This report is about children in Eastern Europe and Central Asia who are deprived of parental care. Despite recent reforms, which have led to an increase in the number of children being placed in alternative families – for example with foster parents, guardians or adoptive parents – the majority of these children are still living in institutions. They live in a child care system which relies heavily on costly residential care and which also undermines their development potential. The report provides an in-depth review and analysis of the latest statistics provided by national statistical offices on children in formal care in these countries. It highlights relevant trends on key issues such as family separation, the placement of children in institutional care and concerns about the abandoning or handing over of small babies to state authorities. Finally, it looks at the heavy reliance on institutions to care for children with disabilities – many people are still under the misapprehension that an institution is the best place for a disabled child. The findings of this report show that there has been impressive progress over the past ten years in the reform of the child care systems in Eastern Europe and Central Asia.