Ukraine: Towards better care for disabled children

In 2015, just over 150,000 children were disabled in Ukraine. Many of them were placed in boarding schools, which are inappropriate structures for the needs of these children, especially in the case of “severe” disabilities (autism spectrum disorders, Down's syndrome…). In accordance with international recommendations, the Ukrainian Government wished to develop and strengthen its Early Childhood Intervention (ECI) services to meet the needs of both children and their families.

In the context of its neighbourhood policy, the European Union has financed a project to assist the central and local Ukrainian authorities with this process. To do so, the project team has worked with several levels of actors: the Ministry of Social Policy at national level, regional administrations in pilot regions, early childhood professionals at local level and, finally, civil society organisations and parents’ associations. Some twenty experts, mainly French but also Portuguese, Greek and Slovenian, have been mobilised by Expertise France, which coordinated activities on behalf of the French social ministries.

During these two years, several study trips were organised in France and the Netherlands. Representatives of the various stakeholders were able to discuss with the different levels of representation in France, for example, during the last study trip organised from 8 to 12 July 2019, with the Vice-President of the High Council for Families, Childhood and Old Age, an advisory body on these issues to the Prime Minister’s Office.

Towards a legal recognition of early intervention services

The assistance initially focussed on the development of the legislative and administrative framework for early intervention. The project team has developed a national reference system of ECI services. Once this document has been adopted, it will facilitate their implementation, functioning and evaluation, based on a framework shared by all.

This reform has been combined with the creation of a National Early Intervention Council, under the Prime Minister's Office. It is an interministerial council and should facilitate coordination between the ministries involved – social policies, health and education. It met for the first time on 5 July, during the official closing ceremony for the twinning operation.

Strengthening coordination with local civil society

At local level, faced with the needs of families, mothers and professionals from the social sphere have set up an association in order to get training and develop ECI services. As the State wishes to play a more active role in terms of child protection, the disability policy and the deployment of health and social services, the twinning operation has supported the creation of intersectoral advisory boards dedicated to ECI to provide a link between field professionals and the authorities. These committees meet at the level of the Oblasts, administrative units that correspond to regions.

Facilitating early detection and intervention

Finally, at local level, coordination committees now gather field professionals in early childhood from the health, social and education sectors in the four pilot regions in order to provide families with a continuity of service and an individualised follow-up of children. The project team has developed tools to assist them in their work, for example, a guide on child development and the early detection of disability, a guide on the coordination of actors, and a booklet on when doctors break the news about disabilities.

This work has been combined with a communication campaign to combat the stigmatisation of disability and raise the awareness of families to the importance of early detection and intervention.

Other regions have expressed their desire to work on developing ECI services and 10 regions are now going to offer these services to families, with the help of the Ministry of Social Policies and the first pilot regions.

Find out about: Expertise France in Ukraine