Introduction
The government of Rwanda is deeply committed to ensuring that all children can grow up safe and protected in families. In collaboration with UNICEF, it has established the Tubarerere Mu Muryango (TMM - Let’s Raise Children in Families) programme to ensure that all children living in institutional care in Rwanda are reunited with their families or placed in suitable forms of family-based alternative care. The TMM programme began in May 2013: Phase 1 was evaluated in 2017 using a combination of quantitative and qualitative methods to consult 289 individuals.
Rationale for the TMM programme
The programme was started in response to the large numbers of children growing up in institutional care in Rwanda, with a survey conducted by the Ministry of Gender and Family Promotion and Hope and Homes for Children in 2011-2012 showing 3,323 children and young adults in government-registered facilities alone. Global evidence suggests that institutional care can be deeply harmful to children’s wellbeing and development. The use of institutional care also contradicts Rwandan cultural norms around the value of the family, and government policies. De-institutionalization was seen as catalyst for the wider strengthening of the child protection system.
Aims and activities of the TMM programme
The TMM programme Phase 1 aimed to ensure that the children and young adults living in institutional care were placed in families and communities, and that further institutionalization was prevented. Key project activities included:
- Strengthening the National Commission for Children (NCC) and developing national standards and guidance on children’s care
- Recruiting and training 68 professional social workers and psychologists, and absorbing these professionals into the civil service
- Providing support packages to the families of reintegrated children, to young adults leaving care to live independently and to 1,000 foster carers
- Preventing further institutionalization, including awareness-raising and the use of short-term emergency foster care
- Enabling 29,674 community volunteers (known as Inshuti z’Umuryango (IZU) or Friends of the Family) to monitor vulnerable children and families, help prevent unnecessary separation and reintegrate children into family care
- Transforming residential care facilities into centres for community outreach that support reintegration and prevention efforts
- Developing case management and monitoring and evaluation (M&E) systems.
Outcomes of the TMM programme
- A dramatic reduction in the number of children in institutional care: At the end of TMM Phase 1, 70 per cent of children (2,388 of 3,323) had left institutional care and been reintegrated into families or placed in foster care. Leaving institutional care had improved children’s lives in a number of respects including stronger family relationships, reduced stigmatisation, and a greater sense of belonging and identity. A number of young adults who had grown up in institutional care had also learnt to live independently.
- Stronger government agencies responsible for care reform, and a professional child welfare workforce: Due in part to the TMM programme, the NCC is now a fully functioning government agency with a cadre of professional social workers and psychologists. A total of 68 social workers and psychologists were recruited and trained through the TMM programme, 30 of whom have been absorbed into the civil service. Children in general feel satisfied by the support they received, though many would like to see social workers/psychologists more frequently.
- The development of IZU community volunteers: 29,674 community volunteers were recruited and trained. Church and community leaders were also utilised to spread awareness of the importance of family-based care.
- The provision of range of care choices for children and support to families: Support was provided to children’s biological families, to kinship carers and to foster carers, ensuring that children leaving institutional care had a range of options. A total of 1,102 foster carers were trained through the TMM programme and 1,601 families received a social assistance package. Social assistance included educational support, medical care, counselling, clothing and livelihoods support. Many families were also supported by NGOs and through national social protection programmes, though some still felt they needed further support.
- Cooperation and transformation of institutional care: An approach of engagement rather than enforcing compulsory closure led to many care homes being transformed into community outreach centres, providing family support, schooling and early childhood development interventions.
- Prevention of further institutionalization: TMM put in place a range of mechanisms to prevent children from entering institutional care including the mass closure of institutions, a two-year mass media campaign, the development of emergency foster care, work with teenage parents, and closely monitoring remaining facilities to check that they were not allowing new children to enter.
Sustainability and efficiency of TMM
The evaluation suggests that the programme used resources efficiently and sustainable with five factors responsible for this:
- Government commitment and ownership of the process.
- The lower cost per child of family-based care compared to institutional care.
- Basing programme design on research and piloting.
- Community mobilization and the use of volunteers.
- Effective partnership and coordination.
The evaluation also found that reintegration was more sustainable when supported by a professional social workforce to support vulnerable children and their families.
Remaining challenges and priority next steps
Despite these successes, some challenges remain:
- At the time of the evaluation (September 2017), approximately 900 children still needed to be reunited with families and supported to effectively reintegrate in communities, or to be placed in foster care.
- Further support is needed to enable children with disabilities to integrate into family care.
- There needs to be greater government ownership of care reform and of child protection structures at district level.
- Social welfare staff workloads need to be reduced, the number of professional social welfare staff increased, and the capacities of IZU further increased.
- Social assistance packages are not yet available to all families.
- Some managers of residential care facilities remain resistant to change.
The evaluation suggests that the most urgent challenge is to augment the capacity of the professional social workforce and the community volunteers. This will have a positive impact on all of the other challenges. It is therefore recommended that TMM Phase 2 focuses particularly on building cadres of professional social workers and community volunteers.
