Support for the improvement of the quality of care services provided for children deprived of parental care in Uzbekistan (P500851) OUTPUT 1 Methodology for monitoring the childcare system May 2024, Republic of Uzbekistan Disclaimer This report is a product of the International Bank for Reconstruction and Development/the World Bank. The findings, interpretations and conclusions expressed in this document do not necessarily reflect the views of the Executive Directors of the World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. Copyright Statement The material in this publication is copyrighted. Copying and/or transmitting portions of this work without permission may be a violation of applicable laws. For permission to photocopy or reprint any part of this work, please send a request with the complete information to The World Bank Group Uzbekistan (87QJ+2V9, Tashkent, Republic of Uzbekistan). 2 Acknowledgements This Output is developed to inform the development of a monitoring system for the childcare system in the Republic of Uzbekistan. It is produced under the “Support for the improvement of the quality of care services provided for children deprived of parental care in Uzbekistan� Rapid Social Response, Adaptive and Dynamic Social Protection (RSR-ADSP) Umbrella TF Program, Round 21: Promoting ‘Cash Plus Care’ Protection of Children Affected by Adversities. It is based on a collective effort between the World Bank, UNICEF Uzbekistan, and the National Agency for Social Protection under the President of the Republic of Uzbekistan. The activities necessary for developing this output were coordinated by Vlad Grigoraș (Senior Social Protection Economist), Marina Novikova (Senior Social Protection Economist) (Task Team Leaders), Cristina Iulia Vladu (Social Protection Specialist), and Alexandru Toth (Senior Researcher), under the guidance of Paolo Belli (Practice Manager, Social Protection and Jobs) and Marco Mantovanelli (Country Manager). The present output condenses inputs provided by the following experts: Cosmin Briciu (Senior Social Research Expert), Gulchexra Nigmadjanova, Nigora Rustamovna Sanginova, Yulduzxon Umarbekova (Child Protection Specialists), Anton Simona, Akmal Axmadaliyev, Irina Boeru, Andra Panait (Social Researchers), Luisa Mardale (Research Assistant). Additional thanks go to Loan Thi Phuong Nguyen, Natalya Shermetova, Shoista Zakirova (Program Assistants), who supported organizational and logistical aspects under the project. In addition, the document benefited from an internal peer review process involving World Bank Social Protection Specialists: Manuela Sofia Stănculescu and Lucía Solbes Castro. Furthermore, the World Bank would like to thank UNICEF Uzbekistan for its cooperation as key technical partner to this present endeavor. Specifically, to its representatives who took part in all stages of development of this output and whose contributions were essential in conceptualizing and finetuning the approach and instruments and linking them to international best practices in child protection: Antonia Luedeke (Child Protection Chief) and Diana Isaeva (Child Protection Consultant). The development of these instruments would not have been possible without the committed engagement of the National Agency for Social Protection, particularly its department responsible for child protection in the country. The team enabled the adaptation of indicators to the national context, and jointly defined the process for an effective implementation of the data collection. Thanks are also due to the Agency’s Department for International Relations, that has provided tremendous liaising support, as well as to the IT Department which advised on technical issues and data security. Moreover, the management of the Agency has shown immense support for all the endeavor, both for steps that have already been achieved, as well as strategizing future implementation plans. The World Bank would also like to thank the representatives of the services for children who took part in the piloting of instruments in Tashkent and other country regions, which took place both on-site as well as online between February 16-23, 2024 and April 29-May 2, 2024. Their essential feedback helped ensure that instruments are practical and anchored in data that can be collected from available documents. 3 Contents 1 General overview ............................................................................................................................ 6 2 The methodological framework...................................................................................................... 9 2.1 Elements that informed the framework ................................................................................. 9 2.2 Defining alternative care....................................................................................................... 10 3 The set of instruments .................................................................................................................. 13 3.1 Child characteristics and well-being ..................................................................................... 14 3.2 Institutional resources and conditions.................................................................................. 17 3.3 Alternative family-based care ............................................................................................... 19 3.4 Entries into and exits out of the alternative care system ..................................................... 20 3.5 Limitations of the current exercise ....................................................................................... 20 4 The data collection process .......................................................................................................... 21 5 Next steps after the first monitoring round.................................................................................. 26 References ............................................................................................................................................ 27 Annexes ................................................................................................................................................. 29 Annex 1. Set of instruments for the first monitoring round ............................................................. 29 Annex 2. Preliminary monitoring reports ......................................................................................... 30 Annex 3. Proposed instruments for regular monitoring updates of the alternative care system ... 31 4 List of Acronyms CRC Convention on the Rights of the Child CRPD Convention on the Rights of Persons with Disabilities NASP National Agency for Social Protection TransMonEE Transformative monitoring of the situation of children and women in Europe and Central Asia to enhance equity UNICEF United Nations Children’s Fund 5 1 General overview The project aims to develop a national monitoring system that will support the National Agency for Social Protection (NASP) under the President of the Republic of Uzbekistan to monitor the transition from institutional to community-based care of children deprived of parental care. The objective of this project is twofold: 1. To support the Government of Uzbekistan in informing the transition from institutional to family-type care of children deprived of parental care by building a robust monitoring mechanism at the national level. Activities supporting the development of a monitoring system for the childcare system focus on: ■ Developing a set of instruments ■ Preparing inputs for a monitoring report of the childcare system ■ Preparing technical inputs for an information system of the childcare system. 2. To build the Government’s capacity to implement measures to improve the quality of services provided for children with disabilities in institutional care and develop adequate family-type alternatives. Activities supporting capacity building in improving the quality of services for children in institutional care and developing adequate family-type care focus on: ■ Analyzing legislation on social services for children with disabilities and related strategic documents ■ Proposing a short-, medium-, long-term vision for the childcare system reform ■ Presenting best practice examples to support the design and implementation of alternatives to institutionalized care. Many children in Uzbekistan live with high levels of vulnerability in large institutions and should be provided with opportunities to live in family-like settings within the community. Large residential care services housing hundreds of children remain a prevalent alternative care choice and are not considered a measure of last resort. Despite evolving perspectives on alternative care, these facilities continue to play a significant role in providing living arrangements for a substantial number of children. According to UNICEF TransMonEE data from 2022, Uzbekistan had 241 children in residential care per 100,000 children. From over 59 thousand children in formal alternative care, half live in residential institutions. Furthermore, out of the children in residential care, an alarming 79 percent have disabilities. Girls, especially those with disabilities, are most at risk of experiencing violence within closed institutions. NASP is in the process of undertaking the coordination of the diverse range of institutions for children as envisioned focal point for child protection, including the alternative care system. Until recently, institutions housing children found themselves under different central authorities (Ministry of Preschool and School Education, the National Guard of the Republic of Uzbekistan, Ministry of 6 Health, Ministry of Employment and Poverty Reduction). After its establishment in mid-2023, NASP is in process of overtaking all these institutions. The services provided by these institutions are currently only partially documented and highly heterogeneous, with limited evidence on how they impact the well-being of children. Institutional care has dramatic long-term effects on the lives of children. The adverse effects exerted by institutional care on children's development and their lack of efficiency compared to family-type care are well documented.1 Children growing up in institutions present delays in their physical, emotional, cognitive, and social development. There is, however, evidence that early deinstitutionalization and placement in a family environment considerably increases their chance of recovering the development deficit, provided that the deinstitutionalization process is correctly planned, implemented, and monitored.2 There is a lack of detailed systematic reporting on alternative services other than residential centers for the latter’s’ improvement and further development, as well as evidence of prevention services at the local level. For example, there are almost 29 thousand children in all formal family care arrangements, of which 850 in patronat families and the rest in kinship care (guardianship). There is no information available on the outcomes provided by these types of arrangements to the children they serve. Uzbekistan is committed to ensuring that children who still live in institutions shift to family-type services in the community. A presidential decree promotes the move away from orphanages and supports biological or foster families to provide a family environment.3 A strategy and roadmap for childcare reform is pending approval, aiming for a shift towards community-based care. The World Bank has supported the Government of the Republic of Uzbekistan in finalizing its National Action Plan for implementing the Convention on the Rights of Persons with Disabilities, which includes developing community-based services for persons with disabilities, including children. The success of deinstitutionalization relies heavily on continuous monitoring and evaluation, but at present there is no established system for overseeing the alternative care system in the country. To prepare the deinstitutionalization process for all children living in institutions, transparent and solid data needs to be available on the number and profile of children in all types of care and the alternatives available. Thus, a monitoring and evaluation system should be built into all stages of transformation and eventual closure of centers. Monitoring and evaluation are essential for each child and family, as well as for all institutional services and newly established preventive services. Moreover, such a system facilitates the identification of centers/regions where the deinstitutionalization process is stalled or improperly executed, allowing for swift corrective actions. Moreover, it enables comparative analyses across the country in terms of alternative services. A monitoring and evaluation system should cover several layers: (i) the implementation of child protection strategies and policies, to understand if they are sufficient for ensuring deinstitutionalization and provision of community-based services (with a focus on outcome and results indicators, and on whether the activities are being implemented as planned); (ii) the residential 1 Tobis, D. (2000) Moving from Residential Institutions to Community Based Social Services in Central and Eastern Europe and the Former Soviet Union, Washington DC: World Bank; Johnson, R., Browne, K. and Hamilton- Giachritsis, C. (2006) Young children in institutional care at risk of harm. Trauma Violence Abuse, Jan, 7, 1, 34- 60.; Browne, K. (2009) The Risk of Harm to Young Children in Institutional Care, London: Save the Children. 2 Browne, K. (2009) The Risk of Harm to Young Children in Institutional Care, London: Save the Children. 3Decree of the President of the Republic of Uzbekistan dated August 9, 2021 “On measures to further improve the system of guarantees of the rights of the child.� 7 center/alternative care level; and (iii) the individual level of each child, to measure outcomes once children move out of institutions or while they still live in institutions. So far, a system for tracking the reform of the alternative care system has not been implemented, and very little information exists on social services and their users. There is no data at the center level on the children's profile and interventions they receive in centers and for moving out of institutions. The NASP plans to develop its capacity to undertake the monitoring of existing institutions and children therein before the complete transfer of institutions under their coordination. This monitoring effort will best inform the development of new family-type models of care, and to follow children after their exit from public care. The instruments proposed in this output are informed by previous experience and by a joint effort between key stakeholders. The effort is based on previous work developed by the World Bank for the deinstitutionalization of children in Romania and Croatia, and for the deinstitutionalization of adults with disabilities in Romania, as well as an UNICEF effort to map residential institutions in the Tashkent region. Instruments were finetuned in a collective effort between the World Bank, UNICEF Uzbekistan, NASP and specialists from the system who offered essential feedback during the piloting of instruments in selected institutions in Tashkent city and Tashkent region between February 16-23, 2024, April 29-May 2, 2024, 2024 and week of May 6 and May 10. This Output includes a set of proposed instruments for the monitoring of the childcare system with focus on alternative care (in the annexes), with the main report describing the methodological framework used, including prior experience this exercise is inspired from, a description of the instruments and the foreseen implementation of the data collection process to be carried out under NASP coordination, as key institution responsible for coordinating the services and monitoring children in alternative care. 8 2 The methodological framework 2.1 Elements that informed the framework Several key elements were at the basis of development of the present methodology: ■ Principles of international human rights documents (Convention on the Rights of the Child – CRC, and the Convention on the Rights of Persons with Disabilities - CRPD). The CRC ratified by the Republic of Uzbekistan in 1992 emphasizes the child’s need for a nurturing family environment conducive to their full development. It asserts children’s rights to live with their birth families (Articles 9 and 7), placing the primary responsibility on parents with state support (Article 18). While safeguarding against harm and ensuring education and healthcare rights (Articles 19, 28, 24), it acknowledges the right to family upbringing. When the family cannot provide adequate care, despite state support, the child has the right to substitute family care (Article 20). Those with disabilities have the right to dignified living conditions, self- reliance, and community participation (Article 23). Aligned with CRPD, Uzbekistan, a state party since 2021, commits to implementing all articles, including Article 19 on living independently. This article mandates strategies for de- institutionalization, eliminating isolation or segregation. Article 31 mandates state parties to undertake the collection of “appropriate information, including statistical and research data, to enable them to formulate and implement policies to give effect to the present Convention�. Article 7 of the CRPD outlines measures for ensuring equal human rights for children with disabilities, emphasizing their best interests, right to express views, and age-appropriate assistance. ■ UNICEF TransMonEE and the Child Rights Monitoring Framework.4 ■ Previous World Bank results on child protection system monitoring and deinstitutionalization carried out in Romania anchored in other international sources from UNICEF, Save the Children, World Vision, on deinstitutionalization of adults with disabilities in Romania and on child deinstitutionalization in Croatia. Romania has made continuous efforts to close centers for children with technical assistance from the World Bank, which included supporting centers to apply detailed guidelines, assistance to carry out an evaluation of all children in institutional care and to prepare centers’ closure plans, supporting the development of community-based services for preventing the separation of children from their families. Progress was followed by setting up a comprehensive monitoring system dedicated to the whole public care system. Efforts have been extended to the deinstitutionalization of adults with disabilities in Romania that generated a wide range of tools, including comprehensive diagnoses of residential centers and community-based services, and practical guidelines for deinstitutionalization. Furthermore, in Croatia, the World Bank is supporting the transition from institutional to community-based care for children, youth, and persons with disabilities by preparing social welfare institutions' transformation plans and setting up a national deinstitutionalization monitoring system. 4 https://www.transmonee.org/media/716/file/ENG%20Child%20Rights%20Monitoring%20Framework.pdf 9 ■ National legislation (as per the References section). The methodology serves a double purpose: diagnosing the current system and testing indicators suitable for a future monitoring system. For example, the instruments cover administrative aspects such as available resources (material, financial, human) with an aim to understand their availability considering the future deinstitutionalization process. However, such information will not be subject to regular monitoring and will only be collected one-off. The recurrent indicators will focus on the implementation of deinstitutionalization, closure, and establishment of new services, as well as measuring changes at child level. Using these technical inputs, NASP will be able to enhance its capacity by establishing means to monitor existing institutions along with resident children to better inform new family-centered models while also continuing support after their exit from public care institutions. The initial data collection for children who are in different types of institutions and services will aim to: (1) provide information necessary for a comprehensive assessment of specific aspects of the situation of children living in alternative care. (2) provide information necessary to assess the current situation of all institutions, including boarding schools that house both children who are and those who are not deprived of parental care, but that are living in a closed environment, from the perspective of human, material, financial resources. (3) create the foundation for the practice of regular and unitary use of monitoring instruments in the field of social services for children. (4) collect the baseline for essential monitoring indicators of the alternative care system. 2.2 Defining alternative care In the scope of the methodology, alternative care covers all forms of care that are alternative to the child living with their family, including institutional and family-based care.5 Institutional care is the care that paid and/or unpaid staff provide to children in any group setting (not family-based) in which children live and receive care (including in non-governmental institutions),6 as a result of administrative or judicial measures. Residential care can be provided continuously, for most of the year, temporarily, or for a specified period of time. Family-based care covers kinship care, foster care, and may also include other forms of family-based care such as guardianship care. Different types of institutions and services for children exist in Uzbekistan, all of which are in process of being transferred under NASP. A selection of those institutions and services that will be included in the alternative care system for the purposes of this exercise was made in joint workshops with NASP and UNICEF and are described in the table below. Additional services were not included under the monitoring scope are: republican education institutions – these services have previously been 5 Definitions as per Unicef TransMonEE. 6 Oversight of public institutions may be carried out by different government departments (for example, social welfare, education or health). This definition of residential care covers a wide range of institutions: from small dormitories to large institutions, for example, infant homes (for children under three years of age) and maternity hospitals providing long-term care for infants, orphanages, institutions for orphans, institutions (including hospitals, special schools and special institutions) for people (children) with disabilities, special boarding schools for children who, for example, dropped out of school, engaged in dangerous activities, became victims of violence, come from families at risk of poverty and social isolation, have special educational needs, as well as other institutions and other environments. 10 overseen by the National Guard and Ministry of Internal Affairs and serve minors between 14-18 who committed socially dangerous acts, being closer to a correctional institution; specialized pre-school educational organizations and joint-type pre-school educational organizations – aimed at preschool education of children with physical or mental disabilities, as well as their upbringing and rehabilitation, as they do not house children overnight. Table 1: Descriptions of types of services for children or alternative care solutions included in the alternative care system Type of care Description Children’s Children homes can be categorized as general, catering to those under 3 years (baby homes home), or specialized, for children with physical and psychosocial development challenges under 4, with the option of extending their stay until the age of 7, subject to the district (city) khokim's decision. Admitted children include those left without parental care, those relinquished in medical institutions, and those with physical and psychosocial development challenges requiring ongoing individual care. Additionally, children from low-income families, including single- parent households, can be accommodated for up to 1 year, with the possibility of extension. Muruvvat "Muruvvat" children’s boarding homes are state medical and social institutions dedicated boarding homes to providing comprehensive medical and social services for children with disabilities aged for children with 4 to 18 with permanent residence in the country. These children typically exhibit disabilities moderate to severe psychosocial disabilities, spanning various diagnoses. The decision to admit children to "Muruvat" boarding homes or transfer them between facilities is made by the head of the regional department. This decision aligns with the recommendations of the permanent Special Commission responsible for determining placements in medical and social institutions. The Special Commission also formulates an individual rehabilitation program for each child with a disability, a document issued by the medical and social expert commission in the prescribed manner. Mehribonlik Mehribonlik facilities are designed for specific age groups and characteristics: Mehribonlik (House of for preschool children aged 3 to 7, Mehribonlik orphanages accommodating preschool mercy) and school-age children or exclusively those of school age, and specialized rehabilitation Mehribonlik for children with physical and psychosocial development challenges. Children admitted to Mehribonlik cover those without parental care, including cases where parents decline responsibility for their children, children relinquished in medical institutions, children with physical and psychosocial development challenges requiring constant individual care. Children typically join the Mehribonlik at the age of 3 and stay until completing compulsory general secondary and secondary special education. Those facing physical or psychosocial developmental challenges or lacking parental care are subsequently directed to specialized state educational institutions such as schools and boarding schools. Temporary placement in the orphanage for up to one year can be made for children from low-income families, subject to approval by the guardianship and sponsorship commission under the district (city) hokim, based on the decision of the district (city) hokim. An extension for an additional year is contingent upon the district (city) mayor's decision, taking into account the commission's assessment that the family's financial situation has not improved, and the child's return home is not advisable. Specialized Specialized educational institutions cater to various needs based on their specialization, boarding schools including those for deaf or hard of hearing children, children with visual impairments, for children with children with severe speech defects, children with musculoskeletal disorders, and children special with developmental delays. educational Admission to specialized educational institutions typically occurs in the year children turn needs 7, while preparatory groups admit children from the age of 6. To safeguard the right to 11 education for children with special educational needs, it is permissible to admit children who are two years older than the age standard set for general education schools. Family-type A family-type home is a non-legal entity designed to provide a nurturing family homes environment for children who lack parental care. The regulations emphasize that placing children in family orphanages should prioritize their best interests and avoid separating siblings whenever possible. To establish a family-type home, candidates submit applications to the competent authority. These applications include comprehensive personal and medical information, along with proof of completing a parenting training course. The authorized body assesses candidates' living conditions, psychological suitability, and childcare skills. Local stakeholders often participate in this assessment. Candidates who receive a positive evaluation are registered. Training and retraining courses are available for custodial parents to enhance their parenting skills and knowledge. Children are selected from various institutions based on their age and consent, with a preference for keeping siblings together. Decisions regarding adoption or returning to biological relatives are made by the district (city) governor. However, legal relations regarding alimony and inheritance are not established between foster parents and children. Family type homes may have between 3 to 5 children. The total number of children, including candidates' own and adopted children, should not exceed 8. New admissions depend on the departure of existing children or reaching the age of 18. All living expenses for foster children are covered by the state budget, with additional financing possible through sponsorship donations and other legal sources. Patronat The patronat family is an alternative childcare solution. Guardianship or custodianship is families established for orphans or children deprived of parental care under various circumstances, such as the death, court-decreed deprivation or restriction of parental rights or parental incapacity, prolonged parental illness rendering them unable to fulfill duties, or temporary parental absence for over six months, during which the child is entrusted to relatives or close individuals. Additionally, guardianship may be appointed if parents are temporarily absent for less than six months, but it is deemed necessary for the child's well-being. Guardianship can also be instituted if parents are evading responsibilities or refusing to take their child from other institutions. In cases where parents have not been deprived of parental rights, a guardian or custodian may be appointed by the guardianship authority if it is determined that staying with the parents is not in the child’s best interests and there is an immediate threat to the child's life or health. This measure aims to prioritize the child's welfare and safety in situations where parental care is deemed inadequate. Guardianship or trusteeship is established at the place of residence of the person in need, or if not fixed, at the place of residence of the guardian or trustee. The decision is made by the governor of the district or city based on documents submitted by the guardianship authority. The appointment must consider the moral qualities of the guardian, their ability to fulfill duties, and the wishes of the ward if over 10 years old. Guardians have the authority to seek legal, methodological, and diagnostic support for the ward’s well-being, conduct transactions on their behalf, and apply for social and medical assistance. Guardianship authorities monitor guardians and trustees' performance at least twice a year, assisting in ward care and upbringing. Monitoring occurs at the ward's residence or the guardian/trustee's location. The decision to remove a guardian or trustee due to non-performance, improper performance, or abuse of rights is made by the governor of the district or city based on a petition from the authorities. Sources: National legislation, as per References. 12 3 The set of instruments The instruments proposed in this output contain a mix of indicators that help both reaching a comprehensive diagnostic of the current alternative care system and providing inputs to a future monitoring and evaluation system. Instruments cover four dimensions: (i) child characteristics and well-being; (ii) institutional resources and conditions; (iii) alternative family-based care; and (iv) institutional dynamics. As will be further described in the next section, different types of specialists will be engaged in providing different categories of information (e.g., information about children will be filled in by social workers, psychologists or other staff who are familiar with the children’s situation, financial information by accountants, etc.). Table 2: Set of instruments to assess and monitor children in the alternative care system, by dimension Dimension Instrument I. Child 1. Questionnaire about the child placed in the childcare system characteristics 2. Questionnaire about the child placed in specialized boarding schools and well-being 3. Trace questionnaire about the youth leaving the childcare system 4. Questionnaire about the youth leaving the childcare system II. Institutional 5. Questionnaire on human resources of the institution resources and 6. Questionnaire on the material resources of the institution and the living conditions conditions of the residing children 7. External evaluation form for childcare institutions and boarding schools III. Alternative 8. Family-type children’s home questionnaire family-based care 9. Patronat family questionnaire IV. Institutional 10. Synthetic data collection sheet regarding entries and exits from the childcare dynamics institution and specialized boarding schools Instruments were developed following numerous technical meetings and piloted in several institutions. Technical meetings were organized together between World Bank, UNICEF, and NASP to discuss the scope of information of interest, of institutions and services that would be included in the future monitoring system. Visits were organized to institutions to discuss with specialists. Based on NASP interests as future coordinator of institutions, a first set of instruments was proposed and improved through several rounds of feedback. The instruments were then piloted in February 2024 several institutions in Tashkent, Tashkent Region, as well as online. This helped better the instruments by reaching an understanding of indicators that need improvement or are not feasible to collect. 13 3.1 Child characteristics and well-being 1. Questionnaire about the child placed in the childcare system The questionnaire serves as a comprehensive tool designed to gather essential information about each child living in childcare institutions. It is structured into distinct sections, each focusing on specific aspects of the child’s background, current situation, and needs: ■ Main information about the child: basic demographic details and legal guardianship status to establish the child’s identity. ■ Information about the child’s family: data on the child’s primary caregivers, offering insights into familial context and potential support networks, with specific focus on the status, parental rights, health, education, occupation, risk behaviors, and domicile of the child’s mother, father, and any other caregiver involved prior to the child’s entry into the system. ■ Information prior to the child’s first admission into the system: circumstances surrounding the child’s initial entry into alternative care, including reasons for separation from their family and any pre-admission support provided. ■ Information at the time of the child’s first admission into the system: detailed data about the child’s initial status upon entering the system, covering health, education, living conditions, family dynamics, income sources, and risk behaviors, aiming to provide a comprehensive understanding of the child’s background, needs, and potential risk situations. ■ The child’s history within the system: tracking the child’s journey through various services, this section documents the transitions and their timelines. ■ The child’s access to recovery and rehabilitation services: assessment of the child’s need for various therapies and interventions and access to them. ■ Disability and other vulnerabilities: recording disability and other vulnerability that may highlight the child’s personalized needs. ■ The child’s current health status: information on the child’s current health status, access to healthcare services, and changes since initial admission. ■ The child’s current education: information on the child’s current educational status, including enrollment details, academic performance, and risk of early school leaving. ■ Independent living skills: assessing independent living skills crucial for self-sufficiency and autonomy for children aged 16 and over and into more nuanced aspects such as reproductive health awareness, social networking usage, and attitudes towards learning and employment. ■ Risk behaviors: captures whether children aged 10 and over have engaged in various risk behaviors during their time in the system. ■ Case monitoring: evaluating the current support system and intervention plans, by recording if the child has a designated specialist overseeing their case and whether there is an individual protection plan or similar document available, outlining objectives and interventions. ■ Quality of services: assessing various aspects of the child’s well-being and the effectiveness of the support they receive, such as (i) receiving timely and appropriate services aligned with their assessed needs, including whether these services were monitored by specialists, (ii) investigating whether the child has been subjected to violence, neglect, or abuse and if they have made any complaints related to their social service, (iii) for children aged 10 and over, engaging in independent living activities and whether their opinions and participation are considered in decision-making processes related to their care and protection. ■ The child’s relationship with their family and chances for (re)integration in a family environment: assessing the child’s relationship with their family and the potential for (re)integration into a family environment through questions about home visits by specialists, interactions with family members, siblings within the system, living conditions of the origin 14 family, identification of relatives, engagement in (re)integration efforts, and assessments of (re)integration and adoption prospects. This questionnaire will be used to collect data about each child placed in the following types of residential services: Children’s homes, Muruvvat boarding homes for children with disabilities, Mehribonlik (House of mercy) and Family-type homes. 2. Questionnaire about the child placed in specialized boarding schools The questionnaire encompasses similar sections as the one about the child in childcare institutions, with a different concept of the section of the child’s current status and future plans to provide a comprehensive understanding of the child’s well-being and support within the specialized boarding school context: ■ Main information about the child: basic demographic details and legal guardianship status to establish the child’s identity. ■ Information about the child’s family: information about the child’s primary caregivers, offering insights into familial context and potential support networks. ■ The child’s admission into the specialized educational institution: includes details such as the date of admission, age at admission, previous educational history, reasons for transfer, academic performance, social skills, overall development, health diagnosis, challenges faced, and support received at the time of admission. ■ The child’s current situation: focuses on various aspects of the child’s development, education, health and access to recovery and rehabilitation. It looks at current academic performance, social interactions, overall development, cognitive abilities, language skills, emotional well-being, physical and motor development, creativity, self-care, and participation in social and civic activities. ■ Independent living skills: assessing independent living skills crucial for self-sufficiency and autonomy for children aged 16 and over and into more nuanced aspects such as reproductive health awareness, social networking usage, and attitudes towards learning and employment. ■ Risk behaviors: captures whether children aged 10 and over have engaged in various risk behaviors during their time in boarding schools. ■ Case monitoring: focuses on the oversight and coordination of activities related to the child's well-being and development within the institution. ■ The child’s relationship with their family and future plans: assesses multiple dimensions of the child’s familial relationships, interactions, and future prospects, covering engagement with typical peers in the community, any instances of violence or abuse experienced, grievances raised concerning the institution, and involvement in activities related to independent living. Furthermore, it seeks to gather data on the future, plans for the child’s reintegration into the family and community, readiness for independent living, potential transfers to other institutions, and continuation of education. This questionnaire will be used to collect data about each child attending a specialized boarding school for children with special educational needs, regardless of whether they use the boarding facilities. 3. Trace questionnaire about the youth leaving the childcare system This instrument is a very short questionnaire aiming to identify where the young person who left the alternative care lives now, so that he’s allocated to the right INSON to track them down and fill in the questionnaire about their current life and the support they need. Is will be completed individually for 15 each young person (18+) who in the last 12 months left the alternative childcare system and each young person (16+) who completed their studies in specialized boarding schools during the previous year. It covers only questions helping to identify the person and current residence. 4. Questionnaire about the youth leaving the childcare system The instrument aims to comprehensively understand the lives of young people who transitioned out of alternative care, to gain insights into their overall well-being by examining their demographics, housing, education, employment, health, life skills, and social connections. The instrument can prove also helpful to support the development of case management practices in the country. ■ Personal information about the young person: it gathers personal information about the young person, the last service they lived in before leaving the system and associated timeline, as well as information about their current domicile, whether they live independently or in an institution for adults. ■ Housing: information on the housing situation covering inquiries regarding legal entitlement to property rights, housing arrangements such as ownership or rental, and the individuals with whom they reside. Additionally, it assesses the quality of housing conditions, the receipt of housing-related support or benefits, and any plans for future independent living or community alternatives. ■ Education, employment and income: information on current education and employment status, including whether the individual has received support for these fields in the past year, and income sources for the past month. ■ Health: information regarding the persons’ access to healthcare services, level of independence in daily activities, and disability status. Additionally, it assesses the presence of chronic diseases, and engagement in risky behaviors such as substance abuse or self-harming behavior. Moreover, it assesses the need for assistive devices, recovery and rehabilitation services and the relevant support received. ■ Independent living skills: assessment of independent living skills, identifying areas where the individual requires support to further develop skills, whether they had already received such support in the past year, including types of support received and its provider. ■ Social connections and participation: It gathers data on the support network, communication frequency with family and friends, how individuals spend their free time, and their participation in social activities or community engagement. ■ Conclusions and recommendations: This section is designed for specialists to evaluate the young person’s settlement into their new community and any progress made since leaving the system. It prompts them to identify challenges the individual may be facing in settling, areas of fulfillment or improvement, and barriers to progress. Additionally, it guides them to evaluate the need for increased support and to offer recommendations for providing such support based on their professional assessment. This questionnaire will be completed for each young person (18+) who has exited the alternative care system within the past 12 months. It pertains to individuals who were in Mehribonlik houses, Muruvvat houses for children with disabilities, family-type children’s homes, SOS children’s 16 villages/families.7 Additionally, the questionnaire aims to gather data about each young people aged 16 and above who completed their studies in a specialized boarding school during the previous year. 3.2 Institutional resources and conditions 5. Questionnaire on human resources of the institution The instrument gathers essential information about staff working in childcare institutions and boarding schools, aiming to provide a comprehensive overview of their qualifications, experience, responsibilities, working conditions, and potential risks or issues through two sections: ■ Information about the position covers data regarding the job title, department, job class, availability of a job description, working hours, required level of education, necessary experience, position level, and current job status. ■ Information about the employee covers details about the employee’s personal information including education level, occupation/professional background, total years of relevant work experience, date of hiring, type of contract, involvement in working with children, night shift and weekend work, participation in advanced training courses, entitlement to paid leave days, overall salary, history of complaints and sanctions, and eligibility for retirement within the next three years. This instrument aims to gather information about each position and employee within the following types of institutions: Children’s homes, Muruvvat boarding homes for children with disabilities, Mehribonlik (House of mercy) and Specialized boarding schools for children with special educational needs. 6. Questionnaire on the material resources of the institution and the living conditions of the residing children The instrument serves as a comprehensive tool for evaluating the material and financial resources within childcare institutions and specialized boarding schools. Its primary objective is to gauge the adequacy and quality of facilities, resources, and financial allocations, thereby fostering an environment conducive to enhanced childcare services. ■ General information about the institution: gathers basic details pertaining to the structure, location, and operational aspects of childcare institutions and specialized boarding schools, including data on the number of children residing in the institution. ■ Location and accessibility: assesses the proximity of essential amenities, transportation options, and accessibility features surrounding the institution. ■ Land, buildings, and facilities: collects information on the physical infrastructure and amenities available within the institution, focusing on aspects such as land area, building conditions, accessibility features, utilities, waste management, and additional on-site facilities. ■ Accommodation capacity and living conditions: assesses living arrangements and conditions within the institution, including accommodation capacity, sleeping quarters, amenities, and living standards provided to residents. 7 SOS children’s villages/families may be classified as institutional care if several homes are placed in a single location, concentrating a large number of children, or family-type chilldren’s home if they are integrated within the community. 17 ■ Catering conditions: assesses food-related facilities, practices, and nutritional aspects. ■ Facilities for education and other specific activities: assesses the educational and developmental resources available within the institution, focusing on both formal education and other supplementary activities. ■ Facilities to spend free time and socialize: evaluates the provision of indoor and outdoor spaces within the institution dedicated to children’s leisure activities and social interaction. It also examines the availability of equipment, materials, and resources in these spaces. ■ Financial resources – institution’s expenditures in the reporting year: assesses the financial resources and expenditures of the institution in the reporting year. One questionnaire on the material resources of the institution and the living conditions provided to the residing children will be completed for each of the following type of institutions: Children’s homes, Muruvvat boarding homes for children with disabilities, Mehribonlik (House of mercy) and Specialized boarding schools for children with special educational needs. 7. External evaluation form for childcare institutions and boarding schools The instrument assesses dimensions related to the living conditions, institutional environment and support provided to children for their well-being, development, and integration into society. ■ Location and accessibility: Proximity to residential areas, public transportation access. ■ Building maintenance and accessibility: Condition and accessibility of the buildings for children, including those with disabilities. ■ Living conditions: Quality of living spaces, including bedrooms, privacy, and availability of bedding. ■ Sanitation and hygiene: Cleanliness and functionality of toilets, washrooms, and overall sanitation. ■ Nutrition and food quality: Availability, quality, and cultural appropriateness of food provided. ■ Safety and security: Measures in place for fire and hazard protection, as well as general safety protocols. ■ Recreation and leisure: Provision of recreational facilities, access to activities, and freedom to choose leisure activities. ■ Healthcare and medical services: Access to medical treatment, health education, and support for general and reproductive health. ■ Staff behavior and support: Treatment of children by staff, provision of support for education, career development, and social integration. ■ Child rights and protection: Protection from abuse, provision of clear information about rights, and mechanisms for filing complaints. ■ Education and life skills: Support for education, development of life skills, and guidance on future career paths. ■ Social connections and cultural activities: Opportunities for social interaction, participation in cultural and community activities. All children’s homes, Muruvvat boarding homes for children with disabilities, Mehribonlik (House of mercy) and Specialized boarding schools for children with special educational needs, will be assessed using this external evaluation form. 18 3.3 Alternative family-based care 8. Family-Type Children’s Home Questionnaire The instrument aims to gather comprehensive information about family-type children’s homes in Uzbekistan. Each questionnaire is to be completed for a single family-type home, regardless of whether children are currently in care. The questionnaire comprises several sections: ■ Information about the foster parents: Details about the foster parents, including their residence, tenure as foster parents, ownership rights, possession of foster parent certificates, and demographic information such as education, occupation, and number of biological and adopted children. ■ Fostered children: Data on the number of children placed in the family-type home since its establishment, whether the foster parents have cared for children from various vulnerable groups, and details of children currently in care, including gender, age, admission date, disabilities, and educational status. ■ Exits from the family-type home during the reporting year: Information on whether any child left the family-type home during the reporting year, the total number of exits, and details of each child who left, including gender, age, presence of disabilities, and reason for leaving. ■ Quality of care assurance: Assessments of the quality of care provided by the foster parents, including their attendance at mandatory training courses, receipt of additional training, oversight by child protection department specialists, frequency of visits by specialists, refusals to care for children or specific groups, involvement in disciplinary investigations or sanctions, and any complaints or accusations received in the past 12 months. 9. Patronat Family Questionnaire The instrument is designed to gather information about patronat families in Uzbekistan, where children who have lost parental care are placed. Each questionnaire is completed for a single patronat family. Key sections include: ■ Information about the patronat family: Details such as residence, relationship between guardians and children, demographic information about the guardian(s), including their education, occupation, and number of biological and adopted children. ■ Children placed in the patronat family: Information about each child currently placed in the patronat family, including gender, age, date of admission, presence of disabilities, source of placement, expected date of exit, and type of education. ■ Exits from the patronat family during the reporting year: Details about any children who left the patronat family during the reporting year, including gender, age, presence of disabilities, and reason for leaving. ■ Quality of care assurance: Assessment of the quality of care provided by the patronat family, including oversight by child protection specialists, frequency of visits, involvement in complaints or accusations, changes in criminal records of individuals in the family, risk of discontinuing placement, training, psychological counseling, and participation in support groups for foster families in the past 12 months. 19 3.4 Entries into and exits out of the alternative care system 10. Synthetic data collection sheet regarding entries and exits from the childcare institution and specialized boarding schools The instrument is designed to capture data on the total number of children, entries, and exits from the institution over the reference year, categorized by age and gender. This section delves into the origin of entries (e.g., families, other institutions) and the destinations of exits (e.g., family reintegration, transfers to other services). Ultimately, the aim of this data collection sheet is to provide a holistic overview of the dynamic of children’s movements within childcare institutions and specialized boarding schools. One synthetic data collection sheet regarding entries and exits will be completed for each of the following type of institutions: Children’s homes, Muruvvat boarding homes for children with disabilities, Mehribonlik (House of mercy) and Specialized boarding schools for children with special educational needs. 3.5 Limitations of the current exercise Lack of qualitative data for a comprehensive diagnostic: The exercise does not include the collection of qualitative data from interviews or focus-groups with children, staff, management, or other local/regional stakeholders. Although the external evaluation instrument is intended to be informed by discussions with children and staff, the absence of structured qualitative data limits the depth of insights. Lack of a dedicated instrument for children’s voices: A dedicated quantitative instrument to capture the voices of children is planned only for future data collection rounds. This delay is due to limited data collection capacity in the current exercise. It is recommended that before implementing such an instrument, dedicated training, guidance, and quality monitoring be conducted. Ideally, an external specialist, not affiliated with the respective institution, should guide the initial steps of applying this instrument. Resource constraints for external evaluation: The external evaluation, planned to be implemented by the NASP, may require additional resources to ensure comprehensive application across all centers. The significant workload of the NASP might delay the results. To mitigate this, additional external evaluators, such as specialists from INSON centers, residential centers from other regions, or NGO representatives, can be engaged. Limited training of specialists on certain topics: Professionals in the system have limited access to training on human rights and issues related to risks and situations of exploitation and abuse. This gap may affect the quality of specific data provided. It is recommended to gradually increase awareness and training on these topics in future waves of monitoring data collection. 20 4 The data collection process The scope of the data collection will cover all closed institutions for children nation-wide, all family- type services and at least key information on each child. Specialized boarding schools will be included in the data collection as they represent a closed environment, even if they also provide education and house children who do not lack parental care. This sample includes public and private institutions (the latter being under SOS children’s villages management). Table 3: Status of institutions that represent the scope of the data collection process (October 2023) Type of service No. institutions No. users Children’s homes 8 339 Muruvvat boarding homes for children with disabilities 7 1,979 Mehribonlik (House of mercy) 2 241 Specialized boarding schools for children with special educational 68 8,934 needs Family-type homes 124 638 SOS children’s villages 3 151 Subtotal 212 12,282 Patronat families 768 992 Total 13,274 Source: NASP. Note: Patronat families are not services by law, but alternative family-based care solutions. In the case of children in patronat families, general profile data will be collected. The preparation of the data collection will cover the development of a PC-based data collection tool that will include all instruments to simplify the data collection process. Instruments will be introduced into a PC-based tool that will embed logical conditions between indicators, in which assigned specialists at service level will be able to enter data. The tool will facilitate the collection, management, and analysis of data related to the alternative care system and the deinstitutionalization process in Uzbekistan. It will be user-friendly and accessible to authorized persons involved in data entry. The tool will encrypt data to ensure its security. The access in the tool will differ at institution/region/NASP levels. Each institution will be able to see only the data they are entering, while the regional coordinators will merge with the help of the tool, all data at the regional level. In turn, NASP will be able to merge all data at national level. It will present all instruments in English, Russian and Uzbek languages and it will be piloted in one region before the actual launch of data collection. 21 Figure 1: Extracts from the data collection tool: (1) main page, (2) data completion monitoring dashboard, (3) sample instrument 22 The data collection process will require the engagement of a significant number of specialists across the system. This will be enabled by the set-up of an organizational structure under the coordination of NASP, with technical support provided by the World Bank and UNICEF. A very important significance will be given to the team of 14 regional coordinators placed under regional NASP offices (see Table 4). They will coordinate institutional-level coordinators who in turn will ensure that data collectors at the level of their institutions are filling in the instruments, as case requires. The support that will be provided to specialists engaged in the data collection process will refer to usage of the PC-based data collection tool, as well as assistance about how to fill in the instruments (such as technical clarifications). Table 4: Detailed roles of engaged parties and specialists Stakeholder Main role and tasks World Bank and ■ Develop, test and pilot the PC-based data collection tool. UNICEF Technical ■ Provide training on using the tool. Assistance (TA) ■ Provide support to users/specialists engaged in the data collection process. Team NASP coordinator ■ Host the master tool and provide the local tool to institutions/services. ■ Receive and import datafiles in the master tool. ■ Monitor the progress of data collection in the master tool and take measures to improve the completion rate, if needed. 14 Regional ■ Coordinate the timely data collection process for all institutions/services at coordinators regional level. ■ Consolidate datafiles received from institutions/services by importing them in the local tool. ■ Provide support to institutions/services, with the help of the TA Team. ■ Send the consolidated regional datafile to NASP. Institution-level ■ Coordinate the data entry at institution level. coordinators ■ Import datafiles with questionnaires filled in by data collectors. ■ Export the consolidated datafile and send it to the regional coordinator. ■ Report issues and unclarities to the regional coordinator. Data collectors ■ Collect the required data from files and other specialists in the institution/service. ■ Fill in the data in the local tool. ■ Export data from the local tool and send it to the institution-level coordinators. ■ Different specialists will be engaged: on child-related data – social worker, other specialist close to the child; on human resources data – human resources or managerial staff; on material and financial resources data – administrator and/or accountant; on data for family-type services – INSON* staff responsible of their monitoring. External ■ Special category of data collectors that are external from institutions. evaluators ■ Visit institutions and collect information through observation, reviewing documents, talking with children and staff. ■ Fill in the evaluation forms in the local tool. ■ Send the datafiles to NASP. Note: * INSON centers are district-level centers having the responsibility to accept applications for social benefits and services, assess vulnerabilities, provide psychological, social, legal assistance and referrals to social care and rehabilitation services, either at home or in community centers or in institutions, including the centers for survivors of domestic violence. They also monitor children in alternative family-based care (family-type homes and patronat families). 23 Table 5: Data collectors by type of instrument Dimension Instrument Data collector I. Child 1. Questionnaire about the child placed in the Childcare specialists (center) characteristics childcare system and well-being 2. Questionnaire about the child placed in Special education/Childcare specialized boarding schools specialists (center) 3. Trace questionnaire about the youth leaving the Special education/Childcare childcare system specialists (center) 4. Questionnaire about the youth leaving the Child protection specialists childcare system (INSON) II. Institutional 5. Questionnaire on human resources of the HR specialist (center) resources and institution conditions 6. Questionnaire on the material resources of the Administrative specialist institution and the living conditions of the (center) residing children 7. External evaluation form for childcare External evaluators (NASP) institutions and boarding schools III. Alternative 8. Family-type children’s home questionnaire Child protection specialists family-based care (INSON) 9. Patronat family questionnaire Child protection specialists (INSON) IV. Institutional 10. Synthetic data collection sheet regarding entries Administrative specialist dynamics and exits from the childcare institution and (center) specialized boarding schools Training will be provided to all specialists to ensure before the data collection to ensure its flow, while ongoing technical assistance will be provided throughout the data collection process. This approach aims to increase preparedness across institutions and specialists engaged from the outset and to offer ongoing support to address any challenges or issues that may arise during the data collection period. The training will be carried out in two main steps: (i) a first training will be offered to the 14 regional coordinators, so that they understand the scope of the data collection, including the institutions involved and the types of instruments used, so that they can develop a realistic understanding of the effort they are committing to and their precise role; (ii) a second round of trainings will be ensured with categories of specialists, by instrument, to ensure they understand both how to use the PC-based tool, but also the content of the instruments contained by it. Complementing the training, training videos on key technical issues and full recordings of training sessions will be made available online. Ultimately, the data collection effort will be used to produce synthetic monitoring tables at national, regional and institution level and inform the future childcare M&E system. These monitoring tables will be generated based on previously prepared syntaxes. Based on the wealth of information produced, a set of key monitoring indicators of the alternative care system will be established in the subsequent output with inputs for the monitoring system. These will include the UNICEF set of 23 key outcome indicators that provide a standardized framework for measuring progress in child protection systems.8 Four main types of reports will be generated through the data collection and reporting tools (see them in the attached Annex): 8 These indicators cover various aspects of child well-being, including access to education and healthcare, protection from violence and exploitation, and the quality of alternative care arrangements (UNICEF 2023). 24 ■ A monitoring report regarding the profile and situation of all children in alternative care (Children_monitoring_report); ■ A monitoring report regarding the material resources of all institutions (Material_resources_monitoring_report); ■ A monitoring report regarding the human resources of all institutions (Human_resources_monitoring_report); ■ A monitoring report regarding the youth who left the institutions over the past 12 months (Youth_leaving_institutions_monitoring_report). The reports will be generated at the national, regional and institution level, using the same structure prepared for the national reports. 25 5 Next steps after the first monitoring round This first exercise aims to be the first step towards building a continuous monitoring system through an information system dedicated to the alternative care system (including updated information regarding all children in alternative care, the staff, the material resources, entries and exits and children who leave institutions). The information system would record more information during the initial stage; however, the wealth of information would be reduced during the regular updates. Draft instruments for the regular updates on the children’s situations, the staff, and the family-type homes can be found in Annex 3. Based on the data collection and reporting efforts for the first monitoring report, the World Bank team, in consultation with NASP and UNICEF, will provide technical inputs into the design of the information system (under the same RSR grant). Under the information system that is under development by NASP, the monitoring tools are recommended to be applied each semester or at every significant change with regard to a child entering and exiting centers. 26 References Literature Browne, K. (2009). The Risk of Harm to Young Children in Institutional Care, London: Save the Children. Available at: https://www.savethechildren.org.uk/content/dam/global/reports/health-and- nutrition/The_Risk_of_Harm_1.pdf Johnson, R., Browne, K. and Hamilton-Giachritsis, C. (2006). Young children in institutional care at risk of harm. Trauma Violence Abuse, Jan, 7, 1, 34-60. Available at: https://journals.sagepub.com/doi/abs/10.1177/1524838005283696?url_ver=Z39.88- 2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed& Save the Children (2015). Child protection outcome indicators. Available at: https://resourcecentre.savethechildren.net/document/child-protection-outcome-indicators/ Tobis, D. (2000). Moving from Residential Institutions to Community Based Social Services in Central and Eastern Europe and the Former Soviet Union, Washington DC: World Bank. Available at: https://elibrary.worldbank.org/doi/abs/10.1596/0-8213-4490-0 Unicef (2023). Child Rights Monitoring Framework. Available at: https://www.unicef.org/eca/sites/unicef.org.eca/files/2023- 11/ECA%20Child%20Rights%20Monitoring%20Framework_Definitions.pdf UNICEF (2016). Child protection resource pack. Available at: https://data.unicef.org/resources/child- protection-resource-pack/ UNICEF (2023). Statistical Manual for a Core Set of Child Protection Indicators for Europe and Central Asia. Set of Indicators - Children in Alternative Care and Adoption. Available at: https://www.unicef.org/eca/set-of-indicators-1 United Nations (1989). Convention on the Rights of the Child. Available at: https://www.ohchr.org/en/professionalinterest/pages/crc.aspx United Nations (2006). Convention on the Rights of Persons with Disabilities. Available at: https://www.un.org/disabilities/documents/convention/convoptprot-e.pdf World Vision International (2013). Compendium of Indicators for Measuring Child Well-being. Available at: https://www.wvi.org/sites/default/files/Compendium_of_Indicators_for_Child_Well- being_0.pdf World Bank (2017). Descriptive Report on the Evaluation of the Existing Resources of Residential Centers. Reimbursable Advisory Services on Development of Plans for De-Institutionalization of Children Deprived of Parental Care and their Transfer to Community-Based Care, signed between the National Authority for Protection of Child Rights and Adoptions and the International Bank for Reconstruction and Development. World Bank (2020). Technical report including inputs into the design of an instrument for monitoring and evaluation of the progress of the transition from institutional to community-based care. Reimbursable Advisory Services Agreement on Capacity Building to Accelerate the Transition from Institutional to Community-based Care for Children Deprived of Parental Care, signed between the 27 National Authority for Protection of Child Rights and Adoptions and the International Bank for Reconstruction and Development. World Bank (2020). Proposed methodology for collecting data for a complex diagnosis of the situation of public social care residential centers for adult persons with disabilities. Reimbursable Advisory Services Agreement on Support to Speed Up the Transition of People with Disabilities from Residential Institutions to Community-Based Services, signed between the National Authority for Persons with Disabilities and the International Bank for Reconstruction and Development. World Bank (2023). Comprehensive work plan for monitoring the transition from institutional to community-based care. Reimbursable Advisory Services Agreement on Supporting the Transition from Institutional to Community-Based Care for Children, Youth and Persons with Disabilities. Legislation Decision of the Cabinet of Ministers of the Republic of Uzbekistan on approval of the regulations on children’s homes (2022). Decision of the Cabinet of Ministers of the Republic of Uzbekistan on approval of the regulations on activities of certain medical and social institutions in the field of social protection of the Republic of Uzbekistan (2021). Decision of the Cabinet of Ministers of the Republic of Uzbekistan on measures to further strengthen the social protection of orphans and children deprived of the care of their parents or other legal representatives (2020). Decision of the Cabinet of Ministers of the Republic of Uzbekistan on measures to further improve the activities of preschool education organizations (2019). Decision of the Cabinet of Ministers of the Republic of Uzbekistan on measures to organize the activities of educational institutions of the republic (2019). The Decree of the President of the Republic of Uzbekistan on measures to further improve the system of guarantees of the rights of the child (2021). Resolution of the Cabinet of Ministers of the Republic of Uzbekistan on approval of regulatory legal acts for the implementation of the Law of the Republic of Uzbekistan “on guardianship and trusteeship� (2014). Resolution of the Cabinet of Ministers of the Republic of Uzbekistan on approval of the regulations on children's homes (2012). 28 Annexes Annex 1. Set of instruments for the first monitoring round Dimension Instrument Data collector I. Child 11. Questionnaire about the child placed Childcare specialists (center) characteristics into childcare institutions and well-being 12. Questionnaire about the child placed in Special education/Childcare specialized boarding schools specialists (center) 13. Trace questionnaire about the young Special education/Childcare person leaving childcare institutions specialists (center) 14. Questionnaire about the young person Child protection specialists leaving childcare institutions (INSON) II. Institutional 15. Questionnaire on human resources of HR specialist (center) resources and the institution conditions 16. Questionnaire on the material Administrative specialist (center) resources of the institution and the living conditions of the residing children 17. External evaluation form for childcare External evaluators (NASP) institutions and boarding schools III. Alternative 18. Family-type children’s home Child protection specialists family-based questionnaire (INSON) care 19. Patronat family questionnaire Child protection specialists (INSON) IV. Institutional 20. Synthetic data collection sheet Administrative specialist (center) dynamics regarding entries and exits from the childcare institution and specialized boarding schools Dimension Instrument I. Child 1. Questionnaire about the child placed in the childcare characteristics system and well-being 1.UZ_ChildDI_Childr en_into_the_childcare_system.docx 2. Questionnaire about the child placed in specialized boarding schools 2.UZ_ChildDI_Childr en_in_boarding_schools.docx 3. Trace questionnaire about the youth leaving the childcare system 3.UZ_ChildDI_Trace _questionnaire.docx 4. Questionnaire about the youth leaving the childcare system 4.UZ_ChildDI_Youn g_person_leaving_care.docx II. Institutional 5. Questionnaire on human resources of the institution resources and conditions 5.UZ_ChildDI_Huma n_resources.docx 29 6. Questionnaire on the material resources of the institution and the living conditions of the residing children 6.UZ_ChildDI_Mater ial_resources.docx 7. External evaluation form for childcare institutions and boarding schools 7.UZ_ChildDI_Exter nal_evaluation.docx III. Alternative 8. Family-type children’s home questionnaire family-based care 8.UZ_ChildDI_Famil y_type_homes.docx 9. Patronat family questionnaire 9.UZ_ChildDI_Patro nat_family.docx IV. Institutional 10. Synthetic data collection sheet regarding entries and exits dynamics from the childcare institution and specialized boarding schools 10.UZ_ChildDI_Entri es_exists.docx Annex 2. Preliminary monitoring reports Monitoring report regarding the children in alternative care UZ_ChildDI_Childre n_in_alternative_care_Monitoring report Monitoring report regarding the material resources of institutions UZ_ChildDI_Materia l_resources_Monitoring report template Monitoring report regarding the human resources of institutions UZ_ChildDI_Human _resources_Monitoring report template. Monitoring report regarding the youth leaving the institutions UZ_ChildDI_Youth_l eaving_care_Monitoring report template 30 Annex 3. Proposed instruments for regular monitoring updates of the alternative care system Dimension Instrument I. Child 1. Questionnaire about the child placed in the childcare system characteristics and well- 1.UZ_ChildDI_Monit oring_Children_in_the_child_care_system being 2. Questionnaire about the child placed in specialized boarding schools 2.UZ_ChildDI_Monit oring_Children_in_boarding_schools.do 3. Questionnaire about the youth leaving the childcare system 3.UZ_ChildDI_Monit oring_Youth_leaving_care.docx II. 4. Questionnaire on human resources of the institution Institutional resources and 4.UZ_ChildDI_Monit oring_Human resources.docx conditions 5. Questionnaire on the material resources of the institution and the living conditions of the residing children 5.UZ_ChildDI_Monit oring_Material resources.docx III. Alternative 6. Family-type children’s home questionnaire family-based care 6.UZ_ChildDI_Monit oring_Family_type_homes.docx 7. Patronat family questionnaire 7.UZ_ChildDI_Monit oring_Patronat_family.docx IV. 8. Synthetic data collection sheet regarding entries and exits from Institutional the childcare institution and specialized boarding schools dynamics 8.UZ_ChildDI_Monit oring_Entries_exists.docx 31