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The forum was organized by Hope and Homes for Children – Bulgaria and was hosted by Equilibrium on 13th and 14th June 17, 2017 in integrated children’s services “Slancho” in Ruse.

The venue was chosen because Equilibrium is the only NGO in the country that manages an innovative social-health service with the support of Ruse Municipality and the partnership of Hope and Homes for Children – Bulgaria.

The round table brought together the large majority of professionals who are leaders and experts in the other 7 pilot facilities in the country. They were opened as a result of the restructuring and closing of 8 pilot Homes for Medico-Social Care under the project “Direction: Family” of the Ministry of Health with the active participation of Hope and Homes for Children – Bulgaria.

The main objective of the conference was to exchange good practices and to reveal the challenges faced by the teams who work in these new services having regard to the planned development of 20 new Centres for specialized health-social care for children with disabilities in need of constant medical care in the updated Action Plan for implementation of the national strategy “Vision for the deinstitutionalization of children in Bulgaria” adopted by the Council of Ministers at the end of last year.

 The representatives of these services in Gabrovo, Sofia, Targovishte, Ruse, consultants from Karin Dom Foundation, representatives of Ruse Municipality, foster parents of children with disabilities and medical experts identified the key factors for success through the consideration of specific cases of children and their families.

It was unanimously agreed that human resources were of critical importance together with the creation of working partnerships with parent / patient organizations and medical experts who both consult the families and monitor the children.

Another key factor was creation of sustainable practical methods of supporting the parents and families of babies born with disabilities or developmental disorders in order to ensure that the infant is never separate from the family. This demands the implementation of a coherent plan of support covering transfer of the child from the maternity unit to the new facility and hospital visits.

Participants in the round-table made recommendations and provided guidelines for both the management of new facilities and improvement in the standards of those that are already operational.

Part of the recommendations relate to detailed prognosis and setting an adequate financial standard relevant to the needs of the service – highly qualified medical staff. (The current standard doesn’t provide sufficient remuneration and this makes it difficult to attract experts to the service). Medical supplies, equipment and overheads are expensive and it is necessary that these are prescribed by the Ministry of Health to ensure full cooperation by the health care system for provisioning of the needs of these children who fight for their lives every day.

It is expensive for these services to be adequately resourced and currently this is not fully covered by health insurance nor by the social welfare system but they are very important for the rehabilitation and the quality of life of these children.

Steps must be taken to allow reconstruction work in the centres that are currently operating. Lack of access by elevators to top floors and the failure to install the appropriate swing doors make it difficult to accommodate or move children who are bedridden and with severe hydrocephalus.  As the facilities were built using European structural funds, there are regulations that prevent reconstruction work for a period of 5 years despite the concerns of the service providers.

Those participating, the EQ team and Hope and Homes for Children would like to convene a meeting in the autumn with high-level stakeholders, key medical experts and representatives of government to review the practical operation of the new services.