wouldn’t have such problems, so much thinking about… how we will manage... or what we will eat today...’297 The plight of single-headed families A lot of biological parents are single parents; they have a small social network, also because of unemployment. It is not easy; they accumulate difficulties without social or familial support. (SOS family survey France) Whiteout a regular job, mothers heading their family alone facing limits in adequate care for their children (SOS family survey Cape Verde)

A high level of family cohesion is found to reduce the impact of stress and chronic poverty on children and their families 298 . Studies have further shown that in difficult situations, families’ resilience primarily depends on the quality of the relationship between parents and children and the extent of support through community networks 299. 295

Evans 2004, Evans et al. 1998, Wachs and Corapci 2003, in: Wachs, Theodore; in: Bernard van Leer Foundation (2009: 6) Wachs, Black and Engle 2009, Beeber et al. 2008, in Wachs, Theodore; in: Bernard van Leer Foundation (2009:5 - 6) 297 Impact Evaluation Uruguay, Page 92 298 Wachs, in: Bernard van Leer Foundation (2009: 4) 299 Einzig, in: Oates (2010: 8) 296

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Often, poor families experience the opposite: The search for income tears them apart, constantly weakening their cohesion and care capacity. Often, one parent has to carry the burden of responsibility alone. Work-related migration (see chapter 3), rising divorce rates and other factors are giving rise to a growing number of single-parent households, in most cases women-headed 300. Single mothers carry the double burden of child-care and work, in often poorly paid jobs, and children are sometimes required to contribute to family income. Children of single mothers are not necessarily poorer, as women are more likely to dedicate resources to their children and access care support 301, and money earned abroad by migrating family members is also used to finance children’s education 302 . However, women often have relatively limited access to education, income, community resources or power, which increases their vulnerability and lowers their children’s developmental chances 303. Children in these families either have irregular contact with their fathers or – as in Africa, Asia and Latin America – rely on several ‘social fathers’ through ties of co-resident nuclear families 304. Studies in various cultural contexts found the absence of a father impacts negatively on the educational achievements and protection of children; children with present fathers had lower rates of psycho-social problems, were happier and more self-confident 305. Teenage motherhood persists and when young mothers are unmarried they can experience severe stigmatisation and cultural, economic and social pressure 306 to abandon their children, especially in parts of Asia, Africa, the Middle East and Latin America 307. Fathers are often either unknown or unwilling to help. Children born out of wedlock are at higher risk of losing care, as child admission trends into alternative are show: 90% of children living in SOS families in Egypt were abandoned after being born out of wedlock, 23%in India, 35% in Sri Lanka 308 . Girls growing up in single-mother households seem more likely to have an early pregnancy or a birth outside of marriage 309. Studies in the UK and United States found young, non-married mothers were more likely to be poor and have significantly fewer educational qualifications 310. Figure 25 illustrates the correlation between teenage pregnancy and poverty.

300

UN DESA (2011: 16); Cerrutti and Binstock (2009), Organization for Economic Cooperation and Development, 2010, table III.1, in: UN DESA (2011: 89) 301 Moore (1994: 7-11) 302 UNDP (2009: 27, 74, 55) 303 Moore (1994: 7-11), United States Census Bureau, 2003, UN DESA (2011: 56) 304 UN DESA (2011: 51) 305 Dubowitz and others 2004, McBride, Schoppe-Sullivan and Ho 2003; Mboya and Nesengani 1999; Lamb 2004; Carslon 2006; Flouriand Buchanan 2002; Schacht, Cummings and Davies 2009; Bernadett-Shapiro, Ehrensaft and Shapiro 1996; in: UN DESA (2011: 57-59) 306 ESCAP (2009: 43), CRSA Senegal (21), CRSA Romania: 16 307 SOS-RELAF (2010: 11-12), Cerrutti and Binstock (2009: 52) 308 SOS Children’s Villages International (2005: 11) 309 Ellis and others, 2003; McLanahan & Bumpass, 1988; in: UN DESA (2011: 59) 310 Carlson and McLanahan, 2010; UN DESA (2011: 95)

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Figure 25: Correlation between poverty and teenage mothers (Source: UNICEF, http://www.unicef.org/sowc2011/statistics.php, download: Dec 8, 2011)

The impact of lacking community support Families are left alone with child rights issues (…). There is no budget or institution engaged in training of families (…) Information has reached parents and caregivers in a distorted way. (SOS family survey Mexico)

Poor people often experience humiliation, despair, and a sense of shame and failure. This contributes to feelings of powerlessness and hopelessness, which in turn increases their vulnerability and undermines their self-belief in their ability to be ‘good parents’. Living in chronic deprivation often leads them to focus on negatives rather than their potential and resources. Research has shown that poor parents can provide children with quality care and maintain stability if they can be optimistic, share with others and receive backing through resources in their immediate social context 311 such as neighbours, friends, relatives, schools, community organisations and services which improve their access to basic benefits and knowledge on child care. Therefore, the development and promotion of such social support networks is crucial. In reality, however, the stress factors at family and household level are often worsened by the fact that poor families tend to be concentrated together in generally impoverished environments characterised by high levels of social and environmental problems 312 such as instability, violence and a lack of social services. In particular, single mothers and partners of migrant workers often rely on kinship and extended family networks for support and protection 313, networks which are increasingly being eroded 314 by modernisation, urbanisation, labour migration, demographic change 311

Zeitlin, Ghassemi and Mansour 1990; McKenry and Price 2005; Thoits 1995, in: Bernard van Leer Foundation (2009: 8, 11) Garbarino and Kostelny, 1992; Coulton et al., 1995 in Oates (2010:10) 313 Development Research Centre on Migration (2009: 24; 34) 314 Pinheiro (2006: 8), sub-chapter ‘violence against children in the home and in the family’; UNESCAP (2009: 7); Belsey, Mark A. (2005: 71); UN DESA (2011: 19, 51); ODI/UNICEF (2009b: 3) 312

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or HIV/AIDS. Where the care capacities of the extended family are overstretched, children living with relatives, informal foster carers or step-parents are at higher risk of domestic abuse, loss of property, sibling separation, child labour or emotional neglect 315. Where traditional support networks break, poor families are left to fend on their own. The absence of support exacerbates family stress and feelings of powerlessness 316, which in turn adversely affects the quality of child-rearing and subsequent child development. Children are most at risk in families with inadequate social support and a lack of surrounding social networks 317. Leaving families alone in raising and educating their children impedes children from reaching their full potential and can create negative long-term effects for society, such as high welfare and health system payments, crime rates or poor economic performance 318. Where parents have little power over their living conditions and struggle to survive, there is a great need for society to empower pro-active parenting and invest in knowledge around child rights, child protection and parental skill-building for the inter-generational cycle of poverty to be broken. When empowered and supported through information, services, resources and support structures, the majority of parents can acquire the skills necessary to support the development of their children. The UN Guidelines for the Alternative Care of Children refer to such provisions, as supportive social and family strengthening services and empowering youth policies 319. Box J: The dangerous mix of unemployment, alcoholism and domestic violence Alcoholism is one of the most frequent causes of domestic violence (SOS family survey Russia) Alcohol abuse is especially fuelled by unemployment (SOS family survey Namibia)

Domestic violence against children and/or partners is found in 20-60% of households around the globe 320, cutting across all social classes and cultural backgrounds. Many studies document the ‘intergenerational cycle of abuse’ – parents’ own experience of suffering violence during childhood makes them more likely to use violence towards their own children 321. While there are many reasons for family violence, and it affects the wealthy as well as the poor, it is especially linked to problems such as poor housing conditions, permanent stress and conflict. In industrialised countries, parents who live in poverty and lack education seem more likely to use corporal punishment in educating their children 322 . Women from poor households and with less formal education are also more likely to accept male

315

CRSA Kenya: 41; CRSA Malawi: 18, UNESCO (2011b: 114-115, 118-119) Torrado Pacheco, in: Bernard van Leer Foundation (2009: 11) Pinheiro (2006: 68), sub-chapter ‘violence against children in the home and in the family’ 318 Barnett, 2008a; 2008b in: Woodhead, and Siraj‐Blatchford (2009:: 7) 316 317

319 320

SOS Children’s Villages International, International Social Service (2010:12)

UN DESA (2011: 57) Contreras et al, in: Bernhard van Leer (2011: 26); UNICEF (2009c: 36); Gilbert, Ruth, et al (2009: 68–81); Pinheiro (2006: 68), sub-chapter ‘violence against children in the home and in the family’ 322 Finkelhor et al., 2005, in: Bernhard van Leer (2011: 8); UNICEF (2009c: 35, 36) 321

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beating 323. SOS Child Rights Situation Analyses in Albania and Palestine found reliance on beating was higher within poorer families 324. A United Nations report indicates that men who are stressed or ashamed as a result of unemployment had higher rates of alcohol use than men without economic difficulties, and were nearly 50% more likely to be violent against their partner 325 . The mix of parental unemployment and alcoholism seems to increase the likelihood of domestic violence. Men who lose their bread-winner status through unemployment feel powerless, take refuge in alcohol and abandon their parental responsibilities 326. Even though there has been progress in the legal prohibition of corporal punishment, globally only thirty, mainly European, states have achieved a full ban including the family home 327. Children experiencing domestic violence are severely affected in their health and development, including problems of attachment, trauma, fear, anxiety, insecurity and shattered self-esteem, and many might experience Post-Traumatic Stress Disorder and depression 328 . They face a higher likelihood of dropping out of school, have social difficulties and risk to later on perpetuate the intergenerational cycle of poverty and abuse. Again, those children exposed to chronic violence, multiple stress and without family stability – as is often the case in poor families – are more likely to suffer severe long-term consequences 329. Work pressure squeezes out time for children Parents have to work and earning for a living all day, they have no time to take care and educate their children (SOS family survey Vietnam)

Another issue which impacts on parental care quality around the world, regardless of the economic status of families and especially in times of crisis, is increased work pressure leading parents to dedicate less time and attention to their children. There is a rising ‘family versus work’ conflict for both mothers and fathers 330. The increasing participation of women in the labour force contributes substantially to alleviating the economic burdens in poor households. However, traditional gender roles and social norms change only slowly, and family policies are often not supportive 331. Women continue to be predominantly responsible for both child care and housework, and men make little use of available opportunities such as paternal leave 332 Mainly only full-time jobs are available for women and there is a lack of day care services 323

UNICEF (2009c: 7-9) 2002, in: CRSA Palestine, 81; MICS 2005 – INSTAT (CRSA Albania: 20) International Center for Research on Women and Insituto Promundo (2010), in: UN DESA (2011: 22) 326 Okwany (2007), In CRSA Kenya: 33; CRSA Lesotho: 26; CRSA Brasil: 28 327 NGO Advisory Council (2011: 10-11). Southern countries having a full ban are Costa Rica, Kenya, South Sudan, Tunisia, Uruguay and Venezuela. 328 Pinheiro (2006: 63), sub-chapter ‘violence against children in the home and in the family’; Bernard van Leer Foundation (2009: 6) 329 O’Donnell, Schwab-Stone and Muyeed 2002, in: Bernard van Leer Foundation (2009: 7) 330 UN DESA (2011: 65) 331 The World Bank (2011:14); Marcela Cerrutti, Georgina Binstock (2009: 41-44) 332 UN DESA (2011: 53); The World Bank (2011: 88); Fursman and Collister (2009) in: UN DESA (2011: 66) 324 325

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for children younger than 3 years old (SOS family survey Hungary)

States have not yet responded by establishing sufficient publicly subsidised child care services, especially for poorer families, workers in the informal sector and rural areas 333. This is important to ease the conflict of parents and guarantee working families access to quality child care; however, it does not resolve the issue of children needing quality time with their parents. There is a need to debate the compatibility of family life and job commitment, and to create more flexible working arrangements, adequate financial care compensation schemes 334 and community support systems. The few studies available from Asia and Latin America suggest that work-life balance of parents is a global concern but there is a need for more research 335 – particularly in Africa and the Middle East, and also among low-income families – to be able to determine the scale of the challenge and define adequate responses to safeguard quality care in families, also in times of increasing economic pressure.

5.2. The Response: Supporting quality care among caregivers and communities We train families to increase their motivation for participating in the development process of their children and to enhance their opportunities in relating with them (SOS family survey Ecuador)

Strengthening caring family environments and supporting communities and parents to provide quality care to their children naturally lies at the heart of the SOS Children’s Villages programmes. Besides dealing with the multiple and cumulative structural and socio-economic risk factors undermining the provision of quality care at environmental and household levels, as described in previous chapters, programmes centre on the psycho-social and care aspects of family life. Programmes seek to address and mitigate factors hampering parental capacity, as well as to build on and strengthen the assets each parent and family has to overcome adverse situations, cope with life independently and build a loving and caring family environment. This is addressed on various levels: 

  

Supporting and providing strengths-based and tailored parental skill-building so that parents and other care-givers develop the attitudes, knowledge, skills and capacity for creating a positive family environment and providing loving quality care to their children. This includes also caregivers in alternative care provision such as foster carers and SOS parents; Supporting and providing activities for children to strengthen their self-confidence and family communication, and give them knowledge about their rights and responsibilities; Initiating and organizing joint family activities to support families in spending time together, getting to know each other and improving their relationships; Supporting and providing ‘child-competent’ capacity-building and knowledge-sharing for and with communities, duty bearers and service providers to develop the

333

World Bank (2011, 26-27 222) World Bank (2011: 26-27, 222) 335 Kim and Kim, 2004; Kusakabe, 2006; Sorj, 2004; Reddock and Bobb-Smith, 2008 in: UN DESA (2011: 66-67) 334

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

capacities, resources, systems and structures necessary to make appropriate responses to the protection and care of individual children; Influencing the social, cultural, economic and legislative framework conditions on community and state level to empower parents and caregivers with the necessary strengths and skills to provide stable and caring relationships.

Quality care in a loving family environment SOS Children’s Villages believes that any understanding of ‘quality’ care must be based on a child development perspective 336. Research (see Box I) shows the importance of loving and stable relationships between children and their parents, siblings, or other consistent caregivers as a foundation for healthy emotional, intellectual, physical, social and spiritual development of children and in supporting them to develop resilience and self-confidence. In accordance with the UNCRC, SOS Children’s Villages believes that children’s development is best realised in a caring family environment, involving children as agents of their own development in taking decisions in their best interests, respecting their rights. Supported by strong social networks, families can enable children to develop to their full potential. However diverse cultural expressions and approaches to child-rearing are around the globe, the essential qualities of reliable relations, belonging and attachment shape family life. 337

A caring family environment ‘Within a caring family environment, the child can form reliable, supportive and lasting relationships with his/her parents (or other care-giver) and siblings. Here, the child’s emotional and physical well-being is secured; he/she can live his/her childhood to the full; and prepare for a future where his/her potential is fulfilled. The role of the child in his/her own development is recognised and he/she is involved in decision-making affecting his/her life, according to his/her age, maturity and abilities. The holistic development of the child is promoted and supported. Within a caring family environment young people find a secure base from which they can take steps to become self-supporting and contributing members of society.’

SOS Children’s Villages promotes this understanding of quality care in family strengthening programmes, in the alternative care sector and on policy level. During 2012, SOS Children’s Villages is launching a global campaign on quality care to promote quality care in international and national policy. Based on the UN Guidelines for the Alternative Care of Children, national social support systems will be assessed in relation to their capacity for supporting families and children at risk or without parental care. The campaign aims at improving national child care and social welfare systems. Strengthening families individual caring and coping capacities Participating families are trained in pedagogy of tenderness, positive education, and participate in sports, cultural, and other activities where they learn about teamwork. (SOS family survey Mexico) We support parents and children on improving family ties, child protection and child rights, and support child participation in decision making through child clubs 336 337

SOS Children’ Villages International (2011: 12) Quoted from the SOS Children’ Villages programme policy (2009: 5)

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(SOS family survey Sri Lanka)

SOS programmes work with individual families to find targeted responses for their specific situation. Training and counselling enable them to discuss and address their risk and stress factors, such as unemployment, economic strains, illiteracy, educational weakness, sickness or disability, conflicts, personal crises, psychological disposition, domestic violence, alcoholism or drug misuse. At the same time, the underlying strengths of each family are made visible and supported. A resource-oriented approach looks at interpersonal relations, communication patterns, potential areas of conflict, problem-solving and social support skills, existing personal attributes and resilience of each family member, and helps the family to develop a positive and warm atmosphere, where everybody is listened to and valued. In general, as an outcome of family skill-building, programmes globally note better intrafamily communication and relations, positive conflict-resolution, application of positive discipline in child-rearing, decrease of family violence, increased self-esteem among especially mothers, higher self-motivation among family members, more time spent together, and better family management skills. Case study 10: Improving parental skills among foster parents in Carinthia, Austria ‘The majority of foster parents have responded very positively. As a civil society organisation, we are regarded by parents to have some distance from the child and youth welfare services, which allows us to establish a higher degree of trust and partnership with them, and leads to good results for children in care.’ (Psychologist, Foster Parents Service Moosburg)

Despite a good general welfare situation, around one million people live below the national poverty line in Austria, and the poverty rate is higher among children than in the general population 338. Every year around 20,000 married couples in Austria divorce, and 175,000 children were living with single carers – the overwhelming majority mothers – in 2009 339. Over 11,000 children live in some form of alternative child care 340, nearly 40% of them in foster families, in many cases for longer than five years. SOS Children’s Villages Austria has developed counseling, support and skill-building programmes to strengthen families in crisis. In 2002, the province of Carinthia realised that its foster care system had little infrastructure in place to guide the 300 foster parents in the region and monitor the quality of the care given. The local government approached SOS Children’s Villages as an experienced partner to initiate a programme in setting quality standards and providing guidance to foster families. At present, the Foster Parents Service guides and mentors nearly 100 foster families. The families either make contact directly or are referred by local child and youth welfare services. The programme aims to strengthen foster parents’ parenting and coping skills by providing counselling and support. Foster children often come from a difficult social 338

EU-SILC 2009, in: Statistik Austria, Bundesministerium für Arbeit, Soziales und Konsumentenschutz (2010). The poverty line is 60% of the median-per-capita-household income Annual yearbook (2008) and family- and household statistic (2009) in: Austrian Institute for Family Studies (2009: 7, 11) 340 Bundesministerium für Wirtschaft, Familie und Jugend (2010), http://www.bmwfj.gv.at/Familie/Jugendwohlfahrt/Seiten/Statistik.aspx 339

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background with specific psycho-social needs; they might have bonding problems after a series of different care placements. Social workers and psychologists advise families and help them in documenting a child’s development and identify the child’s additional support needs. The programme provides obligatory annual training in child care for foster parents. Frequent talks are held between foster parents and one of the Foster Parents Services psychologists; who also offer professional mediation between the foster family and the child’s family of origin. Since 2010, the programme has included age-appropriate emergency foster care for babies and young children in psychosocial emergency and crisis situations, provided by five specifically trained emergency foster families. The crisis placement lasts between eight to twelve weeks before long-term and sustainable care solutions for the children are found. The relationship between the programme and the foster parents is characterised by a high degree of trust, personalised support and continuity. Every foster family has one support person to rely on, the families feel confident and well-informed in their childrearing. An additional asset is that the programmes’ advocacy and quality efforts have contributed to a better recognition of the foster parent model, allowing foster parents to receive social benefits such as insurance coverage and a pension fund. The number of participating foster families is constantly rising and the programme has led to better outcomes and quality support for the children in care. Participatory family development planning ‘The families and communities hold the key to effectively addressing their situation. They can find the best solutions for the protection and care of their own children and they have the capacity to bring them into reality. We can only support them to make it happen.’ (SOS Community Development Advisor, Southern Africa)

Programmes supporting family skill-building require patience in establishing trust relationship with families, helped by a welcoming and supporting attitude of programme staff. In many countries, social assistance work has traditionally focused on providing social benefits and material assistance, and workers in the social welfare system need to be trained on a new participatory approach to working with and empowering families. Social work training curricula sometimes require improvement related to working methods, the complexity of problems families face, and new forms of multi-disciplinary cooperation. An individualised approach is also more resource-intensive and might require additional staffing. SOS programmes use the family development plan as a structured tool to support the self reliance of families and engage them in their own development. Assisted by social or community workers, families set their own goals, look at each family member’s needs and priorities, document progress, and record and coordinate different types of support they receive. These plans enable participating families to take their own personal and household decisions despite ongoing external support, and progressively decrease family vulnerability.

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High-risk families are especially difficult to reach and motivate I understood that it is not the child who is responsible for the difficulties but we all together have come to this situation. (…) Now I know that I can tell my children a lot of things, well, how we are doing and so. I feel there is some trust between us now (parent participating in a programme in Valmiera, Latvia 341)

While improvements are visible, even for families with very limited capacities, a lot of programmes report that some families are unmotivated and difficult to work with. Often, these are ‘high-risk’ families, those which are especially vulnerable and affected by various risk factors. Such clients typically lack income and employment in combination with psychological problems, and deficits in life skills or social relations. A programme in an urban area in Latvia found that more than two-thirds of the interviewed high-risk families admitted difficulties in relationships with their children, a lack of skills on how to raise them, and family disagreements and conflicts. In half of the families, at least one caregiver had a problem of alcohol abuse 342. Such high-risk families may easily develop dependency and find the goal of becoming self-reliant in the care of their children to be too ambitious. Further, when caregivers are unwilling, it becomes more difficult to work with and support children. In cooperating with these families it is important to make a good assessment of the multiple and interrelated challenges they are facing and a careful joint determination of the process toward selfreliance, to set goals in a focused and step-by-step way, and to use techniques such as motivational interviewing. A programme evaluation in Latvia looked at factors that define these high-risk families 343:  Caregivers have either a low ability to identify their problematic situation, or they lack self-esteem and hope to look for or accept support;  Families are located in remote or under-resourced areas outside the reach of supportive institutions and fall through the nets of diagnostic social worker visits;  Community members or specialists who deal with the family (kindergarten or school pedagogues, social workers, etc.) fail to recognise signs of required support (e.g. child neglect, family violence);  Social isolation results from these families being insufficiently embedded in social networks such as neighbours, relatives and friends, meaning nobody provides information or advice about seeking assistance. Case study 11: Improving parental skills through a holistic approach in Peru ‘The most important factor for the awareness of prosperity is self-esteem: believe that you can do it, that you merit it, that you will reach it.’ (programme responsible Peru)

The communities in which the ‘Family strengthening and communitarian development’ programmes operate are located in the periphery of the five most populated cities in Peru: Lima, Cusco, Junín, Arequipa and Lambayeque. The communities are characterised by concentrated poverty, social exclusion and cultural diversity as much of the population was internally displaced by the political violence which took place in Peru 341

Impact evaluation Latvia (31-32) Impact evaluation Latvia (p. 29) 343 Impact evaluation Latvia (p. 14-16) 342

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from the 1970s to the 1990s. Around 67% of the people living there have no direct access to drinking water, 48% of houses have no sewerage and 66% no regular access to electricity 344. Family life is characterised by a unemployment, psycho-social problems, drug abuse, sexual and domestic violence and the prevalence of gangs. This environment contributes to family disintegration and child abandonment. As in all Latin American SOS programmes, efforts are based on the protection and integral development of children and the development and empowerment of women, family and community. Services offered to children aged 0 to 8 comprise day-care and health, nutrition and educational support, which aim to address deficits in health and education service provision by the state. More than 186 community households have been registered to the programme within the last three years 345 , all led by family committees with elected parent representatives. These family committees represent a leadership structure within the community, representatives are appointed by families to take responsibility for joint decision-making in the programme. They further organize trainings, workshops and campaigns to inform the local community, for example on issues related to health, education or parenting, and influence required change at the local government level. Activities targeting women (literacy courses, training on finding work, sexual and reproductive health workshops, and group work on personal development and human rights) result not only in increased self-esteem and paid employment, but also in the improvement of parental skills. After participating in the programme, mothers become more aware of their own importance and all women who have been in the programme for two years have started, despite increased work responsibility, undertaking more joint leisure time activities with their children 346 . Parents further express overwhelming satisfaction with their children’s improvement in areas such as nutrition, health and schooling, but equally they appreciate the children’s improved personal independence and responsibility 347. Interestingly, within the first year of programme participation family conflicts actually increase (by an average of 30%) due to changed family roles and women knowing their rights. Training on dialogue-oriented conflict resolution is important. Conflicts then decrease, and after five years of participation all families indicate that they “rarely” have conflicts 348. While women participating for more than two years in the programmes less frequently use corporal punishment as a disciplinary measure, they still do so to a certain degree; the use of physical violence is highly tied to chronic poverty and a low level of parental education 349, which require even more specific interventions. The community control and protection mechanisms of the family committees are helpful. Asked about the personal benefits of their participation, 94% of participating mothers emphasised as most important the significant improvement of the relationship with their children, followed by their personal development (88%) and a better home organisation

344

Households national survey on live and poverty / Encuesta nacional de hogares ENAHO (2005), National Statistics Institute INEI, in Peru Impact and Evaluation Report (2007: 20) Peru Impact and Evaluation Report 2007 Page 94 346 Peru Impact and Evaluation Report 2007 Page 35 347 Peru Impact and Evaluation Report 2007 Page 83 348 SOS Children’ Villages Continental Office Latin America (2007), p 5-6 349 Peru Impact and Evaluation Report 2007 Page 31-34 345

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(86%) which allows them to improve their work performance. 350 40% of participating families are female-headed, and around 60% of the women live with the fathers of their children. Participation in the programme increased their desire for men to participate more in child-rearing. Case studies of single participating women show that their personal and professional development, independence and satisfaction are positively impacting on their childrenâ&#x20AC;&#x2122;sâ&#x20AC;&#x2122; development, schooling and personality. Also, the increasing recognition and participation of women in the community and resulting self-esteem impact positively on their relation with partner and children 351. The programme shows that the improvement of parental skills is a result of many interlinked factors such as the personal development of parents, their relationship as couple, their educational level and working conditions, their family income and household organisation 352. Addressing the lack of social networks The family committees taught us to live in community and collaboration, We met in homes and spoke of our problems, not only about money but about real problems, how we could help each other, we sat together and decided how to go ahead, this has strengthened us more. 353 (mother participating in a programme in Potosi, Bolivia )

Social networks are essential protective factors in difficult situations both on family and community level. For a sustainable change in the situation of families, it is important to get the commitment of the community and to create social support networks. If networks are weak and communities indifferent, this is visible through unresponsiveness to the needs of children and families, a low degree in reporting incidences of violence and lack of commitment of responsible institutional or community officials - which all impacts negatively on community coherence, child safety and well-being. The programme approaches to supporting community networks depend on the sociocultural context. While generally to be easier where traditional community protection networks still exist, programme evaluations demonstrate that even in a modern urban environment community commitment and mutual support can be increased. This can work through the establishment of self-help groups, involvement of volunteers, and creation of neighbourhood networks, community actions or citizen advocacy. Such responses are even more appreciated when individual families feel isolated with their problems, as is frequently the case in urban settings, and programmes help to tear down social barriers. Regardless of whether the context is urban or rural, developed or developing, most families appreciate community-sharing and social network building. Programmes found that participating families are willing to share their experience and knowledge with other families and positively respond to self-help groups and self-organised community networks. For example, while single mothers in a programme in Belarus felt they did not yet have the skills and motivation for independent decision-making, they also underlined

350

Peru Impact and Evaluation Report 2007 Page 79 Peru Impact and Evaluation Report 2007 Page 110 352 Peru Impact and Evaluation Report 2007 Page 90 353 Impact Evaluation Bolivia, p 90 351

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the importance of the programme’s initiative to create opportunities aimed at supporting each other to solve family problems. 354 Case Study 12: supporting a safe environment and positive parenting for children in SOS families in Bangladesh ‘Because of Child Protection Policy we are able to share our opinion freely. We are not facing any punishment, which is good.’ (boy living in a SOS family in the capital Dhaka)

Although Bangladesh was one of the first countries to have ratified the Convention on the Rights of the Child and the government is continuously working to improve the child rights situation, the number of reports of violence has been increasing significantly. Police and the courts apply ‘safe custody’ and keep children unnecessary in jail 355 . Domestic disputes take place frequently, but remain the most underreported crime 356. 65% of girls are married before age 18 357 and often exposed to violent behaviour. Studies among women in Bangladesh found behavioral problems of children in violent households such as bed-wetting, nightmares, aggression or timidity 358. Not surprisingly, most of the 1,099 children who are currently growing up in SOS families had experienced violence, neglect and trauma before coming into alternative care. Therefore, it is all the more important that a caring and protective environment is created and maintained to support the children in coming to terms with their past and developing resilience and confidence for the future. The initial step was to raise awareness of child abuse. The SOS Children’s Villages International Child Protection Policy was translated into the local language and child protection workshops and trainings are conducted regularly. They aim at sensitising not only caregivers, but all employees and the children themselves, who highly appreciate learning about their rights: ‘I like the fact that I now know more about children's rights. This will make it easier to recognise if my rights are violated. 359 Drama and film shows and essay and debate competitions bring the topic of child protection to children and young people in an understandable and entertaining form. Girl clubs offer a platform for debate and counselling only for girls, as they are especially vulnerable in Bangladesh’s social patrimonial structures. A “Code of Conduct” has been developed and signed by mothers, teachers and other employees intending to foster respectful and dignified conduct towards children and to keep them safe from any kind of abusive behaviour. Besides awareness raising and prevention, reporting of and responding to abuse is enabled through several “Child Protection Teams” on national and programme level throughout the country. They consist of trusted persons elected by children and youth and play an active role in responding quickly to any kind of information regarding child abuse. Other complaint mechanisms that are easily accessible for children, such as complaint boxes and child helplines, are established and communicated. 354

Impact Evaluation Belarus, p 47 Pinheiro, Sérgio (2006: 192) United Nations (2005: 62) 357 Pinheiro, Sérgio (2006: 59) 358 Pinheiro, Sérgio (2006: 64) 359 SOS Children’s Villages International (2008: 21) 355 356

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Violence and corporal punishment against children exists throughout Bangladesh and is widely seen as ordinary. Mindsets on child rights need to change, and this takes time and patience. In particular, teachers initially complained that some children would take advantage of the change in discipline through increased disobedience, and that more guidance in working with difficult children was required. Some employees experienced difficulties in openly discussing delicate subjects, but felt progressively more comfortable and at ease. They changed their attitude towards children and learned concepts of violence-free upbringing, such as positive discipline. Children are now aware of their rights and can actively claim them. Their voices are heard. The experiences SOS Childrenâ&#x20AC;&#x2122;s Villages has gained during recent years have been shared with other NGOs and stakeholders. In 2012, a seminar on child protection is planned with like-minded organisations to start raising awareness among local families and communities, because child safety is everybodyâ&#x20AC;&#x2122;s business.

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5.3. Key learnings and recommendations There is a need for more law enforcement, information dissemination and capacity building for parents around child's rights and child protection (SOS family survey Indonesia)

A holistic approach has to be developed to adequately support and empower parents with the necessary framework conditions, attitudes, capacities and tools they need to provide a secure and loving environment and quality care to their children. •

Recognising the severe impact of poverty and resulting stress on parental care capacity, national policies should put specific emphasis on developing and implementing appropriate support structures, measures and services preventing child abandonment and family separation, as set forth in UN Guidelines for the Alternative Care of Children.

•

Central and local authorities shall promote the development of neighbourhood and community social support networks for poor and marginalised families and set measures for making their environments child-friendly and safe, furthering their access to necessary infrastructure and their social and economic integration.

•

An adequate policy framework and appropriate support measures shall address the situation of single-headed families, in particular teenage mothers, and assure their access to economic and social resources, skill-building and participation.

•

Governments and companies shall respond to the increasing problems around insufficient work-life balance and assure compatibility of family life and job through, amongst others, adequate financial care compensation schemes and community support systems, more flexible working arrangements, in-depth research, and establishing sufficient publicly subsidised quality child care services. Particular attention has to be paid to families with less income, single carers, workers in the informal sector, the situation in rural areas and urban slums.

•

State parties shall commit to the legal prohibition of all corporal punishment and set adequate measures to protect children from domestic violence and neglect, including promoting positive parenting and raising awareness on and addressing social and cultural practices impacting negatively on the rights and well-being of children and women.

•

Social work and assistance shall adopt a participatory, individualised, resourceoriented and holistic approach to working with and empowering families, and receive adequate training and resources for implementing quality support and comprehensive capacity-building measures. Special attention should be given to reach out to high-risk families likely to fall through the nets of supportive institutions

The SOS Children’s Villages Family Report 2012

Kommentar [SI4]: References from previous part two (SOS work and case studies) still to be included

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