Cost Benefit Analysis Results and Proposed Alternative Child Protection Policy in Tajikistan The 2nd Child Protection Forum: Building & Reforming Child Care Systems in Central Asia Maastricht Graduate School of Governance Maastricht University Bishkek, May 2009

Background Tajikistan is a country of children o More than 50% of families with 4+ children Children have higher poverty risk Vulnerable/needy children entitled to social protection (insurance/assistance/care) o Complex and inefficient system o 9,500 children living in residential care (2008) Pilot projects for a comprehensive child protection system (supported by Unicef) o Diversion projects for youth in conflict with law o Pedagogical, medical, psychological consultation o Parents education center/Kindergarten Inclusion projects o Child Rights Departments at district level

CBA: Questions to answer What are costs and benefits of traditional versus alternative child protection services? What is the level of potential savings that can be achieved by transforming existing institutions? Will fiscal space be sufficient for financing alternative community-based services for children and their families?

Current child protection system Residential care o Boarding schools for vulnerable children (orphans, children with minor disability, children from poor families) o Childrens homes (for children in the first years of life) o Special school and special vocational school for children in conflict with law o Sanatorium for disabled children Social pension for full orphans Cash compensation for poor children

Alternative child protection system: family-based, with support services Child Rights Departments (CRD) CRDs provide assistance to children with disabilities, deinstitutionalized children, arrange for guardianship (placement of children in homes of relatives), adoptions. They also play a gate keeping role to reduce the number of children placed in residential institutions. Psychological, medical, pedagogical consultation centers (PMPCC) These units provide diagnosis, referral and therapy for children who have physical and mental disabilities. The PMPCCs try to integrate children with disabilities into mainstream kindergartens and schools. They play a gate keeping role to reduce the number of children placed in residential institutions.

Juvenile Justice Alternative Projects (JJAP) The JJAP provides rehabilitative services for juveniles who have committed minor offences, as an alternative to residential placement. Not included due to insufficient data: o Parents education center/Kindergarten inclusion projects o Other pilot projects Alternative child protection system: family-based, with support services

Costs Direct costs o Capital costs (construction, maintenance, purchase of equipment, etc.) o Recurrent costs (salaries, food, transfers, etc) Indirect costs o Pressure on social assistance

Issues in data collection and data analysis Financing of current institutions vary greatly across types and districts (e.g. from less than 1 somoni per child per day to more than 7 somoni per child per day) Contributions in kind to current institutions are not systematically recorded (e.g. contributions by local sponsors or families), which makes it impossible to estimate them reliably.

Issues in data collection and data analysis Information of costs of alternative programs is available, but sometimes without details (e.g. costs of JJAP are recorded in broad categories) Its too early to document impact of improved conditions of children on their adult life (e.g. benefits on their health or productivity)

Remarks about the CBA analysis The CBA analysis is based on the comparison of four policy scenarios: the current policy scenario and three scenarios that represent policy alternatives The number of children living in boarding schools is kept constant in the current policy scenario, while the number of institutionalized children increases over time The alternative scenarios differ from each other with respect to the rate of de-institutionalization of children, the number of CRD, JJAP and PMPC adequately implemented and the level of guardianship allowance

Results: estimates of costs of the traditional versus alternative child protection services The current policy is more costly than any of the alternative policies in the long term mainly because of the high operation costs of residential institutions.

In the scenario of high de-institutionalization, the cost per child of the alternative policy would be less than half of the cost per child of the current policy by year In the scenario of low de-institutionalization, the cost per child of the alternative policy is still 20 per cent less than the cost per child of the current system (by the same year). Results: estimates of costs of the traditional versus alternative child protection services

Benefits of de-institutionalization Direct benefits o Reduced number of children living in residential care Indirect benefits o Increased productivity in adult life: Institutionalization affects negatively the productivity of children in the adult age. Improved emotional, mental and physical well-being of de- institutionalized children is expected to have a positive impact on the childrens future earnings. Children living in family environment have better scores on developmental measures, fewer medical, cognitive and behavioural problems higher enrolment rates and educational achievements

Results: estimates of benefits of the traditional versus alternative child protection services As the alternative programs also focus on improving skills of children, a long term impact on their productivity might be observed.

Issues: current financing Expenditure on institutional care has increased significantly in recent years (from 2006 to 2007, it increased 21 per cent, reaching 10 MTS). Expenditure on social assistance to children and their families has also increased considerably Still, conditions are precarious

Issues: long-term financing Step-wise transformation of the system gradually creates fiscal space Long term: savings from transformed institutions gives flexibility to policy- making process Resources would be sufficient to finance alternative system, including o Training of social workers o Guardianship allowance

Results: estimates of sufficiency of fiscal space to finance alternative social services The fiscal space created by closing traditional institutions would cover the costs of implementing the alternative programs.

93,84652,88232,05219,71012,0766,9033,6171, ESTIMATED DIFFERENCE BETWEEN FISCAL SPACE CREATED AND NEEDED EACH YEAR (THOUSAND TS) LOW DE-INSTITUTIONALIZATION (ESTIMATES) 315,654195,541126,56981,98352,36432,29018,6099,4933, ESTIMATED DIFFERENCE BETWEEN FISCAL SPACE CREATED AND NEEDED EACH YEAR (THOUSAND TS) HIGH DE-INSTITUTIONALIZATION (ESTIMATES) 230,438140,19689,19756,77135,61421,50612,1035,9912, ESTIMATED DIFFERENCE BETWEEN FISCAL SPACE CREATED AND NEEDED EACH YEAR (THOUSAND TS) MODERATE DE-INSTITUTIONALIZATION (ESTIMATES) YEAR The fiscal space available after covering the costs of implementing the new programs might be used to strengthen the capacities of the child protection system (e.g. by training social workers). Results: estimates of sufficiency of fiscal space to finance alternative social services

Prior to the de-institutionalization of children, new components should be introduced to the system (CRD, PMPC, JJAP, and other services). The process of de-institutionalization of children should be conducted gradually and selectively (i.e. only children who shouldnt be at institutions) In the short term, additional investments are necessary to deal with plausible increments in the public expenditure in child protection. The new child protection system should acknowledge the relation between the well-being of children and the well-being of their families. In this respect, monitoring the conditions of children at home is a crucial aspect for the success of the reform. Final remarks

The current financial crisis puts further pressure on the government budget, and the funding of existing institutions for children. In that context, the establishment of cost-efficient appropriate alternative services should be given priority. The financial planning of alternative child protection should become part of a broader Medium Term Expenditure Framework process. The reform of the child protection system benefits should form an integral part of the overall reform of the social service and social protection system in Tajikistan. The different components, such as the reform of the benefit and service system are mutually reinforcing. Final remarks