Integrated Approach towards Investing in Children Milena Harizanova UNICEF Bulgaria

CRC@25 General Comment 7 (2005) of the Committee of the Rights of the Child: Implementing child rights in early childhood European Commission Recommendation Investing in children: breaking the cycle of disadvantage Principle: EU Member States should always take the child’s best interests as a primary consideration and recognise children as independent rights-holders, whilst fully acknowledging the importance of supporting families as primary carers  

POLICIES – ACHIEVEMENTS AND CHALLENGES Children living in poverty and material deprivations – a set of social benefits; issues of access and adequacy; Access to health care – monitoring and follow up of pregnancies, early pregnancies, access to GP and specialists, mental health care; Early identification of children with developmental problems – no well developed services and instruments for recognition and identification; Early learning and education - no programmes for stimulation of learning after birth, including via parenting support programmes; high average enrollment rate in kindergartens for children 3-6, however significantly lower for vulnerable children Support for parenting – insufficient programmes; Children with one or both parents abroad – difficulties in fulfillment of rights; Access to justice – difficulties in access to justice for children from vulnerable groups, children in conflict with the law, children victims of violence and crime; Sectoral approach vs. integrated policies.

APPROACHES TO INTEGRATED INVESTMENTS IN CHILDREN – CENTRE FOR MATERNAL AND CHILD HEALTH Goal: improvement of primary health care for children below 3ys, pregnant women and mothers via provision of health services in the homes of the families Target groups: pregnant women, mothers, newborns babies, children below 3ys, family members and supporting environment Coverage: regional level – regions of Shumen and Sliven Main activity: home visitations

APPROACHES TO INTEGRATED INVESTMENTS IN CHILDREN – CENTRE FOR MATERNAL AND CHILD HEALTH Results: Shumen (April 2013 – June 2014): 2535 families; Including - 361 pregnant women (156 of them without health insurance); 8989 consultations; 30% от families received intensive package of support. Sliven (March - October 2014) : - 1150 families

APPROACHES TO INTEGRATED INVESTMENTS IN CHILDREN – WORKSHOPS FOR PARENTS Objective: to establish a sustainable model of support to parents of young children below 4 ys as well as to future parents Universal programme Provides a possibility to parents to share their experience, knowledge and concerns related to the up-bringing and communication with their young children, to expand their knowledge on child development and the psychological needs in early childhood. Up to now: 88 рarental groups; Over 800 participants; 66 localities.

APPROACHES TO INTEGRATED INVESTMENTS IN CHILDREN – FAMILY CENTRES Provide support to the whole family in the context of the community; Targets most vulnerable communities, families and children; Flexible service responding to local needs - mapping; Programme approach – early childhood development, family planning, social mediation; Outreach services; Regional approach (Shumen region) and inter-municipal cooperation.

APPROACHES TO INTEGRATED INVESTMENTS IN CHILDREN – FAMILY CENTRES Results (2012 - 2014): Over 3200 families – assessed and included in different programmes; 105 cases of direct prevention of family separation (84 successful); 32 children re-integrated in their birth families; 152 children enrolled in kindergartens; 33 children returned to school; 491 pregnant women without health insurances supported to start monitoring of their pregnancies 587 women included in family planning programmes

APPROACHES TO INTEGRATED INVESTMENTS IN CHILDREN – CHILD MENTAL HEALTH CENTRE RUSE Integrated health-social service for mentally disturbed children and adolescents and their families – counselling, therapy, prevention of separation; Easy access for consultation; Multidisciplinary diagnostic assessment and individual treatment plan; Services: Therapeutic care focused on child or adolescents – individual clinical therapeutic work and therapeutic workshop – a place for inventions; Therapeutic care focused on parents – family therapy and workshop for parents – a place for sharing and learning; Work focused on creation of professional network – multidisciplinary meeting – a place for encounter.