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SOCIAL INCLUSION THROUGH THE PROVISION OF INTEGRATED SERVICES AT COMMUNITY LEVEL IN ROMANIA (BACAU COUNTY)

CASE STUDY: HOW INTEGRATED SERVICE PROVISION ADDRESSES MULTIPLE VULNERABILITIES OF CHILDREN IN A HOLISTIC MANNER

DRAFT 2 (FOR COMMENTS)

© UNICEF Romania/2017

UNICEF Project coordinator: Eduard Petrescu - Policy and Planning Specialist

Document drafted by: Yves Dublin, Social Policy Consultant

August 10, 2017

REPORT: DOCUMENTING THE BACAU MODEL OF SOCIAL INCLUSION THROUGH THE DELIVERY OF INTEGRATED SERVICES AT COMMUNITY LEVEL

AUGUST 2017

FOREWORD

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LIST OF ACRONYMS

ARACIP Romanian Quality Assurance Agency in Pre-university System

AROPE At Risk of Poverty or Social Exclusion

CJRAE County Center for Educational Resources and Assistance

DCT Direct Cash Transfer

DGASPC County Social Assistance and Child Protection Authority

DSP County Health Authority

ECEC Early Childhood Education and Care

EU European Union

FGD Focus Group Discussions

GDP Growth Domestic Product

GMI Guaranteed Minimum Income

GoR Government of Romania

GP General Practitioner

HH Household

HIC Helping Invisible Children

ID Identification document

ISJ County School Inspectorate

KII Key Informant Interviews

MPS Minimum Package of Services

MTR Mid Term Review

NCPAP National Child Protection and Adoption Agency

NCPCR National Council for the Protection of Child Rights

NGO Non-Governmental Organization

QIE Quality Inclusive Education

SAI School Attendance Initiative

UNICEF United Nations Children's Fund

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TABLE OF CONTENT

Foreword 1

List of acronyms 2

Table of contents 3

Table of figures and boxes 4

Acknowledgements 5

Part 1: Introduction 6

A. Purpose of the document 6B. What do we mean by promising practice? 6C. Methodology 6D. Executive Summary 7

Part 2: Situation of children and families in Romania and Bacau 12

E. Excluded and invisible children in Romania and Bacau 12

Part 3: The Bacau model and major innovations 16

F. Supporting the most excluded children to develop to their full potential: Promising solutions for social inclusion from Bacau County 16

G. Operationalization of the model trough effective coordination and collaboration 21

H. Major Innovations 23

Part 4: What has been achieved so far, challenges, enablers and lessons learned 27

I. Initial results 27J. Challenges and enabling factors 30K. Lessons learned and planned solutions for replication 34

Part 5: The way forward 38

L. Sustainability of the model 38M. What comes next? 40

Part 6 Cross sectoral approach to UNICEF programming 41

N. Integrated and cross sectoral approaches to UNICEF programming as a central part of the new UNICEF strategic framework 2018-2022 41

O. Enabling factors 41P. Challenges 42Q. Lessons learned and considerations for UNICEF offices that want to move

towards an integrated approach to programming 44

Bibliography 46

Annexes 48

Annex 1 List of interviewed people and interview guide 48

Annex 2 Detailed activity plan 51

Annex 3 Methodologies and tools 52

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TABLE OF FIGURES

Fig. 1: The situation of children in Romania 13

Fig. 2: Map of Romania and Bacau County 14

Fig. 3: The social inclusion modelling components 16

Fig. 4: The Minimum Package of Services and linkages to the Quality Inclusive Education 17

Fig. 5: The Minimum Package of Services: Interventions and services 18

Fig. 6: The Quality Inclusive Education and linkages to the Minimum Package of Services 19

Fig. 7: The Quality Inclusive Education interventions 20

Fig. 8: Instruments for inter-sectoral collaboration 22

Fig. 9: AURORA screenshot. List of household vulnerabilities 24

Fig. 10: AURORA screenshot. Services to be provided 24

Fig. 11: AURORA screenshot. Service implementation 25

Fig. 12: Vulnerable children and HHs identified by the community social census 27

Fig. 13: Risks and vulnerabilities identified by the community census 28

Fig. 14: Initial results from QIE 29

Fig. 15: Decentralized funding mechanism of MPS (simplified scheme) 31

Fig. 16: Bacau model historic timeline of major events 35

Fig. 17 Cost of scaling up the MPS package 38

Fig. 18 Cost of scaling up the QIE package (2nd year) 38

Fig. 19: The way forward: Major steps of the policy advocacy at all levels 40

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ACKNOWLEDGEMENTS

This publication was commissioned by UNICEF Romania and written by Yves Dublin. The document benefited from the invaluable inputs, feedback, and a final review of the UNICEF Romania team: Sandie Blanchet - representative; Eduard Petrescu - Policy and Planning Specialist; Agatha Popescu - Programme Assistant; Alexandra Grigorescu- Botan – Child Protection consultant; Borbala Koo - Health Specialist; Camelia Ieremia - Operations Manager; Cristina Badea - Programme Officer; Eugenia Apolzan – Youth& Adolescents Specialist; Luminiţa Costache –Education Specialist; Raluza Zaharia - C4D specialist; Viorica tefănescu - Child RightsȘ Systems Monitoring Specialist and Voica Pop – Child Protection Specialist.

The author would like to thank Eduard Petrescu, the project coordinator, for its great support and clear guidance throughout the entire drafting process. A special thank goes to the experts who facilitated and supported the field-work, interviews and focus-group discussions: Nicoletta Elisei – Programme Assistant, Alexandra Grigorescu- Botan – Child Protection consultant and Teona Codreanu – Education County Coordinator in Bacau, who restlessly and simultaneously translated all of the numerous discussions throughout the field trip while never losing her good mood.

The author is also grateful for the information, experience and expertise shared with him by the local authorities and local teams in Bogdăne ti and Târgu Ocna, and to all the interviewees, not listed here. ș

Suggested citation: UNICEF. “SOCIAL INCLUSION THROUGH THE PROVISION OF INTEGRATED SERVICES AT COMMUNITY LEVEL IN ROMANIA (BACAU COUNTY). Case Study: How integrated service provision addresses multiple vulnerabilities of children in a holistic manner”. Bucharest, 2017.

The findings and interpretation expressed in this paper are those of the author, and do not necessarily represent the views of UNICEF.

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PART 1: INTRODUCTION

A. PURPOSE OF THE DOCUMENT The primary aim of this documentation process is to showcase how UNICEF’s engagement in integrated approaches, to promote social inclusion and prevent multi-dimensional child-poverty, can make a difference in the lives of children and help them develop to their full potential. The document presents the major components of the design and implementation of the “SOCIAL INCLUSION THROUGH THE PROVISION OF INTEGRATED SERVICES AT COMMUNITY LEVEL” model currently being implemented in Bacau County. It shows how the model’s different components aim to complement each other, and discusses the relevance for the Government of Romania of delivering social services at community level in an integrated manner.

The model builds on cross-sectoral collaboration and coordination at different levels and uses a number of innovative approaches, i.e. effective use of technology for identification, support and follow-up of vulnerable children and families, and a sustainable financing model. The approach is currently being tested in 45 communities of Bacau county in Romania and will be rigorously evaluated. Monitoring data on the implementation progress is collected on a regular basis and an external evaluation team has so far undertaken a baseline survey, as well as a qualitative mid-term review assessing the progress of the intervention. Initial and promising results can already be seen both from a process and child perspective.

The present document is not intended to be technical in nature or to map out all the complexities of the model developed but rather to present the major innovative practices used in a reader-friendly manner. Special attention will be given to effective results for children, successful and efficient processes, lessons learned, replicability, and sustainability of the approach. The document will support advocacy efforts and serve as guidance for other counties in Romania as well as other countries that would like to engage in similar programmatic and integrated approaches.

B. WHAT DO WE MEAN BY PROMISING PRACTICE In order to document, validate and share good practices in a systematic and standardized way UNICEF has developed guidelines defining the level of maturity of a practice. The document uses a broad definition of the term ‘practice’, encompassing both policy and implementation interventions.

Based on these definitions and criteria, the "Social Inclusion through the provision of integrated services at community level" intervention falls under the category “Promising Practice” which describes “a programming practice, often demonstrating new approaches (or adaptation of existing approaches) where some evidence of success/impact has been documented. Ideally these should have been implemented at scale nationally, but might not have been formally evaluated or replicated internationally, however there should be some degree of evidence around the results achieved and lessons learned from the initiative.” 1

The model uses a large number of innovative approaches, i.e. cross-sectoral collaboration and coordination at different levels, effective use of technology for identification, support and follow-up of vulnerable children and families, and a sustainable financing model. The approach has been used in 45 communities in Romania, and is rigorously monitored and evaluated. Monitoring data on the implementation progress is collected on a regular basis and an external evaluation team has so far undertaken a base- and mid-line survey assessing the progress of the intervention. Initial and promising results can already be seen both from a process and child perspective.

C. METHODOLOGYIdentifying and documenting promising practices is a key part of organizational learning and the pursuit of programme excellence. Such practices allow UNICEF and its partners to learn from innovative experiences and pursue the best approaches in each context. The methodologies to document such practices can range from careful analysis of first-hand experience by programme managers to more in-depth case studies and

1 UNICEF, 2017

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AUGUST 2017consultations, to tacit understanding and description of complex processes. This report uses a mix of these analytical tools and relies on complementary data collection strategies and tools.

In order to achieve an in-depth understanding of the model, its concepts, reported results, challenges and lessons learned, an in-depth literature and document review was undertaken. To complement the information found in the technical documents and to acquire a tacit understanding of the complexity of the integrated approach, first-hand information was collected during in-depth interviews (Key Informant Interviews [KII] and Focus Group Discussions [FGDs]) with a selected number of key stakeholders at national, county and community level (UNICEF staff [10], government authorities [6], community workers [6], implementing partners and representatives of civil society [4]). Finally, direct observations of interactions of Community Consultative Committees (2) and between community workers and beneficiaries (2) were undertaken.2

The first part of the document explains its purpose and the methodology used for the documentation process. The second part provides a general presentation of the initial situation of children and families in the intervention area, the justification for the geographical selection, and the key issues that prompted the development of the model(s). The third part will give an in-depth illustration of the implementation of the model(s) and will also focus on the innovative approaches its major innovations tested in this pilot. Part four will highlight the main results achieved so far – both in terms of process and in terms of child outputs, ideally leading to improved child outcomes. This section will also look at the challenges, enabling factors and lessons learned from the intervention. The final part will present the way forward and upcoming initiatives of UNICEF, the Government of Romania, and partners to scale up and promote this innovative model.

D. EXECUTIVE SUMMARYAbstract: In the aftermath of the 2008/2011 global crisis, and in the context of the EU 2020 Strategy for smart, sustainable and inclusive growth and the new framework of the structural funds for 2014-2020, the Romanian Government embarked on a series of reforms tackling poverty, social exclusion and early school leaving. In that context UNICEF is supporting the Government of Romania to design and implement a model of “Social inclusion through the provision of integrated social services at community level”. The model consists of two components that aim to be complementary and inter-linked: (1) the Minimum Package of Social Services (MPS) and (2) the Quality Inclusive Education (QIE) initiative. As part of the two initiatives the model also promotes communication for social change and gives attention to issues and vulnerabilities related to adolescents. The main objective of the initiative is to promote social inclusion and contribute to the reduction of multiple deprivations faced by children and their families in a holistic and coherent way. The model is based on the hypothesis that by delivering a universal and integrated package of preventive social services (health, education, and child and social protection) at community level to children and their families, one will reduce equity gaps and the deprivations children suffer while, at the same time, reducing the medium- and long-term costs in the social sector. Specifically, it aims to: (1) improve children’s and families’ access to health, social protection and education services; (2) increase access to and completion of pre-school and at least compulsory education; (3) evaluate the needs for local services and improve planning and use of resources at all levels; and (4) ensure that children grow up in a family and a protective environment, free of violence. The Social Inclusion model is currently being implemented in 45 communities in Bacau county including: 34 rural communities as well as 11 urban communities.

Background: The aftershock of the 2008/2011 global crisis has left Romania with reduced living standards, tightened state budgets, deepened disparities and new inequalities. Despite initial improvements and political commitment to both economic growth and poverty reduction over the last decade, Romania still faces significant challenges with regard to the social inclusion of all children in Romania. According to recent statistics, 37.4% of Romanians were at risk of poverty or social exclusion (AROPE) in 2015. Poverty is rarely experienced solely as a shortage of economic means. Large numbers of children experience material deprivations and social exclusion along with scarce financial resources. While one-third of them live in monetary poverty, almost 1.8 million children (46.8%) were considered AROPE in 2015 and the share of children in this situation has remained almost unchanged since 2007. Inequities persist, with Roma children and children living in rural areas being the most affected.

2 To see the full list of people interviewed and the interview guide please refer to Annex 1.

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AUGUST 2017In the education sector, 2012 estimates show that 9.8% of children in the age group 7-15 (approx. 300.000) remain out of school. The early school leaving rate was 19,1% in 2015 and the effectiveness of the educational system also requires improvements as 42 % of Romanian 15-year-olds could be defined as functionally illiterate, according to the last PISA results. Major disparities are registered when it comes to Roma children’s access to and participation in education: the Roma preschool net enrolment rate (among children 3-6 years) was 37% in 2011, compared with a national preschool net enrolment rate of 77%. Moreover, while 95% of non-Roma children aged 7-15 are enrolled in primary and secondary education, this is true for only 78% of Roma children; over 75% of Roma children do not complete Lower secondary education (8th grade).

Violence against children continues to affect thousands of families. Analysis of quantitative data confirms an increasing number of reported cases of violence from 11,232 cases in 2010 to 14,323 in 2016. Some 60,000 children are separated from their families and 1,6% of children lived in formal public care in 2014– two figures that have remained constant for the past 10 years. The main reason for separation and institutionalization of children continues to be poverty.

Romania also has the highest under-five mortality rate in the EU with 13 deaths per 1,000 live births (2010); this rate is 60% higher in rural areas than in urban areas. Nearly 1 million children (a quarter of the child population) are hospitalized 7 days every year (2010). A large number of these cases could be avoided and are related to the limited attention given to preventive, primary and community care.

These figures clearly show that disparities and social exclusion affect a large child population, particularly Roma children, children with disabilities, children living in rural areas, and children living in disadvantaged urban areas

Recognizing these challenges and bottlenecks, UNICEF decided to support its national and local partners with the design and implementation of a model of “Social inclusion through the provision of integrated social services at community level” to promote social inclusion and prevent multiple deprivations of children and their families in a holistic and coherent way.

Strategy and Implementation: A key element of the model is its integrated approach, which is an aspect that is currently still missing in most counties and communities in Romania. The model is testing outreach services at community level that already exist by law, but that are currently not yet properly implemented, to expand their implementation at the national level, and is at the same time improving the quality and inclusiveness of its schools. The model is also developing new services, new protocols, and new standards to improve the quality of these services and make them more inclusive. In this context, working together and in an integrated way at the community level can be considered as one of the most important features of the model and requires a real paradigm shift. Such an approach requires close collaboration at all levels among different sectors involved in delivering the needed services. Indeed, it requires moving away from an isolated service delivery mechanism that is focused on specialized services towards a multi-sectoral, coordinated approach, which can address the complex vulnerabilities faced by children and their families in a holistic manner. To ensure a harmonized implementation of the integrated approach coordination is key, for which functioning coordination bodies are needed at all levels (national, county and community). The model builds on existing structures where possible and either re-activates them if they are not active or creates new ones if they do not yet exist.

A major innovation developed, tested and constantly improvement by the model is the AURORA software and platform. AURORA is an online application that: i) introduces a methodology for a complete diagnostic of vulnerabilities of children and families by community professionals based on a grid of indicators to be applied in a homogenous way for all children and across all communities; ii) allows availability and transparency of real-time data of children and their families at community level for social protection, health and education sectors; iii) increases effectiveness of monitoring and timeliness of feedback and supervision; iv) supports evidence-based policy development using various statistics and reports which can be generated. In that sense, AURORA promotes and facilitates integrated approaches to service provision by social workers and community health nurses. The platform supports integrated case management at local level, and provides outstanding necessary elements for evidence-based adjustments of policies to address existing national

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AUGUST 2017disparities. In addition, a communication for social change component, addressing social norms as well as adolescent issues, was integrated into the model.

The model also includes a significant capacity building component of all stakeholders and implementers at several levels, including (a) local partners to develop community-based services and integrated service delivery, and to increase the inclusiveness and quality of the schools ; (b) higher-level county authorities to provide methodological guidance and supervise activities implemented at the local level; and (c) central authorities to make use of evidence in amending national policies and strategies.

Progress and Results: The Minimum Package of Services has so far achieved a number of results – many of which focus on identifying vulnerabilities and needs, drafting and testing intervention mechanisms, and creating coordination structures and mechanisms for horizontal and vertical cooperation at all levels. As a result of interventions at the community level, the following constitute some of the achievements:

• 93% of the children who at the time of the census did not have birth certificates or ID cards, have now solved their situation: i) they now have birth certificates; ii) they have duplicates in case the certificate is lost; or iii) for children over 14 years of age, they have identity cards.

• 97% of the children who were not on a family doctor's list at the time of filing are now enrolled;

• All children identified as being at risk of separation continue to live in their families, which benefits from the necessary support services thanks to the project. It should also be mentioned that the operational definition of the risk of separation of the child from the family has been tested.

In addition, observations from the field showed that the model gives community workers and the local authorities much better knowledge of social cases and vulnerabilities as a result of the census conducted via AURORA. As such, it was possible to intervene early in serious cases to prevent separation of family children.

The Quality Inclusive Education Initiative has laid the foundations for a "friendly and inclusive school" for all pupils and teachers and has positively changed the image of the school as an institution. The intervention is positively responding to the needs for capacity and professional development of managers and teachers and highlights the importance of early childhood education. This has led to the following outputs:

• 45 schools and kindergartens have increased capacity to offer inclusive quality education for over 22,000 school children (5000 in kindergartens, 9000 in primary education and 8000 in secondary education)

• 156 preschool structures have meaningful didactic materials for quality interaction in 257 groups of children

• 45 school managers, 36 school counselors, and 27 school mediators increased their professional skills (managerial, counselling and mediation)

• 1400 teachers that have increased capacity for positive child disciplining, and to promote child-friendly schools, inter-cultural education, violence prevention, and the inclusion of children with special educational needs

• 151 parental educators in 45 schools, 5000 parents educated

• 11,000 children benefitting from activities developed by micro-grants

As a result, the number of children at risk of drop-out decreased by 27%, of which 74% passed their exams. The parental education courses had, according to all the interviewees, the highest success and highest efficiency in the project. The results have been seen in the behaviour of parents who have begun communicating better with children, have been more attentive to their emotional problems, and have understood that it is important to listen to their children and provide them with affective protection. Furthermore, the interventions increase the satisfaction of school teachers and already changed the attitudes of a number of them.

Finally, from a communication for social change perspective, several achievements can be mentioned:

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AUGUST 2017• Over 150 community workers and 23 county coordinators have improved knowledge and skills to address social norms-related issues as result of training and capacity building.

• The community workers increased their capacity to identify and actively address adolescents’ issues, and to work with adolescents.

• Communication packages were developed and tested to increase the capacity of community workers to use a non-discriminatory approach in service delivery and to influence social norms for identifying and preventing violence in the family and the community. The packages reached more than 50,000 beneficiaries.

The process of designing and implementing the model in Bacau County was not an easy one and institutions at various levels responded differently to the project. Nevertheless, the learning process, guided by a strong vision from the county authorities with support from national level and UNICEF, led to a change in the attitude of the local authorities. The process brought out a number of lessons and solutions, summarized below, that aim to facilitate the replication of this model to other counties in Romania.

A crucial element of success of the model, was that its designers and implementers took the necessary time to create and sustain ownership at all levels and throughout the entire process. Considering that social change is slow, it became clear in this model that it was not possible to achieve the aimed changes in a short period of time and required a long-term vision and commitment from the highest-level leadership down to the grassroot implementers.

A lesson that was learned was that the community census took more time than initially planned and in the urban setting it was found not to be the most adapted and cost-efficient way to identify vulnerabilities. While scaling up, attention will be given to this aspect and one considered solution of solving this challenge will be to better communicate on the objectives of the interventions to the potential beneficiaries trough popular communication campaigns and locally available channels. The implementing team is also in the process of rethinking and adapting the community census to the urban setting.

The AURORA software has been key for the identification of vulnerabilities, provision of services and real-time data sharing across sectors. The software is continuously being improved to include the feedback from its users and permanently respond to the changing needs of the model.

Even though both packages have developed clear working methodologies and a number of tools, procedures and regulations, the documentation regarding the modalities of those packages to work together are being planned to be developed in the second implementation phase. The implementers of the model are considering the development of a guidance manual including the different modules of both components of the model (QIE and MPS) that could serve as a reference document for replication. Furthermore, the developed capacity building tools have the potential to be standardized and certified by the national authorities and will progressively be submitted to the competent authorities to this effect.

Finally, it is important to allow enough flexibility in the replication of the model. Ideally the model should be replicated as a full package addressing all the child related issues in a holistic manner. However, acknowledging existing constrains in terms of human and financial capacity at various levels, the model is designed so it can be scaled up in a progressive manner.

Resources needed: Evidence generated in Romania itself shows, through different models, that the MPS is more cost-efficient than the current approach that focuses on expensive, specialized services. Cost estimates show that scaling up the entire MPS package in all rural areas would not exceed €100 million for the first year, including the costs already covered by the public system which represents approximatively 0.067% of Romanian GDP. The extension to all urban areas would cost an additional € 31 million. These costs include salaries for community workers, the cost of supplies and transportation, the cost of implementing an integrated case identification and management instrument based on internet and mobile technology (AURORA), and the costs of capacity building for community workers and for guidance and supervision from county level.

The cost of implementing the Quality Inclusive Education Package at national level during the first school year represents approximatively €135 million or 0.09% of Romanian GPD which equals €84/student/year as it includes start-up costs such as training of school managers, teachers and parental educators as well as

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AUGUST 2017supplies. From the second year on, the cost would already decrease to Approx. € 32/student/year or a total of USD 63 million (0.04 % GDP).

While scaling up the Minimum Package of Services and the Quality Inclusive Education package at the national level will represent an additional cost during the first years of implementation, expenditures dedicated to specialized services (such as hospitalization, institutionalization and alternative services for children separated from their families, second chance programmes, etc.) are expected to decrease, compensating for the initial investment. Services could be implemented progressively, starting with disadvantaged communities/schools and/or counties. A costing study presents a number of different options for how the MPS could be scaled up in a progressive way.

Replicability: The Bacau model has so far been implemented and tested in 45 communities in Bacau county. Given the promising results the model has brought thus far in terms of social inclusion of the most vulnerable people, one of the major objectives at this stage is to ensure sustainability of the model within the county and extend this type of intervention to the entire county using locally mobilized resources and then move to other counties (5-6 counties are currently planned) in the same region with support from the national authorities.

Furthermore, Bacau County has previously shared its experience with a delegation from Ukraine and other interested counties in Romania. The county authorities always manifested their willingness to share their experience with not only other counties in the country but also other countries in the region and will continue to seek opportunities for horizontal cooperation at national and international levels. These exchanges will be further strengthened through the presentation of the model in knowledge sharing platforms at the European and global levels and internally, within UNICEF regional and global management team meetings and webinars in order to inspire other countries to adopt similar approaches.

Potential application: As spelled out in the new UNICEF draft Strategic Framework (2018-2021), the organization continues to promote the rights of every child, everywhere, and in everything the organization does with a focus on equity. The framework sees the achievement of equity for children as a cross cutting issue. This Goal Area seeks to address some of the key factors that underlie intergenerational cycles of inequity among children and stresses the need for integrated approaches. In that sense, the integrated approach tested by the Bacau model is very relevant in each context where offices would like to address children’s issues in a holistic manner and perfectly fits into this “new” way of working across sectors in a coordinated manner. As such UNICEF Romania has a number of good practices and lessons to share.

One major lesson learned from this experience is the long timeframe that an office needs to consider when moving towards an integrated approach. The collaboration between all sectors in the case of the Bacau model has been a learning by doing experience and operationalized gradually. In that sense, it was key for the office to create ownership and commitment from all sections form the design phase on by agreeing on which parts should be integrated and clearly defining how they should work together.

One of the key success factors in the Romanian experience was their flexibility and ability to adapt their office structure, mechanisms and tools to work more efficiently and systematically across sectors. The creation of a coordinator position and the development of specific cross sectoral working tools and mechanisms were crucial to smooth coordination across sectors. As some of the internal procedures are not yet adapted to work in a cross sectoral manner the office found creative and flexible ways to remain compliant with UNICEF’s procedures and regulations while being able to quickly respond to external needs emerging from such a complex approach. The Bacau model experience has also shown that in order to encourage cross sectoral coordination it is important to also adapt the evaluation mechanisms of the involved professionals. Offices need to create sufficient dedicated time and space for cross sectoral collaboration and systematically include cross sectoral performance indicators in each professional’s performance appraisal rather than evaluating them exclusively on sectoral results.

Next steps: UNICEF and its partners will continue their advocacy efforts at all levels in a flexible and tailored manner and will try to achieve not only sustainability but also ownership and mutual understanding of the integrated approach from national to the community level. These efforts aim to activate all possible means to secure the necessary policy and legal changes. With regard to the large capacity building component of the

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AUGUST 2017entire model, UNICEF will submit the training packages for official certification, and advocate to integrate them into the regular curricula of the community workers and managers at all levels.

In that context, it should be mentioned that UNICEF supported the GoR to submit a proposal to access EU and Norwegian funding to further develop the concept of a Minimum Package of Services as modelled by the present project and to replicate it in another 6 counties. At the same time UNICEF is actively involved in the process of developing proposals for large non-competitive grants in Education funded by Human Resources Operational Programme, including elements of QIE with the aim of national implementation. These proposals are currently being analyzed and waiting for formal approval. Once the funding for continuing the scale-up of the model is secured, UNICEF will continue to provide technical assistance to the Government of Romania to implement the approach in other counties and, eventually, nationally.

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PART 2: SITUATION OF CHILDREN AND FAMILIES IN ROMANIA AND BACAU

E. EXCLUDED AND INVISIBLE CHILDREN IN ROMANIA AND BACAUThe situation at national level:

The aftershock of the 2008/2011 global crisis has left Romania with reduced living standards, tightened state budgets, deepened disparities and new inequalities. After 2011, most macro-indicators show that Romania started improving again and show economic development, with the per capita purchasing power of 186% since 2007. Alongside economic growth, some structural reforms were launched, however, some long-term reforms initiated before 2008 either stagnated or even regressed due to the crisis, particularly those targeting vulnerable children and families. Despite initial improvements and political commitment to both economic growth and poverty reduction over the last decade, Romania still faces significant challenges with regard to the social inclusion of all children in Romania. Since 2010, income inequalities between the wealthiest and the poorest 20% started to grow rapidly and in 2015 the wealthiest quintile possessed 8.3 times more resources than the poorest quintile3. The inequalities risk being perpetuated in the long run since Romania invests comparatively less than other EU countries in the development of the human capital of its children and families e.g. investments in education, health and social protection.

According to recent statistics, 37.4% of Romanians were at risk of poverty or social exclusion (AROPE) in 2015. Poverty is rarely experienced solely as a shortage of economic means. Large numbers of children experience material deprivations and social exclusion along with scarce financial resources. While one-third of them live in monetary poverty, almost 1.8 million children (46.8%) were considered AROPE in 2015 and the share of children in this situation has remained almost unchanged since 2007. 4 Inequities persist, with Roma children and children living in rural areas being the most affected. Thus, in urban areas, 2% of Romanian children are living in poverty compared to 27.3% of Roma children; the breakdown is 10.6% versus 41.1%, respectively, in rural communities.5 According to data from the National Authority for the Protection of the Rights of the Child and Adoption, poverty remains one of the main causes of separation of children from their families (40%).6

In the education sector, 2012 estimates show that 9.8% of children in the age group 7-15 (approx. 300.000) remain out of school.7 The early school leaving rate was 19,1% in 20158, well above the EU average of 11.1% and the national target for 2020 of 11.3 %.

Major disparities are registered when it comes to Roma children’s access to and participation in education: the Roma preschool net enrolment rate (among children 3-6 years) was 37% in 2011, compared with a national preschool net enrolment rate of 77%. Moreover, while 95% of non-Roma children aged 7-15 are enrolled in primary and secondary education, this is true for only 78% of Roma children;9 over 75 % of Roma children do not complete Lower secondary education (8th grade). When it comes to access to upper secondary education a mere 18% of Roma girls attend upper secondary education compared to 86% of non-Roma women, and 29% of Roma men attended upper secondary education compared to 81% of non-Roma men.10

Limited financial commitment to education coupled with a lack of continuity and coherence of the educational reforms undermine children’s access to quality inclusive education. The effectiveness of the educational system would also require improvements: according to the last PISA results, 42 % of Romanian 15-year-olds could be defined as functionally illiterate.11 Limited access to early childhood education and care

3 UNICEF Romania. Situation Analyses of Children and Women in Romania. Draft report. Bucharest, March 2017.4 http://ec.europa.eu/eurostat/statistics-explained/index.php/People_at_risk_of_poverty_or_social_exclusion5 Preda, M. 20136 National Authority for the Protection of the Rights of the Child and Adoption, 20147 UNESCO, 2012. - UNESCO – UNICEF OOSC?8 https://ec.europa.eu/education/sites/education/files/monitor2016-ro_en.pdf 9 World Bank, 201210 World Bank, 201411 OECD, 2015

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AUGUST 2017(ECEC) services (86,4 % nationally and 81,8 % in rural areas)12, insufficient training of teachers, limited mechanisms of interaction between schools and parents undermine the system’s capacity to retain vulnerable children in school.

Violence against children continues to affect thousands of families. Analysis of quantitative data confirms an increasing number of reported cases of violence from 11,232 cases in 2010 to 14,323 in 201613. Some 60,000 children are separated from their families and 1,6 % of children lived in

formal public care in 2014– two figures that has remained constant for the past 10 years 14. The main reason for separation of children continues to be poverty. Many of the decisions to place children in public care could be altered through the presence of a social worker and other community workers at the local level, as proven by a model of community-based services implemented by the GoR with UNICEF’s support15.

While there are legal provisions that foresee the presence of social workers, community nurses, school counsellors, as well as quality inclusive education, laws are not systematically enforced, mainly due to a lack of secondary legislation, capacity gaps of professionals at local level, social norms and financial resources. In addition, the laws in the health, education and child/social protection sectors do not necessarily connect the needed services at the local level. Most budget allocations are made towards specialized services like hospitals and services within the public care system (e.g. institutions, foster care, placement with families etc.) rather than towards preventive interventions. Changes in policies, standards and protocols are therefore required. There is a need to produce compelling evidence showing that it is possible, cost-efficient and effective to provide integrated social services focused on prevention at the local level so that resources are prioritized to ensure that the neediest children are identified early and they access services to remain healthy, raised in a protective family environment, and be better educated.

Romania also has the highest under-five mortality rate in the EU with 13 deaths per 1,000 live births (2010); this rate is 60% higher in rural areas than in urban areas. Nearly 1 million children (a quarter of the child population) are hospitalized 7 days every year (2010). A large number of these cases could be avoided and are related to the limited attention given to preventive, primary and community care.

12https://ec.europa.eu/education/sites/education/files/monitor2016-ro_en.pdf 13 http://www.copii.ro/statistica-2016/14 http://www.transmonee.org/databases.php15 UNICEF Romania. Social inclusion through the provision of integrated social services at community level Project Proposal. Bucharest, 2014.

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AUGUST 2017These figures clearly show that disparities and social exclusion affect a large child population, particularly Roma children, children with disabilities, children living in rural areas, and children living in disadvantaged urban areas. Adolescents also present an elevated risk of poverty, social exclusion, substance abuse, violence, teenage pregnancy (10 % of all pregnancies are among adolescents) and school drop-out. Social exclusion of poor and vulnerable families is often rooted in social norms that result in – often hidden – discrimination. As in other countries, these social norms have been internalized by these groups themselves.

The capacity of the Government of Romania to respond to the various challenges described remains limited: at national level, the total expenditure on social protection was estimated in 2014 at 14.8% of GDP, one of the lowest proportions in the EU.16 Only limited amounts are allocated for provision of services, making it extremely difficult to identify vulnerable children and their families, identify sources of vulnerability, and to address the needs of children in a holistic and comprehensive manner. In 2014, there were only one social worker per 3,350 inhabitants, with many of them being mostly involved in the provision of cash benefits. The institutional capacity to provide social assistance remains therefore extremely limited, especially in rural areas. In the context of the decentralization of social assistance, limited resources and other barriers are influencing the implementation of the legislation at local level, and “unitary”

implementation is constrained by missing secondary legislation (protocols and standards) and capacity gaps of the professionals at local level affecting children’s access to basic social

services.

The situation in Bacau County:

Bacau county was selected to test the social inclusion model as it remains one of the poorest, most deprived and marginalized counties in Romania as shown by the child wellbeing indicators below. Furthermore, UNICEF wanted to build on lessons learned from successful models17 that were previously tested in various counties in Romania addressing social, health and inclusive education issues until 2015.

In order to have a snapshot of the situation of children before the intervention a baseline survey was undertaken in 2014. According to its

results the population in Bacau County were living in rather modest conditions. The average monthly income was 1,537 RON (approx. USD 380,00) and only 14% of households accessed the guaranteed minimum income (GMI). Households missed on average 5 out of the 13 items included in the deprivation index. Only 40% of the households have running water, 32% have indoor sanitation, and 86% have electric power.

In Bacau County, the number of children per household was 1.57. 20% of the households included children younger than 3 and 13% had 3 or more children. 14% children lived in single-parent families. 6% of children were in the care of extended family following the temporary migration of at least one parent. 1% of children lacked an identification document (ID) or birth certificate. 11% of all children were separated from both parents and 34% of parents reported using physical punishment to discipline their children at least sometimes if not more often.

Registration with a family doctor was reported for 98% of all children, while the vaccination rate was recorded at 86%. On average, a child spends 0.39 days per year in hospitalization. 76% of new mothers reported attending at least four ante-natal consultations (one should read this figure with caution due to the low number of cases that were considered). Less than one percent of newborns weighed less than 1.5 kg, and 7% were under 2.5 kg.

There was also evidence on out-of-school children of primary and lower secondary school age. Net enrollment was about 96% in the age group 6-10, and 98% for those 11-14. However, enrollment in pre-school was much lower: 72% for those aged 3 to 5. Early school leaving was comparable to the national average: only 85% of those aged 15-18 are still in school. The percentage of repeaters was 3% for primary school and 6% for lower secondary school. Four out of five children intended to go to at least high school, and their parents display similar expectations.

16 http://ec.europa.eu/eurostat/statistics-explained/images/b/b1/Expenditure_on_social_protection%2C_2004-2014_%28%25_of_GDP%29_YB17.png 17 In particular the “Helping the Invisible Children -HIC” and the “School Attendance Initiative- SAI” models tested previously.

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Baca

Fig. 2: Map of Romania and Bacau County

http://ec.europa.eu/eurostat/statistics-explained/images/b/b1/Expenditure_on_social_protection%2C_2004-2014_(%25_of_GDP)_YB17.png



AUGUST 2017In terms of human capacity, 29 localities reported to have community nurses, school counselors were to be found in 31 localities, and social workers existed in all localities from the Bacau sample. However, knowledge about the role and activity of the social worker was rather poor among potential beneficiaries. About half of the social workers had no university degree in social work or related disciplines, and 15 out of 40 had no university degree at all. Despite this, the survey revealed a tendency to develop cooperation with schools, social workers, county-level agencies, and general practitioners in the area. The school counselors’ representations were quite optimistic. They said that local people knew what they were doing, and asked them for help. However, data from the parents/legal guardians indicated significant confusion with respect to the role and presence of school counselor18.

18 Voicu, B. & Tufiș, C. In-depth assessment of the social, health, and education status of children and their families in target areas of the Bacau County. Baseline report. Bucharest, 2016.

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AUGUST 2017

PART 3: THE MODEL AND MAJOR INNOVATIONS

F. SUPPORTING THE MOST EXCLUDED CHILDREN TO DEVELOP TO THEIR FULL POTENTIAL: PROMISING SOLUTIONS FOR SOCIAL INCLUSION FROM BACAU COUNTY.

In the context of the EU 2020 Strategy for smart, sustainable and inclusive growth, as well as the new framework of the structural funds for 2014-2020, the Romanian Government embarked on a series of reforms tackling poverty, social exclusion and early school leaving. National strategies on social inclusion, prevention of early school leaving, protection, and promotion of children’s rights have been developed and should currently be under implementation. Recent developments at the EU level complement the picture, outlining the need for early intervention and preventive approaches in order to reduce the risk of poverty and social exclusion. Moreover, specific targets have been set at national level in the framework of the EU 2020 strategy, including reducing early school leaving to 11,3% and getting 580,000 people out of poverty19.

In line with these strategies and recognizing the challenges and bottlenecks described in Part 2, UNICEF decided to support its national and local partners with the design and implementation of a model of “Social inclusion through the provision of integrated social services at community level” to prevent social exclusion and address the multiple deprivations of children and families in a holistic and coherent way. The model is based on the hypothesis that by delivering a universal and integrated package of preventive social services (health, education, and child and social protection) to children and their families, will reduce equity gaps and the deprivations children suffer while, at the same time, reducing the medium- and long-term costs in the social sector.20 Specifically, it aims to: (1) improve children’s and families’ access to health, social protection and education services; (2) increase access to and completion of pre-school and at least compulsory education and increase the quality, relevance and inclusiveness of education; (3) evaluate the needs for local services and improve planning and use of resources at all levels; and (4) ensure that children grow up in a family and a protective environment, free of violence. The model will accomplish this by testing services that already exist in the law but are not properly implemented to expand their implementation at the national level. The model is also developing new services, new protocols, and new standards to improve the quality of these services and make them more inclusive. There are several principles guiding the Bacau model’s approach: universality, equity, integration, innovation and prevention in the provision of services.

The Social Inclusion model is currently being implemented in 45 communities in Bacau county including: 34 rural communities as well as 11 urban communities from 4 cities. In order to ensure the representativeness of the sample at county level, the selection of the 45 communities has been made based on an initial assessment and an application of a socio-development index. The evidence generated by the model should inform the development of national and local social inclusion policies.

The model consists of two complementary and inter-linked packages: (1) the Minimum Package of Social Services (MPS) and (2) the Quality Inclusive Education (QIE) package. As part of the two packages the model also promotes communication for social change and gives attention to issues and vulnerabilities related to adolescents. The model

19 UNICEF Romania. Terms of Reference. Mid-Term Review of “Social inclusion through the provision of integrated community services at community level” model, Romania. Bucharest, 2016.

20 The Theory of Change (ToC) was developed in September 2014 and expanded in 2015 including refined objectives and logical framework. The expanded ToC will be further reviewed and adjusted according to the findings, conclusions and recommendations of the current review and of the formative evaluation to be conducted in 2017.

17

Fig. 3: The social inclusion modelling components


AUGUST 2017was designed based on recent literature, consultations with relevant stakeholders, as well as two previous modelling experiences tested by UNICEF in education (The School Attendance Initiative - SAI) and child protection and health (Helping Invisible Children - HIC). While the services are universal, they are focusing on vulnerable families and children, including Roma. This chapter will focus on describing the different packages, showing how they aim to complement each other, and how they intend to address the above-

mentioned challenges and bottlenecks and presenting the innovative approaches used in that context.

The Minimum Package of Services

Within the context of advancing child-sensitive social protection and adequately investing in child wellbeing, UNICEF advocates for a universal and mandatory Minimum Package of Services (MPS), delivered through field work by public authorities at community level21

to fulfil every child’s right to development, to combat poverty, to prevent the risk of social exclusion and to support vulnerable families with children. In this respect, MPS contributes to reduce poverty by facilitating access to food, shelter, education, health care services, information, and specialized social services through a referral system22. It is an umbrella concept for the provision of services at community level provided in an integrated manner by a local team composed of a social worker, a community nurse and a school counsellor - all supported by the Aurora software, an on-line instrument operationalizing the integrated working methodology (the instrument, its methodology and platform are described in detail further down in Part 4 section H) In vulnerable communities, where the needs are greater and additional support necessary, the team can be extended in order to include also a school mediator and/or a health mediator. In parallel with horizontal cooperation, vertical collaboration is also enhanced, with county institutions providing technical and methodological guidance to their local counterparts23.

The major steps and interventions in the provision of the Minimum Package of Services24:

21 The community level is defined as a municipal, town, communal, district or division (village, neighborhood) level represented by local public administration institutions, by other public or private bodies and local interest services, by organized community members and their forms of association (such as community advisory boards), working to develop the territorial administrative structure and its members.22 UNICEF Romania. The Minimum Package of Services. Breaking the cycle of disadvantage for children and their families. Draft policy brief. Internal document. Bucharest, August 2014.23 UNICEF Romania. Terms of Reference. Mid-Term Review of “Social inclusion through the provision of integrated community services at community level” model, Romania. Bucharest, 2016. 24UNICEF Romania. AURORA Application-Assisted Data Collection Methodology: Community Census for Vulnerability Diagnosis. Internal Paper. UNICEF Romania. Bucharest. June 2015.

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Fig. 4: The Minimum Package of Services and linkages to the Quality Inclusive Education


AUGUST 2017The social worker and/or the community nurse identified vulnerable children and their families through a community census (covering every household in a community). They currently assess in a participatory manner the risks (looking for example at the living conditions, whether the child is registered with a family physician, is vaccinated, goes to kindergarten or school, etc.) of the family. Moving forward the model also plans to assess the families’ resources and capacitates to respond to some of these risks. All of this information is entered into the Aurora software.

A comprehensive needs assessment of all family members is undertaken considering age and gender specific risks, and possible multidimensional vulnerabilities faced by children. Intra-household dynamics and broader vulnerabilities of families and communities are also considered. Understanding key sources of vulnerability of the family combined with a list of interventions generated by AURORA, guide the selection of a set of appropriate interventions matching the needs of the child. It can include referral to the public services for social assistance and if eligible, support for filling the request for the Guaranteed Minimum Income and/or preparation of an individual plan of services which includes provision (one or a combination)

of the following seven categories of services:

- accurate information to children and their families for example about social risks, their rights and entitlements, available services; these are essential for ‘equal’ access to benefits and social services, ‘equal opportunities’ and citizens’ participation in economy and society

- counselling of children and their families to overcome demanding situations (as for example to prevent/eliminate violence, abuse and neglect, etc.)

- support and/or accompaniment services focusing on aspects of wellbeing, that include: providing adequate child and maternal nutrition; supporting families in their childcare role, parental support groups; preventing discrimination and child abuse in and outside the home, preparing adolescents for their own livelihoods, taking account of their role as current and future workers and parents, and peer support for children and adolescents. These may be considered feasible solutions with good chances of success.

- referral for children and their families to access other specialized services in health, education and social protection areas (health care, education, early childhood education and care settings, birth registration, psychological counselling, professional training, job opportunities etc.). This service is intended to link children and their families with the services they need, since one of their problems is the lack of knowledge and/or skills to turn to the relevant institution/specialist who can help solve their problem.

MPS provides for a single point of entry – including a common data base for all community workers - ensuring further connection to a broad range of services and co-location of services as much as possible. A joint case management setup, including a single individual plan of services, is implemented by a multidisciplinary and inter-institutional team coordinated by a case manager. MPS also includes provisions

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Fig. 5 The Minimum Package of Services: Interventions and services


AUGUST 2017for sharing information, accountability and joint responsibility among the professionals for the success of the family.

The integrated case management team (at least be composed of two professionals) regularly visits the child and family at home to observe the children’s development, and how parents they fulfil their obligations towards the child. The case team also monitors the progress of the family toward the objectives of the individual plan of intervention. A repeated re-evaluation is undertaken every 9 months and the household profile is updated. They undertake an initial assessment of the services provided and make a comparison on the outputs for the beneficiary. They may identify new objectives or in successful cases decide to close the case if after two consecutive re-evaluations no vulnerability was identified. Within the context of the model, the team has to report to the county level on a monthly basis, in the longer term, county coordinators may consult Aurora and follow progress in real time. Prioritization of the cases to treat first is done based on a number of criteria established regularly within the community team of professionals (case management team, integrated team), in consultation with the county coordinator and validated by the Community Consultative Committee and the mayor. The 0 priority cases are ‘special’ situations, indicative for the risk of separation of children from their families. These cases and the services generated by the cases’ evaluation have a dedicated methodology of work which is requiring rapid intervention (within 48 h). In that sense, the 0 priority cases are the ones to be treated first; as they represent the highest risk of separation of children from their families, with the children facing seven or more vulnerabilities as defined by AURORA.

Monitoring and evaluation also provide grassroots level data (recorded in a database) which is essential for timely policy and programmatic responses at all levels: local, county and national.

In short, it can be considered that the Minimum Package of Services makes a shift to a balanced provision of preventive integrated social services that are provided close to children and families. Previous modelling experiences had shown that there are several barriers in the provision of services at local level and that there is room for substantial progress in this area since solving the cases is dependent on the knowledge and skills of the relevant professionals form the involved sectors and on the collaboration among each other, and the collaboration between the integrated teams of professionals and the beneficiaries. The MPS’s strength lies in the fact that it facilitates equal access to essential benefits and social services for children through information, service provision, referral and accompaniment, and by reinforcing collaboration between all involved professionals.

The MPS is currently being implemented by 57 social workers, 36 community health nurses, 7 health mediators, 36 school counsellors, and 27 school mediators. These professionals make up the integrated community teams. The collaboration of these teams and between county teams and community teams will be described in detail in Part 3 section G).

The Quality Inclusive Education (QIE) initiative is a comprehensive package of interventions targeting the quality and inclusiveness of education with the objective that every child enrolls in school at an early age, learns to his/her full potential, completes compulsory education, and is adequately prepared for the labour market and active citizenship. QIE also aims to increase the school participation of all children, especially vulnerable ones. It includes child-centered interventions at school, family and community levels. The education package is universal as all students and schools benefit from its interventions. The package

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Fig. 6: The Quality Inclusive Education and linkages to


AUGUST 2017particularly focuses on the children who are the most at-risk of dropout and on the most disadvantaged schools25.

Concretely, the Quality Inclusive Education Package includes interventions to: (1) strengthen the capacity of the school management and teachers to support each child, according to his or her needs; (2) improve teaching methods and tools; (3) increase the interactions between families and schools; (4) boost parental skills; (5) mobilise communities to support local schools; (6) enhance children’s competencies and motivation; (7) encourage diversity among students regardless of gender, ethnicity, religion, (dis)ability and socioeconomic status. In addition, QIE provides every school with micro grants to promote projetcs that aim to prevent/reduce absenteeism and drop-out and to increase the quality of education, the relevance of teachers’ practices, and students’ participation.

QIE is currently implemented in 45 pre-school, primary and secondary school units across 37 rural and urban municipalities in Bacau County. QIE is implemented in

partnership with the Ministry of National Education, the Romanian Agency for Quality Assurance in Pre-university Education, the Romanian Institute of Educational Sciences, the Community Development Agency “Impreuna”, HOLTIS Association and Step-by-Step Centre for Education and Professional Development. At the county level, the model

is involving the County School Inspectorate, the Center for Resources and Educational Assistance and Teacher Training House, the County Directorate for Social Assistance and Child Protection, the County Public Health Authority, and the County Council. The results and lessons generated by the model will inform the elaboration of new laws, standards and regulations applicable nationwide26.

The package addresses bottlenecks and barriers in access to and retention in education of children and adolescents at risk at four key levels: system, community, family, and school levels. The approach focuses on prevention and participation.

Systems level

At the national level, the model focuses on awareness-raising, evidence generation and legislation changes/improvments/revisons activities. This is done by stressing the the importance of education and documenting the impact of the model in order to support evidence-based policies that eliminate the barriers faced by vulnerable children and adolescents with regard to equitable and quality access to inclusive education. QIE is drawing the attention of decision-makers to the magnitude of the school drop-out phenomenon and creating partnerships among the main stakeholders which can be further used to address this issue efficiently. The model also supports the development of secondary legislation and the policy framework to stimulate school participation of students at risk of drop-out, based on field evidence27.

Community Level

At community level, QIE involves professionals from other systems that can contribute to the decrease of school dropout: social workers, health professionals, and local authorities. The model tries to create or revive – where these already exist – community stakeholder networks to bring out-of-school children back to school (e.g local councils, school representatives, social assistance public services representatives, and informal and formal community leaders) and to sensitize the Community Consultative Committees

Self-esteem and low expectations for education outcomes have been identified as influencing the school enrolment of poor and vulnerable children, especially Roma. In order to address this issue QIE supports a role model intervention that promotes the value and benefits of education at the level of children and

25 UNICEF. (2016) Quality Inclusive Education package leaflet.26 UNICEF Romania. Quality Inclusive Education Model’s Theory of Change. Internal document. Bucharest, 2016.27 Idem

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Fig. 7: The Quality Inclusive Education interventions


AUGUST 2017families through school- and community-based communication and information activities. In the long run, such campaigns aim at changing attitudes and mentalities, and empower local communities.

School level

In schools, the focus of the intervention is on capacity building activities for teachers and directors. These professionals benefit from trainings on innvoative and participatory didactic methods, on school management, and on inclusive education, as well as on how to lead extracurricular activities to promote greater child participation at school. School mediators and school counsellors are trained and empowered in selected communities. They play a key role in linking families, the school and the community. They monitor children of school age who are at risk of drop-out and jointly, with the social worker and the community nurse, support families to get children back to school.

Family level

To empower and strenghen the role of families, the model promotes the active involvement of parents in school life and awareness raising on the importance of education. To improve parenting skills, parental education programmes comprising several sessions are delivered in schools. These sessions aim to enhance positive communication between parents and children and increase parents’ know-how on child developmental needs and on how to promote their child’s best interests. In addition, especially trained school mediators, who ideally are members of the disatvantaged community, visit households on a regular basis to support parents to overcome the difficulties of sending their children to school28.

The aim to integrate both complementay components of the Social Inclusion model is a new way of delivering services at community level and is only feasible with effective coordination at all levels and the support of a number of innvations introuced by the Bacau model and descibed below.

G. OPERATIONALIZATION OF THE MODEL TROUGH EFFECTIVE COORDINATION AND COLLABORATION

A prerequisite of the model and its integrated approach is effective coordination and collaboration at all levels, which is an aspect that is currently still lacking in most counties and communities in Romania. A number of studies show that the lack of coordination at all levels remains a serious issue and represents a major barrier to ensuring access of all children to the services they need29.

In this context, working together and in an integrated way at the community level can be considered as one of the key features of the model and requires a real paradigm shift. Such an approach necessitates close collaboration among different sectors involved in delivering the needed services. Indeed, it requires moving away from an isolated service delivery mechanism that is focused on sectoral services towards a multi-sectoral, coordinated approach, which can address the complex vulnerabilities faced by children and their families in a holistic manner30.

To ensure a harmonized implementation of the integrated approach coordination is key, for which functioning coordination bodies are needed at all levels. The model builds on existing structures where possible and either re-activates them if they are not active or creates new ones if they do not yet exist.

At central level, the coordination is ensured through a Steering Committee that includes representatives of all involved line ministries: Labour and Social Justice, Education, Health, Youth, Regional Development and Administration, European Funds and other key partners from civil society and academia. The Steering Committee meets twice a year. During these meetings, the progress of the model is monitored and its strategy and approaches are discussed. Furthermore, central authorities receive information about the latest field visits and the implementation status of the model, and agree on the work-plan for the next period. The meetings are also an opportunity to ensure the integration of the model and its results into the process of policy planning and implementation of national strategies with national budget and EU funding.

28 UNICEF Romania. Quality Inclusive Education Model’s Theory of Change. Internal document. Bucharest, 2016.29 UNICEF Romania. The Minimum Package of Services. Theory of Change. Internal document. Bucharest, 2014.30 UNICEF Romania. Minimum Package of Services. Internal draft concept paper. Bucharest. 2015.

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AUGUST 2017Based on the decision of the Steering Committee, the model was presented to the Coordination Council of the National Authority for the Protection of Child Rights (NCPCR), bringing together line ministries (Social Justice, Health, Education, Interior, Justice etc.), NGOs and other partners. The Coordination Council has an advisory role for the NCPCR and ensures the coordination, monitoring and evaluation of the implementation of the Child Rights Strategy 2014 – 2020 to which the Bacau Model is contributing. In order to ensure communication between different sectors and stakeholders, to use the individual and collective capacity of its members for advocacy and action, and to remove bottlenecks that are impeding the implementation of the project, the NCPCR plans to include a review of the implementation status of its agenda twice a year, into its future meetings.

At county level, coordination is ensured through a local coordination group which is part of the County Commission and includes the Prefecture, County Council, representatives of the County Social Assistance and Child Protection Authority (DGASPC), County Health Authority (DSP), County School Inspectorate (ISJ), County Centre for Education Resources and Assistance (CJRAE), and the County Authority for Employment, Youth and Sports. The model is included in the County Social Inclusion Strategy. Therefore, regular updates and coordination with other local activities are ensured through the County Commission that coordinates the implementation of the strategy. This will ensure harmonization and coordination with all the relevant local initiatives31.

The selected county supervisors, (21 in total, coming from county institutions responsible for social assistance, health and education) are performing regular monitoring visits at the community level and provide technical assistance, support and monitoring for the community workers and schools. They ensure the coordination, technical guidance and capacity building for the community teams and school teams that are involved at local level in the delivery of the 2 packages

As mentioned earlier, the Minimum Package of Services is delivered at community level by ensuring the presence of a social worker, community nurse, a school counselor, and, where Roma populations are present, by school and health mediators. As such, the development and implementation of the working methodology that brings these service providers together and facilitates their joint work at the local level is key to the success of the model. The methodology deployed builds on previous experiences already tested and evaluated by UNICEF, which focus on cross-sectoral approaches and case management. The collaboration of the community workers is supported by an online software and platform called Aurora that will be described in detail in the next part. The implementation is also supported by the Community Consultative Committee established by the local authority through a local council decision and to be supervised, guided and monitored by dedicated staff (county coordinators) integrated in the health, education and social protection departments existing at county level32.

The Community Consultative Committee is supposed to support the delivery of the MPS at the community level and includes the majority of stakeholders present in the community. According to the law, these committees meet to discuss all identified cases and service plans with a particular attention given to complicated and complex cases. The meetings are conveyed by the mayor and usually facilitated by the social worker who presents the different cases that will require inputs and support from the other sectors. In these meetings, the mayor plays an observer role and the main discussion and decisions take place among the professionals from the different sectors. In all cases they have to agree on the service delivery plan on which professional will contribute to

31 UNICEF Romania. Second progress report of the social inclusion model grant to the French National Committee. Bucharest, 2016.32 UNICEF Romania. Minimum Package of Services. Internal draft concept paper. Bucharest. 2015.

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Fig. 8: Instruments for inter-sectoral collaboration


AUGUST 2017which part of the implementation of the plan. At the community level, partners include local authorities (municipalities), schools, the police and other social actors such as NGOs, churches, etc. Their capacity to work together on identifying and supporting vulnerable families was strengthened over the past two years. The 45 community teams receive guidance and supervision from the 15 county coordinators mentioned earlier. These coordinators are grouped in cross-sectoral teams, and each team supervises and supports 6–7 communities. Currently, the county coordinators receive technical support from UNICEF sector specialists; however, in the long run, the plan is to progressively have the national authorities take up this technical and leadership role.

QIE vertical and horizontal coordination

Quality Inclusive Education (QIE) is a comprehensive model consisting of a multitude of interventions, tackling various problems and causes of dropout and engaging all decision making and implementation partners in different sectors, in addition to the education system. QIE includes several component based interventions and targets multiple groups of key right holders (children at risk, parents, preschool and school personnel) and duty bearers (national, district and local authorities and professionals from various fields that could support children’s retention and participation to school).

At central level, QIE is coordinated through a Steering Committee that includes the Ministry of National Education, the Institute of Educational Sciences, the Romanian Agency of Quality Insurance in Pre-university Education alongside with three NGOs acting at national level: Centre for Education and Professional Development Step-by-Step, HoltIS Foundation and Community Development Agency „Impreuna”. The Steering Committee has regular programatic meetings in which the progress recorded is reviewed and implementations issues are addressed systematically for the overall horizontal and vertical coordination of the interventions. Based on the monitoring data collected by all partners, the Steering Committee decides on the necessary adjustments of the design, planning, implementation and monitoring and evaluation of the QIE components and interventions.

At county level there is set up a County Steering Committee which includes the County School Inspectorate (ISJ), the County Council, the County Resource and Educational Assistance Centre (CJRAE), County Teachers’ Training Houses (CCD), county education coordinators. Currently, the county education coordinators receive technical support from UNICEF sector specialists; however, in the long run, the plan is to progressively have the national authorities take up this technical and leadership role. Coordination at county level is key in QIE, as the current model envisages the scaling up of QIE at the level of one county, in view to test how scaling up works at the level of one county before proceeding to the scaling up of the model at national level.

At community level, horizontal coordination is ensured via the local level Steering Committee that includes the leadership of the school units and teachers, local governments, parents and other local networks.

The Steering Committees at each level meet regularly to assess progress, tackle the implementation challenges and fine-tune interventions based on the evidence collected. Vertically, the QIE is coordinated through the vertical coordination channels available in the education sector: satellite schools report to the school units (with legal personality), school units (with legal personality) report to the County School Inspectorates and local governments, and the County School Inspectorate reports to the Ministry of National Education.

H. MAJOR INNOVATIONS Innovation 1: AURORA software and platform

One of the major innovations in the context of this model is the development, testing and constant improvement of the AURORA, an on-line instrument operationalizing the integrated working methodology. AURORA i) introduces a methodology for a complete diagnostic of vulnerabilities of children and families by community professionals based on a grid of indicators to be applied in a homogenous way for all members of the household and across all communities; ii) allows availability and transparency of real-time data of children and their families at community level for social protection, health and education sectors; iii) increases effectiveness of monitoring and timeliness of feedback and supervision; iv) supports evidence-

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AUGUST 2017based policy development at various levels using various statistics and reports which can be generated. In that sense, AURORA promotes and facilitates the dismantling of barriers for integrated service provision by community team. The platform supports integrated case management at local level, and provides outstanding necessary elements for evidence-based adjustments of strategies at local and county level, including policies to address existing national disparities33.

Aurora is first and foremost a tool for community workers. For the community teams at local level, the diagnosis of vulnerabilities is an important step toward defining the adapted and individualized intervention plan, including the integrated social services to be provided to the vulnerable children and their families 34. Professionals at various levels have different data visibility—they can usually only access information from their level and the levels of those below them. Social workers, community nurses and school counselors working together in one community, therefore, share the same data, as AURORA’s purpose is to facilitate an integrated case management. To avoid discrepancies in the identification of vulnerable children, a standardized methodology was introduced by the model. The methodology was developed based on a broad theoretical basis and consultations with different stakeholders involved in the process. It is also adjustable over time to better respond to changing and needs on the ground35.

Furthermore, through the web platform, Aurora represents an effective tool for the real-time monitoring of activities on the ground and data aggregation at various levels (community, county, national levels), offering multiple options, from the management of vulnerable children’s cases to timely project adjustments 36. As a result, AURORA could prove to be a useful instrument for local and county authorities for planning their development strategies, as well as for the Government to better plan public policies and national programmes. Since AURORA combines social, health, and education dimensions, it also aims to simplify and increase effectiveness and efficiency of monitoring and evaluation. Moreover, the online platform can also support county coordinators through the monitoring of field activities from the county level to reduce eventual gaps between different communities’ performance37.

How AURORA works:

The platform supports the community workers in each of the steps described earlier in the MPS methodology section.

The identification part of the tool consists of a guided questionnaire of a maximum of 226 structured questions and offers detailed explanations of all questions, as well as a clear description of the vulnerabilities (through direct access to the users’ manual). The questions intended for household members are divided into seven sections: 1) general information about the household and its composition; 2) data about household

members under one year of age; 3) data about household members ages 1 to 5 years; 4) data about household members ages 10 to 17 years; 5) data about women from the household aged 10 years or older who have ever had a partner, 6) household income data; 7) evaluation by the community worker of the household38. These seven sections provide in-depth information on the following dimensions of the household as a whole and of all of its

33 UNICEF Romania. AURORA-Documentation of UNICEF innovations. Internal documentation paper. Bucharest, 2015.34 UNICEF Romania. AURORA Project: AURORA 1.1.1. APP User Guide. Manual. Bucharest, July 2016.35 UNICEF Romania. AURORA-Documentation of the best practices. Internal documentation paper. Bucharest, August 2016.36 A map of existing services is currently under development. Once finalized this map should be linked with Aurora. By superposing the map of services with the vulnerabilities assessed through Aurora, the software should be able map out the needs of services in the community.37 UNICEF Romania. AURORA-Documentation of the best practices. Internal documentation paper. Bucharest, August 2016.

38 UNICEF Romania. AURORA-Documentation of the best practices. Internal documentation paper. Bucharest, August 2016.

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AUGUST 2017members: poverty, living conditions, health, education, family and social conditions and risky behavior (with a focus on adolescents)39. At the end of the questionnaire, the application generates a diagnosis with vulnerabilities (AURORA recognizes 14 vulnerabilities and 40 sub-vulnerabilities detailed in Annex 3) and suggests a number of interventions or services that the community team needs to perform40. Field data is checked and supplemented by information from other local stakeholders like the school, the doctor, the police, etc. The list of vulnerabilities and the grid of indicators measuring each vulnerability are meant to warn of a potential risk for the child/children or the woman/women in a household. AURORA identifies 257 possible interventions/services (see Annex 3) that are grouped in the seven categories presented in Part 3 section F).

Although the entire household is interviewed, the minimum package of services is only generated for vulnerable children and women. The minimum

intervention package is individualized and adjusted to each case. With 257 possible interventions41, Aurora creates the context for a vulnerable child or woman to benefit from at least this minimum package, which is merely a reference point for the work conducted by the community team. The minimum intervention package includes a special service for children at risk of being removed from their families (those who accumulate 7 or more vulnerabilities), called the zero priority service. For the delivery of the zero-priority service, the community worker contacts the DGASPC to validate and supplement/adjust the list of services. 42.

Nevertheless, it should be stressed that Aurora is only a tool and not a magic solution to all case management problems. Users need to put their brains into it. In order for AURORA to be effective as a tool and produce a correct and meaningful diagnosis, community workers need to be able to build good relations with their communities and gain the trust of beneficiaries to dissipate any rumors related to their work and to make beneficiaries comfortable when answering some sensitive and personal questions (i.e. ID number, income, violence, and sexual behavior).

After information and counselling services have been provided by the community workers, the latter will have to join efforts to provide accompaniment and support services when the beneficiary does not

manage to take care of the problem on his/her own. The community workers identify service providers and community or county resources, and take the required steps with the client, helping him/her fulfill various steps to access the required services. The community worker accompanies the parent/legal representative to different institutions in order to acquire the required documents and information and, if needed, it mediates the relationship with other relevant institutions to resolve the case.

Referral services are provided when the solution to the case lies with another professional/institution or when community resources don’t cover the client’s needs. They are delivered either to complement the services provided by the community team or after all the resources of the main service providers and all local solutions have been exhausted. Where the case falls within the competence of a professional available in the community, the community worker will notify that professional about the household’s situation or will help prepare and send the beneficiary and its information to the relevant institutions.

After all the previous steps have been completed, the software supports the community team for their continuous follow-up and monitoring activities on the agreed actions and services to access by the beneficiary. This is done jointly with the beneficiary and the service provider of the needed service. The

39 A detailed list of all dimensions, vulnerabilities and sub-vulnerabilities in AURORA can be found in Annex 340 UNICEF Romania. AURORA-Documentation of UNICEF innovations. Internal documentation paper. Bucharest, 2015.41 A detailed list of all AURORA services for children and their caregivers can be found in Annex 342 UNICEF Romania. AURORA Project: AURORA 1.1.1. APP User Guide. Manual. Bucharest, July 2016.

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Fig. 9: AURORA screenshot. List of household vulnerabilities

Fig. 10: AURORA screenshot. Services to be provided


AUGUST 2017continuous monitoring step is essential for timely re-prioritization of cases and eventual definition of new objectives for each beneficiary and the identification of remaining barriers to access certain services.

Re-evaluation is conducted at least every 9 months during the intervention and is based on the Aurora questionnaire. Similar as in the identification phase the data collected is again checked and supplemented by information from other local stakeholders like the school, the doctor, the police, etc.

Although still in the testing phase, AURORA can already be considered to be a reliable and effective case management and monitoring tool and is appreciated as a promising option for the components of the new e-social assistance system or reporting e-system for community nurses to be developed at national level by the Government. The evaluation of the model in Bacau will bring additional arguments on the relevance, effectiveness and efficiency of such a tool at national scale.

Throughout the process, a couple of challenges (see Part 4 section J) have been highlighted. Some of them are currently being addressed. The three main limitations mentioned are: 1) although AURORA generated a list of services that should be provided to beneficiaries, it did not include a database of services available at the local level. This module has now been finalized and will be launched in September 2017; 2) AURORA only identifies child- and mother-related vulnerabilities and interventions; and 3) up to now only the school meditator can enter data directly into the plateform, the school counsellor not yet. In this context, several additional upgrades may be considered, such as: i) the enlargement of the number of vulnerabilities and services (including ones relevant for adults and the elderly); ii) reviewing the job description of the school

counselor and providing him/her data entry rights accordingly.; iii) improving reporting facilities to correspond to administrative requirements, ie. reporting forms to be generated by the community workers or the local authority; iv) adding pictures and copies of various personal documents, forms 43 etc.

43 UNICEF Romania. AURORA-Documentation of the best practices. Internal documentation paper. Bucharest, August 2016.

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Fig. 11 AURORA screenshot. Service implementation


AUGUST 2017

Innovation 2: Mainstreaming adolescent issues and communication for social change

Another innovative feature tested by the Bacau model is the integration of a communication for social change component addressing social norms that particularly affect Roma communities as well as adolescent issues. Evidence shows that stigma and discrimination are often reported as a barrier for Roma in accessing public services. In addition, a lack of self-esteem and low expectations for education outcomes have been identified as negatively influencing the school enrolment of poor and vulnerable children, especially Roma. Parental attitudes, coupled with low expectations and discrimination from teachers, influence children’s self-esteem and educational aspirations.

Other studies show that the level of knowledge and motivation for safe behaviour among adolescents is low and often determines adolescents’ adopt risky behaviours resulting in teenage pregnancies, substance abuse, alcohol consumption, etc. Adolescents are particularly vulnerable to alcohol consumption, which affects even young adolescents below the age of 15. The communication for social change component focuses on the following campaigns:

a. Local communication campaign to increase children’s aspirations in relation to their educational pathway. This aims at further promoting the value and benefits of education using success models from the community through school and community-based communication and information activities. Based on previous experience, a pedagogical kit was developed along with other didactic materials (movies, book, and an online platform) to allow teachers to increase the self-esteem and educational aspirations of children and their parents.

b. Local communication and behaviour change campaign targeting public service providers from administration, health, education and the social sector for reducing stigma and discrimination against Roma. The campaign is implemented in 34 communities but also targets the whole county to raise public awareness. A special training module, delivered in partnership with the National Council against Discrimination, was developed aiming at building the capacity of the local service providers (school counsellors and mediators, social assistants and community nurses) to recognize and actively prevent inequalities and discrimination based on ethnicity and gender. A similar training package was designed and implemented for school directors. All activities directly address forms of discrimination specifically experienced by Roma girls, boys, women and men.

c. Local communication and education campaign to provide education and behaviour motivation to vulnerable adolescents, to adopt healthy lifestyle and avoid alcohol consumption. This campaign aims at increasing their knowledge about the health and social risks of this behaviour and at building non-cognitive skills in adolescents. It is disseminated online and through three different TV and radio spots at national and local level. Additionally, local professionals were trained and have been working with adolescents to increase their knowledge and build their competencies (non-cognitive skills) to avoid such risky behaviours. Adolescent participation and participatory design is an integral part of the various communication campaigns. In addition to the ongoing national campaign on the prevention of alcohol consumption, adolescents receive services and support from social workers, community nurses, school counsellors and teachers44.

44 UNICEF Romania. Social inclusion through the provision of integrated social services at community level Project Proposal. Bucharest, 2014.

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AUGUST 2017

PART 4: WHAT HAS BEEN ACHIEVED SO FAR, CHALLENGES, ENABLERS AND LESSONS LEARNED?

I. INITIAL RESULTS In the first two years of implementation, several studies, analyses and monitoring activities have already been undertaken. The model possesses a solid baseline of the situation before the intervention started and a detailed diagnostic of all vulnerabilities faced by the children and their mothers for most of the targeted communities. More recently, a midterm review (MTR) was completed. Based on the findings coming out of all these documents, which are complemented by the observations coming from the FGDs, KIIs, and field visit done in the context of this documentation, this chapter will focus on what has already been achieved, what elements have enabled these achievements, what challenges were encountered and which lessons have been learned during this period. It should be mentioned that after only two years it is too early to see outcome level results, and most of the results presented will be at output or process level.

As of today, the majority of activities were carried out according to plan, even though the plan had to be adjusted several times and some of the activities took longer than initially planned (see detailed plan in Annex 2). The main interventions developed during the period October 2014-May 2017 are the following45:

a) Initial assessment and community selection: a selection of 45 urban and rural communities in Bacau County was made by a team of independent researchers.

b) Partnerships: partnership agreements with national, county and local institutions were developed and signed with 4 public and private institutions at national level, 7 institutions at county level, 45 mayoralties and 45 schools.

c) In-depth assessment: a baseline report was written by an independent research team against which the progress of the model will be measured in 2019. The baseline report shows the initial situation in the 45 communities benefiting from all the interactions as well as in 6 control communities from Galati.

d) Selection and recruitment of human resources: professionals from county and local level were recruited for the delivery of the 2 components of the Bacau model (MPS and QIE). At county level, the model recruited 22 coordinators in health, education and child protection who were tasked with providing technical and methodological guidance to local teams. At local level, 57 social workers, 36 community health nurses, 7 health mediators, 36 school counselors, 27 school mediators were hired.

e) Community census methodology using AURORA was developed and used by community workers for the community census and case management in the 45 communities, allowing for real time monitoring of vulnerable children and their families. Based on the real needs of children and women, as identified through the community census, integrated services are provided at community level. This activity is still ongoing. So far,

approximately 19,800 vulnerable children and women have been identified. f) Capacity building for delivery of the minimum package of services and quality inclusive

education: county and local teams were trained in order to enhance their knowledge and skills so that they are able to deliver the minimum package of services, while actively challenging social norms that perpetuate Roma discrimination, risky behaviour among adolescents, and low educational aspirations for and of vulnerable children. A training package on adopting an integrated

45 UNICEF Romania. Terms of Reference. Mid-Term Review of “Social inclusion through the provision of integrated community services at community level” model, Romania. Bucharest, 2016.

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Fig. 12: Vulnerable children and HHs identified by the community census


AUGUST 2017approach at local level was developed, tested and is ready to be certified as part of the national accreditation system for professional training.

g) Capacity building for school and kindergarten staff: 335 teachers received support in order to promote a child-centered approach and prevent school drop-out and absenteeism. A special training module was designed for this purpose and was already delivered.

h) Parenting education: a network of parent educators was established at county level and parenting sessions were organized for 5000 parents. A guide was developed and 151 teachers trained. In all communities, a first round of this activity has been implemented.

i) A local communication campaign to increase children’s aspirations in relation to their educational pathway: a methodology for the selection of positive role models was designed.

j) A local communication and behaviour change campaign targeting public service providers from administration, health, education and social sector for reducing stigma and discrimination against Roma: capacity building of local professionals was enhanced in order to recognize and fight discrimination related to the access of public services.

k) Local communication and education campaign to provide education and behaviour motivation to vulnerable adolescents, including Roma, to adopt healthy lifestyle and avoid alcohol consumption. Several media campaigns were rolled out with the active participation of adolescents in the elaboration of the messages. A training curriculum was also developed and is currently being certified.

l) Communication, monitoring and advocacy activities are undertaken on a permanent basis: website, promotional materials, technical monitoring reports, activity reports, community fiches, field trip reports, high level visits and events46.

In general, all of the documents as well as the first-hand observations confirm that in the initial phase, the integrated community-based Bacau model already shows first promising results in promoting social inclusion and inclusive education. Even if the level of provision of the minimum package of services is still quite low, the simple identification of problems and needs in the community has allowed rapid interventions in serious cases and has prevented child abuse and/or separation of the child from their family. At the same time, the activities of the Quality Inclusive Education Package have contributed to reducing school drop-out and improving parents' relationship with their children. Furthermore, the model responds to the strategic directions on integrated services at the local level set out in the National Strategy on Social Inclusion and Poverty Reduction 2015-2020, the National Strategy for the Protection and Promotion of the Rights of the

Child 2014-2020 and various other national strategies in the health and education sector 47. Recognizing the need to stimulate the development of preventive social services at the local level, and improve the inclusiveness in education, the Bacau model focuses on both: (1) the rapid and coordinated action to reduce the risk that a child will be separated from their family and (2) promote quality inclusive education.

The minimum package of services has so far achieved a number of results – many of which focus on identifying vulnerabilities and needs (see Fig. 13), drafting and testing intervention mechanisms, and creating coordination structures and mechanisms for horizontal and vertical integration and cooperation at all levels (local and county).

46 UNICEF Romania. Terms of Reference. Mid-Term Review of “Social inclusion through the provision of integrated community services at community level” model, Romania. Bucharest, 2016. 47 Academia Romana. Mid-Term Review. Preliminary results.2017.

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AUGUST 2017As a result of interventions at the community level, the following constitute some of the results:

93% of the children who at the time of the census did not have birth certificates or ID cards, have now solved their situation: i) they now have birth certificates; ii) they have duplicates in case the certificate is lost; or iii) for children over 14 years of age, they have identity cards;

97% of the children who were not on a family doctor's list at the time of filing are now enrolled.

All children identified as being at risk of separation according to the definition from Aurora’s methodology, continue to live in their families, which benefits from the necessary support services thanks to the project. It should also be mentioned that the operational definition of the risk of separation of the child from the family is currently been tested and results of an evaluation in 2019 are expected to refine or adjust the definition 48.

However, some vulnerabilities could not be solved in this brief time frame. For example, for approximately 140 mothers under-18 or pregnant teenagers identified, support services are being provided to ensure a good start in the newborn’s life and the mother's health. Additional services will be needed all throughout childhood, however, and beyond as well. For over 1,400 adolescents identified with risk-related behaviour tied to sexual activity, information, communication and awareness campaigns will also need long-term support and follow-up. Another example may be children from over 1400 households that have been identified as being at risk of poverty and whose families do not benefit from the social benefits they are entitled to under the social protection system. These families received adequate support and are now either benefiting or undertaking the administrative procedures that will allow them to benefit from family allowances. However, in order to reduce poverty, a sustainable solution is needed involving other measures such as training and employment, etc. The intervention will have to be considered in the long-term and in correlation with other social inclusion programmes for the parents.49

In addition, observations from the field showed that the model gives community workers and the local authorities much better knowledge of social cases and vulnerabilities as a result of the census conducted via AURORA. The cross-sectoral collaboration through local teams contributed to the identification of more complex vulnerabilities which were previously neglected or insufficiently explored by the available staff within the mayoralty. As such, for example, it was possible to intervene early in serious cases to prevent separation of children from their families. These cases could not have been solved by one single sector but needed the intervention of multiple sectors. These results raise awareness of the importance of prevention and the need to increase the share of preventive activities in all sectors at the local level. The various sectors have also started to gain a better understanding of each other’s mandates, perspectives and bottlenecks and feel empowered in solving cross-sectoral issues as a team. They are now more cognizant of each other’s added values and limitations and can better envision joint solution finding.

The Quality Inclusive Education Initiative has laid the foundations for a "friendly and inclusive school" for all pupils and teachers and has positively changed the image of the school as an institution. The intervention is positively responding to the needs for capacity and professional development of managers and teachers and highlights the importance of early childhood education. This has led to the following outputs:

45 schools and kindergartens have increased capacity to offer inclusive quality education for over 22,000 school children (5000 in kindergartens, 9000 in primary education and 8000 in secondary education)

156 preschool structures have meaningful didactic materials for quality interaction in 257 groups of children

45 school managers, 36 school counselors, and 27 school mediators increased their professional skills (managerial, counselling and mediation)

48 UNICEF Romania. Social inclusion through the provision of integrated social services at community level in Bacau County. Power Point Presentation prepared for the CEECIS Regional Director’s field visit. Bucharest, May 2017.49 Idem

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10% in risk of

repeating the

school year

15% in high risk

of dropout

22,000 students

Fig. 13: Risks and vulnerabilities identified by the community census

Fig. 14: Initial results from QIE


AUGUST 2017 1400 teachers that have increased capacity for positive child disciplining, and to promote child-

friendly schools, inter-cultural education, violence prevention, and the inclusion of children with special educational needs

151 parental educators in 45 schools, 5000 parents educated

11,000 children benefitting from activities developed by micro-grants

As a result, the number of children at risk of drop-out decreased by 27%, of which 74% passed their exams50.

The parental education courses had, according to all the interviewees, the highest success and highest efficiency in the project. The results have been seen in the behaviour of parents who have begun communicating better with children, have been more attentive to their emotional problems, and have understood that it is important to listen to their children and provide them with affective protection. Parents have also become much more present and active in the school environment. Some of them have even asked to become parental trainers and facilitators of parent support groups51.

Furthermore, the interventions increase the satisfaction of school teachers and already changed the attitudes of a number of them. The involved teachers were very satisfied by the training they received. The goal of the teacher training was to create a "friendly school" and the result is that some teachers have changed their teaching style, adopted a modern didactic model in which the emphasis is on creative thinking, involvement and participation of pupils, and not only on memory and reproduction52.

Finally, from a communication for social change perspective, several achievements can be mentioned:

Over 150 community workers and 23 county coordinators have improved knowledge and skills to address social norms-related issues as result of training and capacity building.

The community workers increased their capacity to identify and actively address adolescents’ issues, and to work with adolescents.

Communication packages were developed and tested to increase the capacity of community workers to use a non-discriminatory approach in service delivery and to influence social norms for identifying and preventing violence in the family and the community. The packages reached more than 50,000 beneficiaries53.

J. CHALLENGES AND ENABLING FACTORS Integrated approaches are complex processes that are not yet a characteristic of the working culture in Romanian administration. It goes without saying that this brings a number of challenges to the table and need an enabling environment to be successful. This part will analyze the main constrains faced at an initial stage and factors that enabled the success of such an approach.

Challenges54

As was mentioned above, a commonly acknowledged challenge was the fact that before the introduction of this model there was no culture of working across sectors. Even though cross-sectoral collaboration at the local level is encouraged by the normative framework in Romania and existing methodologies (e.g. quality standard for case management, working methodology for addressing violence against children) these legislations and methodologies are not implemented in a homogenous way throughout the country. Joint planning and implementation of initiatives is often perceived as additional workload and not really part of the mandates of the respective sectors. As a result, some sectors were resistant to collaborate at an initial stage. In general, the collaboration between the social workers and the community health nurses is found to

50 Idem 51 Academia Romana. Mid-Term Review. Preliminary results.2017. 52 Idem 53 UNICEF Romania. Social inclusion through the provision of integrated social services at community level in Bacau County. Power Point Presentation prepared for the CEECIS Regional Director’s field visit. Bucharest, May 2017.54 All challenges identified came out of the interviews with stakeholders involved in the design and implementation of the model at various levels (detailed list in Annex 1) and were confirmed by either monitoring data and progress reports from UNICEF and/or the preliminary findings from the Mid-Term Review of the Bacau model.

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AUGUST 2017function well in most communities, as they work together under the same institution and with the same data collection and data sharing tool (AURORA). On the other hand, the collaboration between the team at the mayoralty and the school counselor, presented more challenges because of their accountability to different institutions. School counselors were not involved in the initial community census and started to have access to Aurora and input the system only after this census was finalized. Also, when starting the service delivery, the availability of the school counselor in the community was very limited given that fact that the number of children that he/she is supposed to serve is 800 as per the legislation and often one school counselor is shared between two or more communities. This made the process of joint case management more difficult.

While documenting the experience it became clear that the aim of integrating all or parts of the interventions offered by the two components of the model is not yet achieved, and that the complementarity of the two packages is not yet fully understood. Both components are still perceived as different, largely because they are implemented at different levels of the community. For example, the QIE package is perceived as being part of the school, which leads to less involvement from the mayoralty. At this stage of the implementation this is not surprising as the full integration of the two packages has not yet started. The strategy was to first design and implement them in a coordinated way and in the same communities while creating space for potential integration of the two packages once they are fully owned by the community authorities and mature enough. Furthermore, the model does not yet have a manual laying out the different modules, tools and methodologies that both packages could potentially offer.

The involvement of the local actors differed significantly and, in some communities, it was found below the desired level and intensity, which had an impact on the number of implemented activities. The main observation that emerged from the preliminary analysis of the MTR and the field visit was, that even if in most cases there was support from local authorities for the implementing the model, the manifestation of this support differed significantly. In addition, local authorities, especially in rural areas, often had little capacity to design and implement measures and services for vulnerable populations. If in some communities the support was predominantly formal and limited to hiring local team members, in others, the authorities became more involved in providing transport means for the movement of local teams, mobilizing other local workers in the activities, and providing space and co-financing opportunities for micro-grant activities.

Two systemic challenges that were repeatedly mentioned were the lack of a harmonized salary scale of community workers between different communities and the variation in the level of commitment and motivation of community workers. Observations showed that for example, social workers with the same level of education and the same level of experience get paid differently in different communities. According to a county coordinator, this can vary from a small discrepancy to salaries that are double the amount earned by someone in the same position elsewhere. After a recent salary scale reform for local professionals by the GoR, harmonized salaries and their sustainability remain a serious issue. This

creates a certain level of frustration in the communities that pay lower salaries, which can lead to either a drop in the motivation of the respective workers or to the workers’ abandoning of their positions for a better paid job in another community or sector. Aside from the different salary scales, motivation and high turnover of

33

Fig. 15: Decentralized funding mechanism of MPS (simplified scheme)


AUGUST 2017community workers is another systemic problem that needs close attention in the future. The most recurrent reasons mentioned are low payments and a lack of dedication to solve social issues.

Another structural issue is the difference that exists in the level of decentralization of various sectors and the gaps in legislation55. Distinct levels of decentralization in various sectors mean that county authorities do not have the same level of responsibility across sectors. The current funding and budget execution processes are quite complex, as described in Fig. 15. Some of the funding goes directly from national level to community level; some of it goes via the county authorities to the community level; some of the funding is clearly earmarked; while some of it is subject to the discretion of the mayoralty. This creates a certain level of flexibility but also leads to confusion, gray areas, and no harmonized way of implementation. In addition, the focus remains on allocating and spending resources based on historical spending, and not strategic priorities and reforms. So, despite good will and commitment to developing and expanding cooperation between sectors at county level, progress remains constrained by such a system. The medium- and long-term sustainability of any service established at the community level remains dependent on budget from the county or national levels. In addition, limitations in the legislation related to budgets, financial flows, structure of the mayoralty, recruiting and retention policy make it difficult and time-consuming to set up new services, even if those are covered by existing legislation.

The successful implementation of the model's activities also depends on the level of qualification of local team members. Even if the hiring requirements were the same for all the communities included in the model, the skill level of the local team workers would not be homogenous, often affecting the implementation of the activities. Even though the project is ensuring the resources for hiring community workers in some communities, the availability of human resources is limited and the model had to top up this investment with intensive capacity building activities for the community workers in order to ensure a reasonable level of service delivery quality. This additional effort increased the number of days of training, coaching and mentoring required but at the same time reduced some costs related to residential trainings. Recruiting competent human resources for the local delivery of social services has been very challenging, especially in rural areas.

Another issue identified is the resistance of several households (mainly from urban areas) to participating in the community census and in the offered support. Analyses and field observations showed that the objectives of the census and support interventions were not always clearly understood and families feared that when community workers from the mayoralty would come to their homes, it was to separate their children from them; alternatively, they feared being stigmatized and labeled as poor. They did not always understand that the purpose of the visit was to first identify the needs of each household and then to offer them the necessary support. Local communities were more reluctant at first but once they understood the benefits of such an intervention, their collaboration with local team members increased. An important contribution to persuading community members to participate in the activities provided by the model was the involvement of existing community workers already familiar with the community.

According to the MTR data, part of the staff that was recruited, were not from the community they were responsible for (about 20% of the community workers are commuting), which sometimes affect the activities of these employees. This raises concerns about community awareness and worker acceptance by members of the family. These are stronger in rural and small communities where people establish closer relationships and know each other. In urban areas, interactions are generally more distant and often occur in formal contexts and with a lower frequency.

A major issue identified both at the level of the QIE and the MPS is the insufficient number of school counsellors and the conflicting expectations for their role. Although the number of graduates in education science, psychology, psycho-pedagogy is increasing, their choices for the position of school counsellors are reduced. The main causes identified are related to the risk and burden of commuting between two or more schools. This challenge is created by the legislative provisions that regulates the number of students per school counsellor and reduced financial incentives. Thus, given the ratio of 800 students/school counsellor, a counsellor should cover more than one school. In such cases, the presence of a school counsellor in a community is only possible for 1-2 days per week, which affects not only the time allocated to student

55 UNICEF Romania. Second progress report of the social inclusion model grant to the Norwegian Government. Bucharest, 2016.

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AUGUST 2017counselling but also the collaboration with the other members of the integrated team. Furthermore, the group of schools in which a counsellor operates does not take into account the distance between them and the counsellor's residence, which makes it even more difficult to carry out the activity.

Finally, the MTR and the field observations found that communication for social change is not yet a full part of the government system and that this component of the model is currently being implemented on an ad hoc basis and in the form of campaigns, which raises questions about its sustainability.

Enablers 56:

One of the major enabling factors, mentioned at all levels, that makes such a complex model work is a strong vision and leadership at the highest level. This holds true both within UNICEF and for the GoR. For both sides, it is crucial to bring all involved sectors together around the same vision in order to build a common understanding and ownership of cross-sectoral work, and show them how this approach helps achieve common goals for social inclusion of all children. This also includes creating the ideal conditions and structures for the sectors to work together and recognize cross-sectoral efforts.

Discussions with local officials and community workers have confirmed that thanks to such an approach, they gain a much better understanding of their own community and a realistic view of all the different vulnerabilities faced by local children and women. They also realize that, as vulnerabilities are often multiple, complex and overlapping, it is impossible for one single sector to address them fully . They can only be addressed through collaboration across sectors and by referring children to the required specialized services. Before, sectors were mostly accustomed to working in a vertical manner and could often not solve the issues of a certain number of children either because they did not feel that it was part of their mandate or because they were not aware of the problem. In that same context , the establishment of partnerships and functioning coordination structures at county and community level should be considered a cornerstone of the mode. Taking into account the legislation in place (e.g. Social Assistance Law, Child Rights Law and Community Health Law etc.), the responsibility for identifying local social needs and the provision of primary social services lies with the public social assistance services at the level of the local authorities. At the same time, the implementation of the principles of inclusive education rests with the educational institutions. As the Bacau model tries to integrate both components, it supports local communities to implement existing legislation.

It goes without saying that functioning Community Consultative Committees that meet on a regular basis and involve all major stakeholders in a participatory manner are a prerequisite for successful coordination. Functioning Community Consultative Committees: The functionality of the Community Consultative Committee (CCC) also varies from community to community. While in some localities these structures/committees are more formal and only meet when there are serious cases of child abuse at the level of the locality. In such cases their involvement as an advisor in the implementation of the model's activities has been extremely low and decisions are being taken by the local authority. However, the observations in the visited communities showed that the CCCs meet at least once a week and there is a good collaboration of the all local actors and the MPS team.

During the field visits and discussion with implementers on the ground it became also clear that the communities where the QIE and the MPS work closely together are often the ones where the mayor and the school director have a positive and constructive relationship and dialogue. In these cases, the local leaders understand that integrating both approaches is to the benefit of their respective sectors and, in the long-run, benefits the entire community. Social assistants and school mediators are able to provide the school with information about the external environment in which the pupil lives so that the school can work in a team with social and health services to address the needs of the child in a comprehensive way. As relationships between the school and the other institutions at community level are not always smooth, meetings between these institutions were facilitated as part of the model. The MTR revealed that the organization of these meetings was perceived as extremely beneficial and improved the collaboration at local level. In some communities, it was also observed that the micro-grants helped to bring the mayoralty and the school together, since one of the requirements was that the two jointly requested micro grants make sure the

56 All enablers identified came out of the interviews with stakeholders involved in the design and implementation of the model at various levels (detailed list in Annex 1) and were confirmed by either monitoring data and progress reports from UNICEF and/or the preliminary findings from the Mid-Term Review of the Bacau model.

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AUGUST 2017activities proposed in both plans were aligned to each other, complementary and addressing issues set as programme objectives. In some cases, this not only strengthens the relationship and collaboration between these two institutions, but it also boosts the capacity of the managers to draft funding requests and respect timelines, templates and reporting requirements. The new skills will be important to ensure sustainability and scale up as the communities now have more capacity of tapping into potential funding sources.

Good communication within the project team, between the community workers or between them and the county coordinators, but also between the project team and the local actors is one of the factors that facilitate the implementation of the model. This is not subject to strict rules, but adapted to the local context and social capital of team members (personal or professional relationships established outside the project), which they have not hesitated to capitalize on in order to complete the professional tasks of the project. As mentioned in the innovation part., the model has succeeded in facilitating communication between the three local actors responsible for community welfare and made them work together using the same online tool called AURORA, which encouraged them to visit families in joint team and move away from their offices. The AURORA application can form the basis of an e-social welfare system as it permits all sectors to access the same level of information when needed which helps to take evidence based decisions. Beside the formal communication ways, the local teams have also set up informal communication mechanisms like Facebook groups that are very helpful for regular sharing of information and pictures in a less formal and quicker manner.

The concept of county authorities providing support, guidance and assistance to local stakeholders represents a shift in a culture that used to focus more on monitoring and sanctions. This change was welcomed from the community workers. The fact that they can require support from the county level coordinators strengthened the communication between both levels and improves the quality of the delivery of the services. Both level now better understand the challenges of each other and in as a team find more tailored solutions for the complex cases that need to be solved. The county level coordinators go on regular joint missions (education, health and social protection) to monitor, coach and support the community teams and are much closer to the community and more aware of the respective realities.

According to many respondents another major factor of success was the large effort to invest in people’s capacities. The level of qualification of human resources are crucial to implement such a complex approach. The model has largely invested in the community workers technical skills training them on the working methodologies and tools, but also provided them with opportunities to improve their soft skills with regard to interaction and communication with the beneficiaries. Joint trainings of social workers, community nurses, school counselors, school and health mediators have been an efficient manner to bring the three sectors together and stimulate their involvement and collaboration at an early stage. In both packages, the experience sharing and peer learning component is an integral part of the process and very well appreciated at all levels. Both, the MPS and QIE take the practitioners to communities where the models have been found successful and showing good practices. This helps the practitioners to see that the issues faced by other communities are often very similar to their own and they can learn from their peers. In the QIE package peer learning is part of the ongoing capacity building with an online platform being in place. Here the teachers and schools can post their good practices and activities that are undertaken in the context of the micro-grant implementation, but also ask questions and share experiences about the newly acquired teaching techniques. They can post their challenges and get responses from other colleagues in other schools. These platforms are very valued by most teachers and managers but its utilization varies from one community and one teacher to another. Additionally, the peer learning has been found to be a cost-efficient practice that can serve as continuous learning opportunities.

K. LESSONS LEARNED57 AND PLANNED SOLUTIONS FOR REPLICATIONThe process of designing and implementing the model in Bacau County was not an easy one and institutions at various levels responded differently to the project. Local authorities having had little to no previous

57 All lessons learned identified came out of the interviews with stakeholders involved in the design and implementation of the model at various levels (detailed list in Annex 1) and were confirmed by either monitoring data and progress reports from UNICEF and/or the preliminary findings from the Mid-Term Review of the Bacau model.

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AUGUST 2017experience in establishing similar partnerships and implementing such a model, some partners in particular at the local level responded initially with reluctance, not fully understanding the utility of the model for the community. However, the learning process, which was guided by a strong vision from the county authorities with support from national level and UNICEF, led to a change in the attitude of the local authorities, which gradually became active factors, involved in solving the problems identified by the community workers and key resources for the success of the project.58 The process brought out a number of lessons and solutions, summarized below, that will be considered when replicating this model in other counties in Romania.

Lesson 1: Ensuring ownership of the approach at all levels and at each step is key

A crucial element of success of the model so far, was that its designers and implementers took the necessary time to create and sustain ownership at all levels and throughout the entire process. This started at the initial phase of conceptualization where all three involved Ministries formally agree on the approach and the vision and provided their feedback to improve the design. In the phase of setting up the teams at local level the local authorities fully owned the process and recruited the community workers through their regular procedures with support from UNICEF. With regard to the large capacity development efforts, a number of trainings where provided by experts from the different line ministries. Finally, the implementation and monitoring of the model is currently partly done by the local teams with strong support from the county coordinators and UNICEF. In the long-run, this function should be assumed by a national management unit. Involving the authorities at the national county and community levels in each step is a lengthy process that needs a lot of dedication and long-term perspective from all involved parties, however is necessary to ensure the sustainability of the model.

Lesson 2: Plan with a vision and long-time perspective. Based on this first lesson and on the fact the social change is slow, it became clear in this model that it was not possible to achieve the aimed changes in a short period of time (i.e. 2-3-years). As shown by the summarized historical timeline in Fig. 16 the timeframe of the Bacau model from the initial preparation to its planned support for scale up is closer to 11-years. This period includes the testing of the two “predecessors” components of the Bacau model before deciding to integrate them into a single one. After the conceptual phase, a rigorous baseline and bottleneck analyses was undertaken to have a snapshot of the initial situation of children before starting the intervention. The baseline is crucial in order to show the real impact of

the intervention. The first and major step of the model consisted in the recruitment and training of human resources to then undertake an in-depth diagnostic of all the vulnerability of all children and mothers in targeted areas, before starting the provision of the needed services. In parallel UNICEF and its partners continuously advocated, and continue to advocate for the importance of such an approach at all levels, build up capacity building of human resources and constantly adjust the model and its tools integrating the feedback received and responding to the new emerging needs

Preparation and capacity building of QIE

58 Academia Romana. Mid-Term Review. Preliminary results.2017.

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Fig. 16: Bacau model historic timeline of


AUGUST 2017When designing the QIE Model there was placed a specific focus on identifying resources already existing in the system of education and avoid creating new posts and generating corresponding costs associated with additional human resources. Instead, at all level the existing institutional structures and human resources have been adjusted for the implemention of QIE and its scaling up at the level of Bacau County. This approach also helped in sustaining the ownership of the existing institutions at all levels (from the Ministry of National Education to each school involved in the Model). Within QIE Model the current set up of the system was used in order to address the barriers faced by the vulnerable groups of children at grass-root level (school, family and community level). At county level there were used county coordinators, connected with the county level agencies that guide activities at school level.

The capacity building activities in QIE also took into account the various layers of implementation from the national level to the local level. At national level, the capacity building activities targeted the Ministry of National Education, the Institute of Educational Sciences and the Romanian Agency for Quality Insurance in Preuniversity Education. At county level, capacity building activities targeted the county educational agencies (County School Inspectorate, County Resource and Educational Assisstance Centres, County Teachers’ Training House. At local level, QIE includes numerous capacity building activities for the promotion of the quality and inclusiveness of education targeting the school actors: school management, teachers, school counselors, school mediators, local governments and parents. QIE Model induces a shift of paradigm in the education system in Romania where instead of designing the policy framework and then monitoring compliance of schools with the new framework (top-down approach), the policy framework is developed based on the evidence generated and collected at school level - needs, bottlenecks, issues – (bottom–up approach). This shift of paradigm is in itself a capacity building exercise with the Ministry of National Education and the County School Inspectorate exploring the ways on how to best serve the schools in their improvement efforts.

The historical timeline only reflects the major milestones in the Bacau Model. Its objective is to show that while trying to bring a paradigm shift at various levels, be it in the mentality of community workers and their way of working as well as at the entire community level, such changes cannot be expected in a short term. This requires a long-term vision from the highest-level leadership down to the grassroot implementers , and a lot of stamina and commitment at all levels throughout the process. In this context, it worth mentioning that the implementing team allowed sufficient time in the preparation phase such as, setting up structures, recruiting qualified people at community level and strengthening their capacity. This was key to achieve the promising results up to now. Such long timelines can create frustrations, as such it was important to keep in mind the end results and the significant changes that can be achieved in the wellbeing of the children and their mothers and ultimately of the entire community. This might seem obvious at this stage but it is helpful to keep this in mind when replicating such a complex model.

Lesson 3: The universal community census presented more challenges and was more time intense than planed

Beside the fact that the universal census was way more time intense than initially planned, the team also learned over time that it was maybe not the most adapted way of identification of vulnerabilities in a cost-efficient way in all types of communities. As mentioned earlier the communication on the community census was not always sufficient for the beneficiaries to understand the entire objective of the exercise which resulted in some resistance and in particular in the urban areas, where the community workers struggled most in terms of responsiveness of the people. Main stakeholders even questioned the fact if this census would be adapted in the urban setting

To address this issue the implementers decided to improve the communication to the local population, on the objectives of the census and the support provided afterwards. The channels of communication will be adjusted to each context and will be inspired by good practices used in some successful communities (e.g. locally designed communication campaigns using inexpensive channels like community information boards, information sessions for parents in schools and letters send to parents by schools.) or by the statistical institute during their regular population census. This solution will also be considered for the replication phase

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AUGUST 2017Furthermore, the implementation team is in the process of assesing if the community census is most efficient way to identify vulnerabilities in the urban setting and to develop an intermediate methodology. One suggested intermediate solution, is to use the existing lists of already identified vulnerable people (from different sectors) at county and/or community level and undertake the community census in a progressive manner but with a longer timeframe. According to a Government Decision (HG691/2015) the social worker is supposed to visit and diagnose all HHs in the community at least every two years. So, these lists would be a start to identify the most urgent cases until the community is fully assessed by the community workers. In the same context, the timeframe should be much longer then planed in the model.

The team also decided to rethink and adapt the model to the urban setting: This holds particularly trough with regard to the community census and the identification of vulnerabilities but also the schools and their respective pupils involved in the programme and the artificial delimitation of the urban community as the school catchment area. In urban areas, some children did not live in the catchment area of the community census and in other cases they live in the census catchment area but go to schools not targeted by the model. This makes it hard for the community workers to follow up with them and identify their needs. Once the model works at larger scale this issue will be naturally addressed, but the issue will be considered in the short term.

Lesson 4: AURORA is crucial for identification of vulnerabilities, provision of services and real-time data sharing across sectors

As mentioned in the innovation part, AURORA is at the heart of this model and approach. It increases the efficiency of the community workers, gives them a methodology to identify vulnerabilities sand provide services and facilitates the data-sharing of all involved sectors. Nevertheless, a number of challenges still remain with the software and that will need to be need further attention.

In that sense the development and improvement of AURORA needs to continue Even though AURORA has constantly been adjusted over the two last two years there still a number of gaps that should be addressed before scaling up. A first step that is in the process of being implemented, is to give data entering access to the school counselors and managers for services that they are providing. This will not only make the process smoother and create full ownership of the AURORA methodology at the level of the school, but will also potentially improve the collaboration between both components of the model. UNICEF and its partners also carefully considers extending AURORA to other categories of populations and their respective vulnerabilities to make it a full integrated case management tool not only focusing on children. This could provide useful information to decision-makers to be used to adopt effective social policies for the entire community.

Additional solutions referring to the challenges identified:

In order to replicate the model at a larger scale, UNICEF and its partners will continue the advocacy for for structural changes in the national legislations It is important to clearly define the roles and responsibilities of the school counselors, re-define the number of students per school counselor and the limit his geographical area of work. Additional changes in legislation are needed to make the recruitment of community nurses and social workers mandatory and harmonize the salary scales across communities. The evidence generated by the model also suggests earmarked funding to finance the model structure.

Even though both packages have developed clear working methodologies and a number of tools, procedures and regulations, there is no document laying out all the potential modules an intervention that both components have to offer. In the context of the replication of the model (fully or only certain parts of it) the design and implementing team plans to de develop guidance manual for both components of the model (QIE and MPS). Such a document could serve as reference for other counties that would like to replicate parts of the model the Bacau model or even the full package. The manual should include the different tools, training packages, needed structures and the detailed definition of the type of services for the most common categories of vulnerabilities. The document should also clarify how both components could potentially be integrated and how to include the methodology in cross sectoral legislation.

Ideally the model should be replicated as a full package addressing all the child related issues in a holistic manner. However, acknowledging existing constrains in terms of human and financial capacity at various levels, the model is designed so it can be scaled up in a progressive manner. If for example in some communities the priority is to address the multiple vulnerabilities of children and women in a first stage

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AUGUST 2017before tackling the quality of the education system, it could start by replicating the MPS component before moving to the QIE component in a second phase. The same holds true if the community wants to start by improving the quality of its schools, it could decide to implement the QIE interventions before moving to the MPS package. Even within both components there is some flexibility to start by implementing a number of selected modules before rolling out the entire package. To support the progressive scale up of the model UNICEF and its partners will continue to share its satisfactory results at all levels, advocate for the relevance of the approaches and technically support its scale up.

Finally, the two packages have developed an impressive number of capacity building tools which all have the potential to be certified by the national authorities. This provides an opportunity to develop standardized tools that respond to high quality standards and the needs identified in terms of capacity gaps of community workers, school teachers and managers, for the training needs of the respective sectors. UNICEF submitted the developed tools to the competent authorities to obtain the necessary certification and will advocate for the integration of some of these packages (e.g. soft-skills and participatory teaching methods) into the regular curricula of the community professionals and into their “on the job” training programmes.

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AUGUST 2017

PART 5: THE WAY FORWARD

L. SUSTAINABILITY OF THE MODELAs already mentioned, the provision of integrated services at community level is an integral part of the Government’s National Strategy on Social Inclusion and Poverty Reduction which will guide the allocation of national and European funds for the period 2014-2020. Integrated services are also featured in the Child Rights Strategy and various other strategies in the health and education sector. The modelling of such services in at least one county was agreed with three ministries. To enforce the social inclusion strategy, the sustainability of the Bacau model was embedded into the project as one of the main components and is addressed through the involvement of all concerned local and national authorities from the design phase to the coordination phase, and up to the regular and joint monitoring of the model. Furthermore, the model uses regular government structures, procedures and budgets to recruit, train and employ all staff deployed by the project. The model also created clear linkages between the evidence generated at county level, on the one hand, and policy reforms and budgeting, on the other hand. Particular attention is given to the allocation of EU funding for the 2014-2020 cycle59. Finally, the model builds the capacity of local authorities to access EU funding to finance the cost of the provision of social services and inclusive schools. UNICEF Romania has also started a dialogue with the Ministry of Regional Development and European Funds to advocate for the allocation of national resources and European funds to support this reform60.

Even though the legislation in place for the provision of health, education and social services includes the possibility of hiring the required staff to implement the model, the administrative procedures to secure these positions are often too complicated and, even if funding may be available, these positions are not considered a priority. To address this issue, the project not only ensures commitment from the local authorities to take over the salaries for the outreach staff, but also advocates that the salaries for the outreach workers are included in the local budget as a mandatory component for each community.

Compelling evidence generated in Romania itself also shows, through different models, that the MPS is more cost-efficient than the current approach that focuses on expensive, specialized services. Cost estimates show that scaling up the entire MPS package in all rural areas would not exceed €100 million for the first year, including the costs already covered by the public system which represents approximatively 0.067% of Romanian GDP. The extension to all urban areas would cost an additional € 31 million 61. These costs include

salaries for community workers, the cost of supplies and transportation, the cost of implementing an integrated case identification and management instrument based on internet and mobile technology (AURORA62), and the costs of capacity building for community workers and for guidance and supervision from county level.

The cost of implementing the Quality Inclusive Education Package at national level during the first school year represents approximatively €135 million or 0.09% of Romanian GPD which equals €84/student/year as it includes start-up costs such as training of school managers, teachers and parental

59 UNICEF Romania. Social inclusion through the provision of integrated social services at community level Project Proposal. Bucharest, 2014. 60 UNICEF Romania. The Minimum Package of Services. Theory of Change. Internal document. Bucharest, 2014.61 Price Waterhouse Coopers. Financial impact analysis for scaling up a model of community based services at national. Internal document, not published. Bucharest, 2015.62 This estimate only includes the tablets. The costs for the maintenance of the entire system was not included into the calculation.

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Fig. 17 Cost of scaling up the MPS package

Fig. 18 Cost of scaling up the QIE package (2nd year)


AUGUST 2017educators as well as supplies. From the second year on, the cost would already decrease to Approx. € 32/student/year or a total of USD 63 million (0.04 % GDP)63.

While scaling up the Minimum Package of Services and the Quality Inclusive Education package at the national level will represent an additional cost during the first years of implementation, expenditures dedicated to specialized services (such as hospitalization, institutionalization and alternative services for children separated from their families, second chance programmes, etc.) are expected to decrease, compensating for the initial investment. Services could be implemented progressively, starting with disadvantaged communities/schools and/or counties. A costing study presents a number of different options for how the MPS could be scaled up in a progressive way. Extra-budgetary sources (e.g. European funding) could initially be used to offset the additional cost. The costs in the medium- and long-term of the MPS could be covered by the savings resulting from a reduction in specialized and expensive services64.

Based on the discussions held at local level as well as some of the preliminary results from the midterm review, one can conclude that sustainability and replicability of MPS and QIE heavily depends on political will and is directly linked to the perception of the utility of the community workers. The sustainability and replicability of the model also depends on which components we are referring to. None of the interviewed partners could give a full picture of the sustainability and replicability of the entire model with the totality of its components. Overall, there is nonetheless quite a bit of optimism in this regard, both on the part of national level partners as well as on the part of the community.

The MTR confirms that the local authorities' representations of the sustainability of the model are rather optimistic and not always based on analysis of the concrete ways in which it can be assured. Thus, representatives of local authorities are interested in continuing the project after the end of the funding but only some of them have actually attempted to identify sources of funding. The county actors believe that resources will be found for the subsequent financing of community workers, not just those from the “Programul Operațional Capital Uman” (POCU) funded by the European Union, but also from other national programmes or even their own funds65. Furthermore, in 2016, the Ministry of Health has increased the budget allocated to community nurses and the number of posts (increased by 30%)66.

Regarding the sustainability of QIE, it can be said that the objectives pursued by this package are compatible with those stipulated in the national polices and strategies regarding the organization and functioning of the Romanian education system. From this point of view, embedding the practices and objectives of the model in legislation and in the regulations governing the education system is a possible aspect and facilitates the sustainability of the project. However, the implementation of the project also requires some financial support, training of teaching staff, micro grants are not yet fully covered by the current available resources. From the discussions with local public authorities and with national partners, school principals have not yet identified all necessary resources with which to continue the project. Even if a lack of financial resources remains a risk factor for the sustainability of certain components of the package67, some of the above-mentioned gaps could for example be covered by Programmes of National Interest or by amending the per capita formula. Furthermore, continuous teachers training is already part of the national policy and included in the education budget.

63 UNICEF Romania. Costing of the Quality Inclusive Education package. Internal document, not published. Bucharest, 201564 UNICEF. (2016) Community-based child services: Social inclusion through the provision of integrated services at community level and UNICEF. (2016) Quality Inclusive Education package65 Academia Romana. Mid-Term Review. Preliminary results.2017.66 UNICEF Romania. Second progress report of the social inclusion model grant to the Norwegian Government. Bucharest, 2016.67 Academia Romana. Mid-Term Review. Preliminary results.2017.

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AUGUST 2017

M. WHAT COMES NEXT?

Given the promising results the Bacau model has brought thus far in terms of social inclusion of the most vulnerable people through early identification and prevention of risks, one of the major objectives at this stage is to ensure the sustainability of the model within the county and extend this type of intervention to the entire county using locally mobilized resources, before moving to other counties in the same region with financial and technical support from the national authorities. As such, UNICEF Romania, jointly with its partners, is currently analyzing all opportunities to attract additional funds - to support the replication within Bacau and to other

counties - through projects with objectives aimed at increasing access to social services and the social inclusion of the most vulnerable children and their families.

In that context, it should be mentioned that UNICEF supported the GoR to submit a proposal to access EU and Norwegian funding to further develop the concept of a minimum package of social services as modelled by the present project and to replicate it in another 6 counties. These proposals are currently being analyzed and waiting for formal approval. Once the funding for continuing the scale-up of the model is secured, UNICEF will continue to provide technical assistance to the Government of Romania to implement the approach in other counties and, eventually, nationally. By continuously supporting the development of national strategies and operational programmes, the Country Office already succeeded to incorporate the Minimum Package of Social Services into these strategic documents and is in a unique position to support the definition of guidelines to facilitating the operationalization of such a model at larger and influence the future allocation of financial resources. At the same time the UNICEF office was actively involved in the process of developing the plans for large non-competitive grants in Education funded by Human Resources Operational Programme. These proposals are requesting over 115 million Euro and include elements of QIE with the aim of national implementation.

As already mentioned earlier, the operationalization of the MPS and QIE on a larger scale can be achieved either by modifying sectoral laws separately or by enacting a unique law to define the framework for this inter-sectoral approach, clarify the roles and responsibilities at national, county and community levels, and to define the management, funding flows, and monitoring and evaluation mechanisms. In that sense, UNICEF and its partners will continue their advocacy efforts at all levels in a flexible and tailored manner and will try to achieve not only sustainability but also ownership and mutual understanding of the integrated approach from national to the community level. These efforts aim to activate all possible means to secure the necessary policy and legal changes. With regard to the large capacity building component of the entire model, UNICEF will submit the training packages for official certification, and advocate to integrate them into the regular curricula of the community workers and managers at all levels.

Finally, Bacau County has always manifested its willingness to share their experience with not only other counties in the country but also other countries in the region. Previous exchange of experiences with Ukraine, for example, was extremely productive. Bacau County will continue to seek other opportunities for horizontal cooperation at national and international levels. These exchanges will be further strengthened through the presentation of the model in knowledge sharing platforms at the European and global levels and internally, within UNICEF regional and global management team meetings and webinars in order to inspire other countries to adopt similar approaches.

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Fig. 19: The way forward: Major steps of the policy advocacy at all levels


AUGUST 2017

PART 6

N. INTEGRATED AND CROSS SECTORAL APPROACHES TO UNICEF PROGRAMMING AS A CENTRAL PART OF THE NEW UNICEF STRATEGIC FRAMEWORK 2018-2021

As spelled out in the new UNICEF draft Strategic Framework (2018-2021), the organization continues to promote the rights of every child, everywhere, and in everything the organization does with a focus on equity. Each of the Goal Areas defined in this framework ought to work in an interlinked manner. Progress in one area requires, and contributes to, progress in others, reflecting the complexity of the challenges children and their families face and the interconnectedness of the world they live in. Furthermore, the framework sees the achievement of equity (Goal Area 4) for children as a cross cutting issue. This Goal Area seeks to address some of the key factors that underlie intergenerational cycles of inequity among children and stresses the need for holistic and integrated approaches. In that sense, the framework outlines “fostering cross-sectoral and multisectoral programming that responds to children as a whole and to the environment in which they grow up” as one of the main priorities and change strategies that UNICEF will deploy to achieve its 2021 results68.

Even though the equity, and the multi- sectoral approaches are not new to UNICEF, the organization has not yet established standardized procedures and mechanisms for systematic cross sectoral programming. Nevertheless, there are a few promising examples in certain UNICEF offices that the organization can build on. The Bacau model perfectly fits into this “new” way of working across sectors in a coordinated manner. As such UNICEF Romania has a number of enabling factors, challenges, lessons learned and thoughts to share. This section will highlight these aspects from an internal perspective and aims to provide practical considerations that could help other UNICEF offices to effectively engage in cross sectoral programming and integrated approaches.

O. ENABLING FACTORS69

One of UNICEF Romania’s main strength and value-added to work in an integrated manner, is the fact that it engages on a regular basis with all line ministries that are mandated to work on child related issues (i.e. Social Protection and Labour, Education, Health, Justice, Youth and Adolescent). The office works both on upstream policy advocacy at national level, but also provides capacity building and technical support to local partners for programme design, modelling, and implementation. This dual working stream provides the organization with the necessary expertise and credibility to undertake informed policy advocacy and positions the organization as a reliable and trustworthy working partner for the Romanian Gouvernment. While supporting the various sectors individually, this also gives UNICEF a unique position to mobilize a large number of different sectors around common objectives and play a facilitating role in cross sectoral collaboration. In the case of the Bacau model this is done through the establishment and facilitation of steering committees at national and council level that coordinates the implementation of the integrated approach with a representation of all involved stakeholders as described in Part 3 section G).

Evidence also shows that the success, ownership and sustainability of such programmes depend a lot on political will. Based on the preliminary findings from the MTR and discussions with a couple of mayors and coordinators at the county level, one key factor of success is the fact that local leaders are realizing that such an approach can improve their capacity to serve the community and to lead to political gains and increased legitimacy. This might seem irrelevant at first sight but the realization that, in some communities, solving social issues could be as relevant – if not more – than solving economic issues is a major step forward towards building-up political will and supporting the continuation and scale-up of the Bacau model.

68 UNICEF Strategic Framework 2018 – 2021, Discussion Paper Draft October 201669 All enablers, challenges, lessons learned and considerations identified in this section came out of the interviews with UNICEF staff involved in the design and implementation of the model at various levels (detailed list in Annex 1).

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AUGUST 2017Even if the organization has an added value to work across sectors, it needs to create a conducive environment internally that encourages such collaboration. The UNICEF Romania team identified some success factors and practices that promoted the coordination across sections and joint accountability.

Since its initiation, the Bacau model has been seen as the office’s main priority and every section is joining efforts to achieve common objectives. This is reflected in the office’s vision and believe that sectoral approaches alone cannot solve the complex issues faced by children and their families and that an integrated way of working is more coherent, efficient and cost effective. The vision starts from the fundraising activities, that are done exclusively in a cross sectoral manner . Furthermore, the management not only encouraged and facilitated cross sectoral coordination form the onset of the model on, but was also involved in each step of the approach starting from the design phase, over the implementation and advocacy phase, up to the evaluation of the intervention. The office also insists on good collaboration between different programme sections and the communication team to ensure that the communication around the approach is in line with the reality on the ground, and that all teams share a common vision and messages on the model. In the same context, the office developed a number of tools and mechanisms to improve collaboration between different sections:

1) Weekly programme and coordination meetings which are facilitated by the county office coordinator and involve all programme sections. The main objective of these meetings is to report on progress made and challenges faced in the implementation of the approach, and to jointly come up with potential solutions and provide feedback to the other colleagues. The different sections also communicate on major upcoming events and the respective inputs required from other sections. In addition, there are bi-monthly meetings (or more often if needed) between the county representative, programme sections and operations to discuss strategic and operational issues.

2) The office created a coordinator position to facilitate the day to day collaboration activities among all involved sections, as well as the support that UNICEF is providing to its local partners at county level. While creating this position it was crucial to exactly define its roles and responsibilities and make all involved sections accountable to the coordinator even if they don’t have direct reporting lines. Among other things the coordinator established, monitors and updates a cross sectoral working plan laying out the major activities implemented by the different components of the model in order to avoid overlaps in major events, and involving the same stakeholders in the respective activities. In addition to the coordinator position the approach required a programme assistant in Bacau county to support the local partners with regular planning, financial management and reporting requirements.

3) Even though the financing sources for the integrated approach were diverse, the received funds were merged into one single budget for the Bacau model, creating economies of scales and leveraging different funding sources for various aspects of the model. Each section remains responsible for the management and reporting of its share of the joint budget. This was possible with the help of supportive and flexible donors embracing systematic and holistic approaches.

In addition to the above-mentioned enablers the office is planning to provide further capacity building opportunities to its stuff to improve the systematic work in task forces and across sectors.

P. CHALLENGESAs described in the previous paragraph, the office created an enabling environment for the implementation of an integrated approach. Despite all efforts, one must acknowledge that working across sectors is still relatively new within UNICEF and requires changes in the ways of working that are not always straight forward and easy to implement. As this has so far been a learning by doing process, a number of challenges were identified since the beginning of the initiative. Some of these were addressed, while others remain, but regardless of their status they all remain important and need to be taken into consideration when trying to change the internal ways of working.

A first challenge that can hardly be addressed by UNICEF, but makes the implementation of such an approach complicated is the political instability at national level and the permanent changes of high-level decision-makers. Since the Bacau model started, some of the ministries changed their ministers up to four times, which

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AUGUST 2017had implications on the different directorates and the lower level policy makers and made it difficult to create a common ground across sectors and to ensure continuity in the implementation phase. However challenging this has been so far, it should be noted that, despite these numerous shifts, the political support for the model has remained unchanged at all levels. This is partly thanks to the continuous advocacy and capacity building efforts of UNICEF and its partners with the new and changing leaders.

Even if mechanisms are in place to facilitate cross sectoral collaboration, coordinating different sectors remains a challenging task for various reasons. At an initial stage, the common objectives of working across sectors might not be equally understood and not every section necessarily sees how its own outcomes will benefit from such an approach, which could create some resistance. To overcome this challenge, it should be clear to all sectors how an integrated approach will contribute to the individual sectoral results. Even if an office decides to work in an integrated manner most sector specialists will still have to report on their sectoral outcomes at regional and global level. Another challenge is the ways of working and timelines various sectors have. As an example, one can mention the parallel timelines between for example the education and the health sector. The schoolyear that starts in September and ends in June. Most of the services and every intervention in the education sectors will have to be aligned to these timelines that do not necessarily apply for the health sectors where services are provided all year round. In the same context, the level of decentralization differs from one sector to another, as does the way support is provided to their partners. While some sectors try to provide most of its support through the government system, others cannot do that as the systems might not provide the needed services (e.g. parental education). In such cases support will have to be provided through NGOs for example. Finally, some interviewed staff mentioned a lack of clarity with regard to the definition of roles and responsibilities between the coordinator, the sectoral specialists and its partners. All these issues and realities need to be considered and addressed while working and planning jointly.

Another challenge that was mentioned by most interviewed people was the long timeframe that needs to be considered when trying to move towards an integrated approach. As mentioned earlier, cross sectoral planning and programming requires a paradigm shift in the ways of working it should be stressed that such changes sometimes take time to take place. This has already been described in detail in section 4 K, referring to the government partners, but is equally relevant internally. The major issue in that context is to set realistic goals and manage expectations at all levels, starting from the involved professionals up to the management, including from the donors. As an integrated approach aims to bring systematic changes, one cannot expect fast results. It is important to keep the motivation and focus while delay gratification of long term results. In the case of the Bacau experience these timelines went way beyond a regular programme cycle. The preparation of the model began in 2011 and the support to the government will continue at least until 2018.

There are also a couple of operational challenges related to the implementation of such an approach. With regard to the transfer of budgets to the implementing partners, the office uses direct cash transfers (DCT). Due to the government procedures, it was not possible to send a single transfer to the national and or county treasury who could have re-distributed it to the different communities and schools that receive financial support from UNICEF. In that sense, the office has to undertake a separate DCT for each of the benefiting mayoralties and schools which results in more than 80 DCTs. This adds a large financial management and reporting burden, both internally for the operation section and programme assistants, as well as on the implementing partners. In addition, a number of communities never received any prior financial support which created an additional capacity challenge in terms of fund management and reporting. Furthermore, some of UNICEF’s internal procedures have been found not to be adapted to such complex and time-consuming approach. One of the examples mentioned here is the renewal procedure of long term agreements (LTA) the organization has with certain service providers. According to the UNICEF regulations these LTAs have to be opened up for competition every two years, which has created some challenges in this context. The project developed, and is constantly improving an IT platform supporting the model, called AURORA (see section 3 H for details). The company that won the bidding process for this contract has provided highly satisfactory services over the entire period of the project and its services will be required until the model is handed over to the government as the software is constantly being adapted. In that sense, they do not only have the unique technical IT experience required to finalize this process but as well the institutional memory of the entire process and the required tacit knowledge of the model’s specific needs. As

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AUGUST 2017UNICEF has to renew the LTA every two years and open it up for competition there is a risk to compromise the progress done up to that point, by recruiting a different company.

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AUGUST 2017

Q. LESSONS LEARNED AND CONSIDERATIONS FOR UNICEF OFFICES THAT WANT TO MOVE TOWARDS AN INTEGRATED APPROACH TO PROGRAMMING

As described throughout the document, it has become clear that the process of moving towards an integrated approach was not an easy one. Having had limited previous experience in working in a cross sectoral manner the office learned and adjusted alongside the process. While moving towards integrated programming the Romania office learned a number of lessons, summarized below, that should be considered by other offices when embarking on similar experiences.

Lesson 1: One major lesson learned that was already mentioned a number of times, is the long timeframe that an office needs to consider when moving towards an integrated approach. The collaboration between all sectors in the case of the Bacau model has been a learning by doing experience and operationalized gradually. In a preparation stage, before the Bacau model was designed, the office tested the two main components of the model (HIC and SAI) separately, evaluated them and learned from them. In a second stage, the office identified the need to integrate both components and get all teams to agree on joint objectives. In the current implementation stage, the model is still constantly adjusted and improved based on the feedback received from professionals on the ground. In parallel, it is crucial to engage high-level policy makers continuously to create the same level of ownership and sustainability of the approach at the Government side. This iterative and gradual approach showed good results in terms of ownership at all levels but took much longer as initially planned, which has the potential to create temporary frustrations.

Consideration 1a: Create ownership and commitment from all sections form the design phase on by agreeing on which parts should be integrated and clearly defining how they should work together . As the preparation phase is crucial for the success of such an approach it is important to plan sufficient time for that phase (1.5 years in the case of Romania), while not expecting tangible results. During that phase, the office mobilized all the sections around the same objective by undertaking a thorough bottleneck analyses looking at determinants of social exclusion of children and their families. The results of these analyses showed that there was a lot of overlap across sectors in terms of bottlenecks that needed to be removed to improve child wellbeing and reduce vulnerabilities and social exclusion.

Consideration 1b: In terms of policy advocacy it is important to remain flexible and opportunistic in order not to lose momentum in such a complex and lengthy process. Policy makers constantly need to be up to date with the major learnings from the interventions on the ground and need to remain committed to the approach. The office should not wait for tangible evaluation results before communicating with policy makers, they need to be engaged at each step of the process. This is even more relevant in a changing political context where there is a high turnover of high level officials.

Lesson 2: One of the key success factors in the Romanian experience in moving towards an integrated approach was their flexibility and ability to adapt their office structure, mechanisms and tools to work more efficiently and systematically across sectors.

Consideration 2 a: The creation of a coordinator position with clear roles and responsibilities is key to smooth coordination across sectors. Ideally the coordinator should not come from any of the involved sectors, have a full picture of the entire intervention and the planned activities and should be able to facilitate a smooth collaboration between a large number of stakeholders, while monitoring the progress status and ensuring that major events and activities don’t overlap. In this context, it is key that the coordinator needs to be empowered and the accountability of different sectors towards the coordinator should also clearly be laid out and need to be supported by the management. In addition to the coordinator position the office should assess whether additional positions are needed to support the cross sectoral work (e.g. additional programme assistant to manage increased fund transfer to partners and support eventual capacity gaps).

Consideration 2b: Offices that want to move towards systematic cross sectoral programming need to develop specific cross sectoral working tools and mechanisms that are effectively used by all involved sections. Some examples are the setup of regular coordination and implantation meetings, cross sectoral

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AUGUST 2017working and event plans, integrated budgets, shared drives with updated reference documents, joint communication strategy and advocacy messages, technical task forces, joint reflection and planning sessions etc. This list is not meant to be exhaustive and not suggesting that each office needs to have all of these tools in place, they are just some examples that could guide offices.

Consideration 2 c: As some of the internal procedures are not yet adapted to work in a cross sectoral manner the office needs to find creative and flexible ways to remain compliant with UNICEF’s procedures and regulations while being able to quickly respond to external needs emerging from such a complex approach. The challenge described further up with regard to the LTA renewal procedure was not meant to question any particular procedure, but rather a call to allow COs more flexibility to adjust certain procedures to their needs and realities.

Lesson 3: The Bacau model experience has shown that in order to encourage cross sectoral coordination it is important to also adapt the evaluation mechanisms of the involved professionals.

Consideration 3: Offices need to create sufficient dedicated time for cross sectoral collaboration and systematically include cross sectoral performance indicators in each professional’s performance appraisal rather than evaluating them exclusively on sectoral results. To complement the formal evaluation, offices should also find informal ways of creating incentives to work in an integrated manner (e.g. public recognition of professionals that put a lot of efforts in achieving cross sectoral results).

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BIBLIOGRAPHIE

Academia Romana. Mid-Term Review of “Social inclusion through the provision of integrated community services at community level” model, Romania. Draft report with preliminary findings. Institutul de cercetare a calitatii vietii. Buchartest, Mai 2017. Price Waterhouse Coopers. Financial impact analysis for scaling up a model of community based services at national. Internal document, not published. Bucharest, 2015.Preda, M. (coord.). Situation Analysis of Children in Romania. Vanemonde. Bucharest, 2013.UNESCO Institute of Statistics, Global Initiative: Out of School Children, National Study: Romania, Bucharest, 2012.

UNICEF. Strategic Framework 2018 – 2021, Discussion Paper Draft. New York, October 2016.

UNICEF Romania. AURORA Application-Assisted Data Collection Methodology: Community Census for Vulnerability Diagnosis. Internal Paper. UNICEF Romania. Bucharest. June 2015.

UNICEF Romania. AURORA Project: AURORA 1.1.1. APP User Guide. Manual. Bucharest, July 2016.UNICEF Romania. AURORA-Documentation of the best practices. Internal documentation paper. Bucharest, August 2016.UNICEF Romania. AURORA-Documentation of UNICEF innovations. Internal documentation paper. Bucharest, 2015.UNICEF Romania. Costing of the Quality Inclusive Education package. Internal document, not published. Bucharest, 2015.UNICEF Romania. Minimum Package of Services. Internal draft concept paper. Bucharest. 2015.UNICEF Romania. First Priority: No More Invisible Children! A modelling project for the development of basic social services at community level. Exit Strategy. Bucharest, 2015.UNICEF Romania. Quality Inclusive Education Model’s Theory of Change. Internal document. Bucharest, 2016.UNICEF Romania. Second progress report of the social inclusion model grant to the French National Committee. Bucharest, 2016.UNICEF Romania. Second progress report of the social inclusion model grant to the Norwegian Government. Bucharest, 2016.UNICEF Romania. Situation Analyses of Children and Women in Romania. Draft report. Bucharest, March 2017.UNICEF Romania. Social inclusion of vulnerable children, especially Roma children, in Romania. Project proposal to the French National Committee for UNICEF. Bucharest, 2014. UNICEF Romania. Social inclusion through the provision of integrated social services at community level in Bacau County. Power Point Presentation prepared for the CEECIS Regional Director’s field visit. Bucharest, May 2017.

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AUGUST 2017UNICEF Romania. Social inclusion through the provision of integrated social services at community level Project Proposal. Bucharest, 2014. UNICEF Romania. State of adolescents in Romania. Bucharest, 2013.UNICEF Romania. Terms of Reference. Mid-Term Review of “Social inclusion through the provision of integrated community services at community level” model, Romania. Bucharest, 2016. UNICEF Romania. The Minimum Package of Services. Breaking the cycle of disadvantage for children and their families. Draft policy brief. Internal document. Bucharest, August 2014. UNICEF Romania. The Minimum Package of Services. Theory of Change. Internal document. Bucharest, 2014.UNICEF. Documenting, Validating and Sharing Good Practice in Europe and Central Asia. New York, March 2017.Voicu, B. & Tufiș, C. In-depth assessment of the social, health, and education status of children and their families in target areas of the Bacau County. Baseline report. Bucharest, 2016. World Bank. Toward an equal start: Closing the early learning gap for Roma children in Eastern Europe. Washington DC, 2012. World Bank. Diagnostics and Policy Advice for Supporting Roma Inclusion in Romania. Washington DC, 2014

Internet sources:

UNICEF. (2016) Community-based child services: Social inclusion through the provision of integrated services at community level leaflet: http://unicef.ro/serviciicomunitarepentrucopii/en/aboutUNICEF. (2016) Quality Inclusive Education package leaflet: http://www.unicef.ro/wp-content/uploads/Pachetul_Educatie_Incluziva_de_Calitate.pdfEurostat : http://ec.europa.eu/eurostat/tgm/refreshTableAction.do?tab=table&plugin=1&pcode=t2020_50&language=enhttp://ec.europa.eu/eurostat/statistics-explained/images/b/b1/Expenditure_on_social_protection%2C_2004-2014_%28%25_of_GDP%29_YB17.pnghttp://ec.europa.eu/eurostat/statistics-explained/index.php/People_at_risk_of_poverty_or_social_exclusionNational Authority for the Protection of Child Rights and Adoption: www.copii.ro . http://www.copii.ro/statistica-2016/EU : http://ec.europa.eu/education/library/publications/monitor15_en.pdf

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http://ec.europa.eu/education/library/publications/monitor15_en.pdf

http://www.copii.ro/



http://ec.europa.eu/eurostat/tgm/refreshTableAction.do?tab=table&plugin=1&pcode=t2020_50&language=en

http://ec.europa.eu/eurostat/tgm/refreshTableAction.do?tab=table&plugin=1&pcode=t2020_50&language=en

http://www.unicef.ro/wp-content/uploads/Pachetul_Educatie_Incluziva_de_Calitate.pdf

http://unicef.ro/serviciicomunitarepentrucopii/en/about


AUGUST 2017https://ec.europa.eu/education/sites/education/files/monitor2016-ro_en.pdfOECD, Pisa 2015 Results in focus, available at

http://www.oecd.org/pisa/pisa-2015-results-in-focus.pdf

UNICEF CEECIS TransMonEE database: http://www.transmonee.org/databases.php

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http://www.oecd.org/pisa/pisa-2015-results-in-focus.pdf



AUGUST 2017

ANNEX 1: LIST OF INTERVIEWED PEOPLE AND INTERVIEW GUIDENAME ORGANIZATION/

INSTITUTIONPOSITION

UNICEFSandie Blanchet UNICEF Representative Eduard Petrescu UNICEF Policy and Knowledge

CoordinatorVoichita Pop UNICEF Child Protection SpecialistAlexandra GRIGORESCU-BOȚAN

UNIEF Child Protection Consultant

Luminita Costache UNICEF Education SpecialistBorbala Koo UNICEF Health Consultant Viorica Stefanescu UNICEF Child Rights Systems

Monitoring SpecialistEugenia Apolzan UNICEF Youth and Adolescents

Development SpecialistRaluza Zaharia UNICEF C4D OfficerCamelia Ieremia UNICEF Operations ManagerChristina Badea UNICEF Programme Officer Local

Partnerships Agatha Popescu UNICEF Programme Assistant

BucharestNicoleta Elisei UNICEF Programme Assistant

BacauNational partners

Ciprian Fartusnic Institute of Educational Sciences

Director

Marcela Claudia Calineci Institute of Educational Sciences

Coordinator Parents’ Counselling subcomponent

Serban Iosifescu ARACIP (Romanian Agency for Quality Assurance in Pre-university Education System

President, Head of management Subcomponent

County PartnersSimona Boghiu County DGSACP Chief strategy, project

and monitoringTeona Cordreanu Deputy Principal at

“Colegiul National Vasile Alecsandri” in Bacau

County Education Coordinator

Focus Group Discussion with Bacau County Coordinators

MPS County Coordinators from county health, education and social protection directorates

County MPS coordinators 7 social protection, 7 health and 3 educations

Community PartnersCommunity visit urban community

Team Targu Ocna Mayor, public administrator (social services), 1 SW, 3 school

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AUGUST 2017counselors, 1 school principle school, 1 community nurse, 1 school mediator

Community visit rural community

Team Bogdanesti Mayor, SW, community nurse, county social protection coordinator, county education coordinator, school principle, school counselor, school mediator, social assistant, general practitioner, priest, 2 beneficiaries.

QIE Training for school managers and county coordinators (Around 45 school principals and regional QIE coordinators)

County and community education administrators

County coordinators and school managers

NGOSCarmen Lica Step by Step (NGO) Executive Director Gelu Duminica Impreuna (NGO) Executive Director Stefan Cojocaru HoltIS (NGO) Executive Director Delia Elena Rusu HoltIs (NGO) Programme OfficerAlexdandra Galbin HoltIs (NGO) Programme Officer Dana Otilia Farcașanu CPSS: Center for Health

Policies.Executive Director

Mirela Mustață CPSS: Center for Health Policies

Communication and Public Relation Specialist

INTERVIEW GUIDE

I. SEMI-STRUCTURED INTERVIEW QUESTIONS FOR KEY INFORMANT INTERVIEWS (KII)

General information:

How was your section involved in this pilot? (Design, implementation, M&E, coordination etc.)

How does you section interact/coordinate with other sections for the implementation of this model? Any coordination?

Results, relevance and cost efficiency:

What were the major results achieved so far from your sectoral point of view? Do you think the model / approach addresses the root causes and major bottlenecks/

barriers for the most vulnerable to access the respective services? If yes, how? If not, why? From your perspective, what are the major benefits of a cross-sectoral approach? Do

you think you could reach the same results without an integrated approach? If not, how does it help you?

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AUGUST 2017 Do you think the approach is efficient and cost-effective?

Innovation

In your opinion, what are the major innovations introduced by this model?Sustainability

Do you think this model is sustainable? How did the model assure sustainability and local/ national ownership?

Replicability

Do you think the model is replicable in other counties in Romania? What does it take for the Government of Romania (GoR) to scale up this approach to

other regions / counties? How could the GoR finance its scale up? Do you think this approach is replicable in other contexts and if yes what are the

minimum requirements for doing so?Enablers and challenges

What are the major enablers of the success of this approach? What are the major bottlenecks / challenges?

UNICEF’s added-value

How do you see UNICEF’s role and added-value in such an approach? Do you think this approach could be mainstream in UNICEF’s general programming

and made into the “new business as usual”?Recommendations

What recommendations do you have for other counties, COs or regions who might want to use a similar model?

Are there any other thoughts you would like to share that could be relevant for the documentation of this approach?

II. INTERVIEW GUIDE FOR FOCUS GROUP DISCUSSIONS

A. WITH COORDINATION STRUCTURES AT COUNTY LEVEL General information

How are you involved in the implementation and development of this project? Who is part of this coordination body? How often do you meet? Are the meetings well attended? What kind of issues do you discuss in this forum and how do you track agreed

actions? What is your general feeling about working together with other sectors (each other)?

Results

What are the major achievements of this project in your county? How do you see the major benefits of this cross-sectoral work and of this integrated

approach more broadly?

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AUGUST 2017Challenges

Do you face any challenges? How could they be overcome?

Recommendations

What would you recommend to other counties, COs or regions who want to use a similar model?

Any other thoughts you would like to share that could be relevant for the documentation of this interesting and innovative project?

III. SHADOWING (FOLLOWING A SOCIAL WORKER, NURSE AND SCHOOL COUNSELOR)

No specific questions to be asked of the frontline worker and the beneficiary. Instead, the consultant plays the role of an outside observer and tries to get a tacit understanding of how frontline workers interact with each other.

The end objective is to draw a detailed flowchart explaining the entire process at each stage and getting quick feedback from beneficiaries on the services provided and what changed compared to previous isolated interventions?

IV. DEMONSTRATION OF AURORA

Getting in-depth understanding of how Aurora works. This could be done at national or county level. The objective is to understand how the tool is used beyond the data collection aspect e.g. from a case management, planning and resource allocation perspective.

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AUGUST 2017

ANNEX 2: LINKS TO DETAILED ACTIVTY PLAN OF BACAU MODEL

Need to insert the detailed activity plan

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AUGUST 2017

ANNEX 3: METHODOLOGIES AND TOOLS

Detailed list of dimensions, vulnerabilities and sub-vulnerabilities in AURORA

Dimension

Vulnerability Sub vulnerability

Poverty Children living in poverty

Children in household affected by monetary poverty

Children in household affected by extreme poverty

Health

Children unregistered to

a GP

Children aged up to 1, in risk

situation

Child with low birth weight

Child not vaccinated

Child not receiving Vitamin D and Iron Supplements

Child not within the development standards

Children aged between 1 and

5, in risk situation

Child not vaccinated

Child not receiving Vitamin D

Child not within the development standards

Children suffering from a chronic disease or living in a hh with a person

suffering from a chronic disease

Child suffering from a chronic disease

Children living in a household with a person suffering from a chronic disease

Pregnant woman not registered to a GP (primary care physician)

Pregnant women at risk situation

Pregnant woman without prenatal care

Unwanted pregnancy

Education

Children unregistered in school, which

Children of preschool age, unregistered in kindergarten

Children aged 6 to 9, unregistered in school

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AUGUST 2017

dropped out or is at risk of dropout

Children aged 10 to 15, unregistered in school

Children at risk of school dropout

Children at risk of school dropout, with special educational needs

Children that dropped out

Risk behavio

ur

Teenager/Children with at risk behaviour

Teenager with risk behaviour concerning a healthy life style (alimentation and sport)

Teenager with risk behaviour regarding sexual activity

Minor mother or minor pregnant woman

Teenager with risk behaviour concerning substance use

Children at risk of violent behaviour

Children living in households with violent behaviour

Children at risk of violence,

abuse or neglect

Children at risk of violence (abuse)

Children at risk of children neglect

Living conditio

ns

Children in poor housing

conditions

Children living in overcrowded housing

Children living in unhealthy living conditions

Family and

social conditio

ns

Children without ID

Children without a parent or both parents at home

Children with only one parent at home

Children from family with migrant parents

Children without both parents at home, with an adult caretaker in the household

Children without an adult caretaker within the household

Children with disabilities

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AUGUST 2017

Children separated from the family or at

risk of being separated by

the family

Children in placement or foster care at risk conditions

Children at risk of being separated by the family – cumulates 7 or more sub-vulnerabilities

Children at risk of being separated by the family – mother with minor children that do not live within the household, but are not in child

protection system

Child at risk of being separated by the family –mother with minor

Detailed list of AURORA Services for Children and Their CaregiversIdentificationNeeds Assessment

Standard social enquiryChecking and supplementing field data

Information and Guidance

Information about professional (re)integration stepsInformation about the child’s right to identityInformation about social assistance rightsInformation about social assistance rights – The rights of single-parent familiesInformation about social assistance rights – The rights of children with disabilitiesInformation about primary health care rightsInformation about primary health care rights – The right of children under 1 year of ageInformation about primary health care rights – The rights of children under 5Information about primary health care rights – The rights of children with chronic illnessInformation about primary health care rights – The rights of pregnant womenInformation about the rights and obligations related to the improvement of living conditionsInformation about parental rights and obligations – Legal provisionsInformation about parental rights and obligations – Legal provisions on childbirth registrationInformation about parental rights and obligations – Legal provisions on the obligation to report the departure at least 40 days before leaving the country and to designate a person to look after the child during parents’ absenceInformation about pregnancy optionsInformation about ways to benefit from emergency material/cash aidInformation about legal opportunities to access specialised health careInformation about the network of community support through parent education programmesInformation about substance use risks

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AUGUST 2017Information about public health risks – Risks specific to children under 1 year of ageInformation about public health risks – Risks specific to children under 5Information about public health risks – Risks specific to children with chronic illnessInformation about sexual risksInformation about individual health risks – Risks specific to children under 1 year of ageInformation about public health risks – Risks specific to children under 5Information about public health risks – Risks specific to children with chronic illnessInformation about public health risks – Risks related to child violenceInformation about public health risks – Risks related to child neglectInformation about public health risks – Risks related to unsanitary living conditionsInformation about all forms of violence, including neglectInformation about ways to adopt a healthy lifestyleInformation about the benefits of preschool educationInformation about the right to education – Children’s right to education and the benefits of educationInformation about the child’s individual care planInformation about the respect for children’s rights – children’s right to protectionInformation about the respect for children’s rights – children’s right to protection and to grow up in a familyInformation about community resources at local and county levelsInformation about the rights of children with disabilitiesInformation about the importance of accessing preventive and curative medical servicesInformation about the importance of accessing preventive and curative medical services – for children under 1 year of ageInformation about the importance of accessing preventive and curative medical services – for children under 5Information about the importance of accessing preventive and curative medical services – for children with chronic illnessInformation about the importance of accessing preventive and curative medical services – Importance of pregnancy monitoring and parental consultationInformation about the importance of accessing preventive and curative medical services – Importance of preventive reproductive health servicesInformation about the importance of accessing preventive and curative medical services – Importance of services provided to children exposed to any form of violence, including neglectInformation about the importance of accessing preventive and curative medical services – Importance of sanitation and cleaning services

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AUGUST 2017Information about the importance of accessing preventive and curative medical services – Information about family planning and contraception

Counselling Advice on the benefits of accessing other community resources at local and county levelsAdvice on professional (re)integration opportunitiesAdvice on the benefits of parent education programmesAdvice on kindergarten enrolment stepsAdvice on pregnant women’s rightsAdvice on the rights and obligations of the person designated to look after the childAdvice on the importance of accessing preventive and curative medical servicesAdvice on the respect for children’s rights – The rights of the child with chronic illnessAdvice on the respect for children’s rights – Parents’ protection of the childAdvice on the respect for children’s rights – Child protection from violenceAdvice on the respect for children’s rights – Child protection from violence, including neglectAdvice on the respect for children’s rights – Children’s right to grow up in a family and the right to protectionAdvice on a healthy lifestyle – Diet and sportsAdvice on a healthy lifestyle – Substance useAdvice on a healthy lifestyle – Violence against and between childrenAdvice for preparing the child’s reintegration into the familyIndividual/family counselling related to health-enabling behaviourLegal and administrative counselling with a view to designating the person who will look after the child during parents’ absenceLegal and administrative counselling related to specialised evaluation – With a view to obtaining the disability certificateLegal and administrative counselling for getting identity documentsLegal and administrative counselling for getting the emergency material/cash aidLegal and administrative counselling for benefiting from social assistance rightsLegal and administrative counselling for benefiting from social assistance rights granted to single-parent familiesLegal and administrative counselling for benefiting from social assistance rights granted to children with disabilitiesMedical counselling within the limits of competenceCounselling for improved communication with the adolescentAdvice on safe sexAdvice on drop-out causesAdvice on health-enabling behaviourAdvice on administrative school enrolment proceduresAdvice on administrative school re-enrolment proceduresHealth education counselling

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AUGUST 2017Advice on risk factors in the living environmentAdvice on importance of school participationAdvice on pregnancy optionsAdvice on family planning and contraceptionAdvice on drop-out risksAdvice on breastfeeding and appropriate nutritional practices for children under 1 year of ageAdvice on breastfeeding and appropriate nutritional practices for children under 5Advice on breastfeeding and appropriate nutritional practices – Pregnant woman’s appropriate diet

Accompaniment and Support

Support for specialised evaluationSupport for the implementation of the therapeutic planSupport for gaining the school guidance certificateSupport for kindergarten enrolmentSupport for accessing other community-based public servicesSupport for accessing institutions and opportunities with the aim of professional (re)integrationSupport for accessing the family physician’s servicesSupport for accessing parent education programmes/actions – Positive discipline methodsSupport for accessing parent education programmes/actionsSupport for accessing community resources at local and county levelsSupport for accessing the services recommended under the child care planSupport for accessing counselling, family planning, and contraceptive servicesSupport for adopting health-enabling behaviourSupport for school enrolmentSupport for drawing up the documentation required for the temporary delegation of parental authoritySupport for drawing up the documentation required for parent’s departure abroadSupport for getting the emergency material/cash aid provided under the lawSupport for getting social protection rightsSupport for getting identity documents – Timely or late registrationSupport for getting the benefits provided by lawSupport for school re-enrolmentSupport for continued school participation

Referral Referral to other community-based servicesReferral to county authorities (the DGASPC or the CJRAE)Referral to the DGASPCReferral to local and county institutionsReferral to local and county institutions to obtain identity documentsReferral to local and county institutions to obtain social assistance rightsReferral to county institutions – The School Inspectorate and/or the CJRAEReferral to professional (re)integration institutions

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AUGUST 2017Referral to the family physicianReferral to the mayoralty to benefit from the emergency material/cash aidReferral to the network of community support through parent education programmesReferral to the local and county networks of social support servicesReferral to family planning and contraceptive servicesReferral to the Comprehensive Evaluation Service of the DGASPCReferral to the public social assistance serviceReferral to preschool from the communityReferral to schools from the community

Monitoring and Evaluation

Monitoring of professional (re)integrationMonitoring of frequency of and participation in educational activitiesMonitoring of access to the community support and parent education networkMonitoring of access to specialised health careMonitoring of access to primary health careMonitoring of access to community resources at local and county levelsMonitoring of safe sexual practicesMonitoring of family planning measures recommended by the doctorMonitoring of therapeutic measures recommended by the family physicianMonitoring of health-risk behaviourMonitoring of kindergarten enrolmentMonitoring of school enrolmentMonitoring of further educationMonitoring of procedures to obtain the school guidance certificateMonitoring of school re-enrolmentMonitoring of temporary delegation of parental authorityMonitoring of procedures to report departure abroadMonitoring of the measures recommended by the DGASPCMonitoring of the measures recommended by the SPASMonitoring of procedures to obtain the emergency material/cash aidMonitoring of procedures to obtain social assistance rightsMonitoring of procedures to obtain social assistance rights – The right of single-parent familiesMonitoring of procedures to obtain social assistance rights – The right of children with disabilitiesMonitoring of procedures to obtain identity documentsMonitoring of individual health risksMonitoring of the situation of the child left home aloneMonitoring of completion of the specialised evaluation

EvaluationZero Priority Service

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