On January 13th
and 14th, 2015, the Committee on the Rights of the Child considered
the combined second to fourth periodic report of Turkmenistan on the situation
of the implementation of the Convention on the Rights of the Child in the country. The
Turkmen delegation was led by Mrs. Lyudmila Amanniyazova, Deputy
Head of the State Statistics Committee and H.E. Mr. Atageldi Haljanov, Permanent
Representative of Turkmenistan to the United Nations Office at Geneva.
General overview of
breastfeeding in Turkmenistan
Breastfeeding rates are low in Turkmenistan: nine children out of 10 are
not exclusively breastfed under 6 months of age and less than 4 children out of
10 receive continued breastfeeding until 2 years of age. The rate of early
initiation of breastfeeding is also very
low (59.8%) while neonatal, infant and under-5 mortality rates are still high in
the country.
In 2009, Turkmenistan adopted the Law on Protection and Promotion of Breastfeeding and Requirements for Infant Feeding Products, amended in 2013, which determines
the main public policies on child nutrition and regulates the distribution and
marketing of safe baby foods. However, this law implements only partially the International Code of Marketing of Breastmilk Substitutes and there is no
clarity on its implementation or on any monitoring mechanism.
Besides, there is no recent data on the implementation of the Baby-Friendly Hospitals Initiative in the country. In 2009-2010, 81% of the maternity facilities
were certified as ‘baby-friendly’. Finally, no comprehensive information on maternity
protection, HIV and breastfeeding and infant feeding in emergnecies is available.
Discussion on infant and young child feeding
The CRC Committee specifically addressed the issue of breastfeeding and
the lack of breastfeeding-related information. After welcoming the adoption of the 2009 law(see
above)and its 2013 amendments, the Committee expressed concern for the low
exclusive breastfeeding rate under 6 months and asked about the root causes of
this drop as well as about the measures taken to tackle it.
Additional questions were made on the number of
Baby-Friendly hospitals in the country and on the training available for
expecting mothers and fathers on parenthood and breastfeeding practices. The
CRC Committee also raised the issue of the training provided to health professionals
on breastfeeding, the duration of the maternity leave and the existence of a
paternity leave. It also highlighted that information on mother-to-child HIV transmission
and on HIV and breastfeeding was missing.
The Turkmen delegation specified that according
the 2009 law prohibits the distribution of samples of infant formula to
families, in line with the International Code. It mentioned that currently,
some 95% of hospitals and maternities are certified as “Baby-Friendly”, that
expecting mothers learn about breastfeeding as part of their preparation to
motherhood, and that about 2,000 parents have been given training on child
care. Thanks to the measures undertaken, the rate of children ever breastfed
increased from 41% in 2008 to 61% in
2014. A study conducted in two regions of the country showed that 59% of children
aged 0-5 months were exclusively breastfed. Lastly, a study assessed that
doctors and nurses have good knowledge on breastfeeding.
Concerning maternity protection, the delegation
explained that there are 3 types of State maternity allowances for child care,
given respectively before delivery, at delivery and after deliver. It also
mentioned that the maternity leave should not be less than 190 days, according
to the Turkmen legislation, which also provides for a paternity leave. The
delegation stated that legislation provides breastfeeding breaks of 30 minutes
every three hours, available for lactating mothers with children up to 1 year
and a half of age. The duration of the breastfeeding breaks can change
depending on the number of children and it is considered as working time, thus not
deducted from the salary.
Additional information was given on the network
of health care centres that is being developed and empowered throughout the
country, in order to provide coverage of maternal and children’s health
services in the main cities as well as in the rural areas. No information was
given on HIV and breastfeeding.
Concluding Observations
In its Concluding Observations, the Committee
made several recommendations directly related to breastfeeding.
With regard to breastfeeding protection, the
Committee urged Turkmenistan to “enact legislation implementing all the provisions of the International
Code of Marketing of Breast-Milk Substitutes” (§ 49b), as well as to “ensure
that working mothers have the practical possibility to breastfeed, including by
developing breastfeeding-friendly workplaces and child care centres at work” (§
49e). Concerning the promotion of
breastfeeding, the Committee recommended the country to enhance its efforts to
promote exclusive breastfeeding practices (§ 49a) and to raise awareness about
optimal breastfeeding practices among the population (§ 49c). Finally, on data
collection, the Committee urged Turkmenistan to “ensure systematic collection of data on
infant and young child feeding” (§ 49d).
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