Thursday, 28 May 2015

Honduras at the CRC: Lack of Funding for the Implementation of National Policies and Insufficient Maternity Leave


On May 20 and 21, 2015, the Committee on the Rights of the Child considered the combined fourth and fifth periodic report of Honduras on the situation of the implementation of the Convention on the Rights of the Child in the country.

On this occasion, IBFAN presented an alternative report to inform the CRC Committee on the situation of infant and young child feeding in Honduras.

General overview of breastfeeding in Honduras

IBFAN pointed out the decline in the rate of early initiation of breastfeeding within one hour after birth between 2005-2006 (79%) and 2011-2012 (64%) which appears to be even higher in rural areas (70% in 2011-2012) according to the survey ENDESA 2011 - 2012. IBFAN also noted with great concern that the rate of early initiation of breastfeeding is lower among children born with delivery assistance by health professionals. In addition, in 2011-212 almost 7 children out of 10 were not exclusively breastfed until 6 months of age, while half of them were bottle-fed. 

IBFAN further highlighted the absence of funding allocated to the implementation of national policies and plans on breastfeeding and infant nutrition by the National Breastfeeding Committee (CONALMA). For example, due to the lack of funding, all the activities designed in the National Breastfeeding and Complementary Feeding Plan 2009-2013 could not be implemented. As a result of such poor funding of national policies and plans, there is a deficiency in the training of health professionals on optimal breastfeeding practices which leads to a lack of skilled counseling on infant and young child feeding. 

Only few provisions of the International Code of Marketing of Breastmilk Substitutes are implemented and there is a lack of knowledge on the Code among health personnel resulting regular Code violations. 

Regarding maternity protection, the report stressed that the maternity leave (12 weeks, of which 6 weeks after delivery) does not allow mothers to breastfeed exclusively for 6 months. There is no paternity leave entitlement and many workplaces are lacking nursing areas and childcare facilities. Finally, IBFAN emphasized the absence of any preparedness plan to ensure the protection and support of breastfeeding in emergencies. 

Discussion on infant and young child feeding

The discussion between the Committee and the delegation has been very much focused on the issue of the violence against children and the condition of by migrant children. The issue of the prohibition of abortion has also been raised by several members of the Committee 

However, the Committee raised concerns about the high rates of teenage pregnancies in the country, and asked what is done to prevent them. It also emphasized the high rates of malnutrition in the country. More specifically, the Committee asked the delegation about the measures taken to protect and promote breastfeeding.

Regarding adolescent pregnancies, the delegation explained the First Lady recently launched a prevention campaign and that a multisectoral approach is followed by the government. For example, there are clinics specifically aimed at adolescents, where they can go without their parents. The delegation also specified that no women who require treatment are turned away even in the case they have had an abortion. The delegation stressed that since 2010, a guidance on how to teach sexual education to adolescent is in place, but it admitted that the government needs to step up its efforts in this area.

Regarding breastfeeding, the delegation mentioned the 2013 law on breastfeeding protection, promotion and support and specifically referred to the articles 10 (on the constitution of the CONALMA), and 19 to 31 (on the regulation of the marketing of breastmilk substitutes).

Concluding observations

In its Concluding Observations, the Committee made several indirect recommendations to Honduras in relation with infant and young child feeding. However, it did not refer specifically to breastfeeding.

The Committee first urged Honduras to provide the adequate resources for the effective functioning of data collecting systems, by including disaggregated data and high quality and timely information (§16a-c).

After welcoming the decline of infant and under-5 mortality and the adoption of the Breastfeeding Law, the Committee expressed its concerns on the “delay of adopting a primary health-care strategy and the limitations imposed on the Expanded Programme of Immunization” (§60). In this regard, the Committee recommended Honduras to adopt of a primary-health care strategy (§61a) and the adequate allocation of human, technical and financial resources to the immunization programme (§61b). The Committee also stressed the need to improve the coverage and the quality of health services, particularly in rural and indigenous areas (§61c). Regarding HIV/AIDS, the Committee highlighted the importance sustain measures to prevent mother-to-child transmission (§67b) and to improve the follow-up treatment for infected mothers and their children (§67c).

Lastly, regarding nutrition, the Committee highlighted the high level of chronic malnutrition, which affects twice as many children in rural as in urban areas (§68) and thus recommended the State party to strengthen its efforts to reduce the rated of chronic malnutrition (§69c).