In
its Concluding Observations, the CRC Committee referred specifically to
breastfeeding for 3 of the 7 countries under review (Brazil, Timor-Leste and
United Arab Emirates). Bangladesh did not receive direct recommendation on
breastfeeding, but was urged to implement the Technical Guidance on child
mortality (A/HRC/27/31) which refers directly to breastfeeding and calls
specifically for implementation and monitoring of the International Code of
Marketing of Breastmilk Substitutes.
General measures of implementation
The Committee has put an emphasis on the
improvement of the data collection mechanism
in Bangladesh, particularly the implementation of the project to collect
data in the nine districts. However, it remains concerned about the lack of
disaggregated data. Likewise, the CRC Committee noticed in Brazil the insufficient
data on health as well as children in street situations, children with
disabilities and indigenous children. Regarding Timor-Leste, the Committee
noticed that no national central database on children has been developed. Therefore,
it stressed the importance of collecting disaggregated data for effective
evaluation of the implementation of the Convention and the analysis on the
situation of all children. Finally, it recommended the three states to collect
disaggregated data that should cover all areas of the Convention and share it
among the ministries.
Then, the Committee addressed
the issue of the impact of the business
sector on children’s rights, expressing concern about the activities
of the mining and construction sector in Brazil, as well as agribusiness, food corporations, contamination of
water resources and food, unhealthy diet
due to misleading advertisement and environmental contamination. The lack
of regulatory framework for social and environmental responsibility of business
corporations and industries was an issue also raised by the Committee. In light
of the CRC General Comment No. 16 on State
obligations regarding the impact of the business sector on children’s rights,
the Committee urged Brazil to establish a
regulatory framework for the impact of the business sector on children’s rights
in order to ensure effective implementation by companies of international and
national environment and health standards and appropriate sanctions or remedies
when violations occur. It also asked Brazil to require companies to undertake
assessments, consultations and full public disclosure of the environmental,
health related and human rights impacts of their business activities and their
plans to address such impacts.
Regarding environmental
health, the Committee expressed concerns about the negative effects of
polluted air, water and soil in Brazil, as well as food contamination on children’s health, in particular the
excessive use of agrochemicals, the contamination of water resources and the
decrease availability of drinking water and its deterioration in quality. Thus,
the state party was urged to ensure that existing laws and regulations
concerning the use of agrochemicals
are enforced, improve water supply infrastructure and access to safe drinking water, end illegal mining activities and conduct
a comprehensive assessment of the effects
of polluted air, water and soil on children’s health.
Additionally, United Arab Emirates was
recommended to assess the negative consequences of oil consumption on
children’s rights and address the situation with adequate measures to reduce
air pollution and lead poisoning.
Health resources and budget
The Committee called for strengthening of
resources allocated to health by urging Bangladesh
to
substantially increase budget allocations to all social sectors, particularly on
health services in all regions and upazilas to eliminate regional disparities in the provision of
health services.
The
Committee urged Brazil to conduct a
comprehensive assessment of the budget needs of children, addressing
disparities through the application of indicators related to social sectors as
well as the allocation of adequate human, technical and financial resources to
the Indigenous National Supervision System (SISVAN) in order to ensure that children affected by
malnutrition receive adequate food and safe drinking water. It also
highlighted the need to define specific budgetary lines for children living in
marginalized urban areas, including favelas
and rural areas in the North and Northeast of the state.
Concerning
Timor-Leste, the
Committee recommended the state to ensure adequate financial and human
resources, in particular with respect to the provision of neonatal, prenatal and post natal care, especially in
rural areas. It also urged the state party to establish a budgeting
process, which includes child rights perspective and specifies clear
allocations to children in the relevant sectors, in order to address the lack
of data on the proportion of budgetary allocations for the implementation of
children’s rights as well as a mechanism to monitor and evaluate the adequacy
and equitability of the distribution of resources allocated to the
implementation of the Convention.
Preventive health
The importance of preventive health has
been highlighted in several recommendations.
In its recommendations to Bangladesh, the
Committee explained the need to implement the OHCHR Technical guidance on child
mortality (A/HRC/27/31), which includes specific recommendations on
breastfeeding protection (including the implementation of the International
Code of Breastmilk Substitutes) and promotion. Likewise, it recommended the
state party to develop and implement policies to improve health infrastructure and intensify training programmes for all health professionals, in order
to address the issue of regional disparities in the provision of health
services and the low percentage of women delivering with a support of skilled
attendant.
Brazil has been urged by the Committee to
increase investment in existing programmes aimed at improving the reach and quality of health services with a view to
ensuring access to quality health services for indigenous children,
Afro-Brazilian children, and children living in rural areas as well as for
children living in marginalized urban areas. The Committee further highlighted
the decrease in child mortality. Nevertheless, the Committee is still concerned
about indigenous children,
particularly the Guarani, who do not have adequate access to medical services
and sanitation in overcrowded settlements. Thus, it asked Brazil to provide the
Special Secretariat for Indigenous Health with adequate human, technical and
financial resources to guarantee access to quality health services for all
indigenous women and children and strengthen its efforts to ensure that Family
Health Support Units are accessible for indigenous children.
Then the Committee congratulates Timor-Leste for its
commitment to provide access to primary health care free to all nationals of
the state party and the decrease in the under-five mortality rates.
Nevertheless, the insufficient number of skilled health care professionals, poor
health standards and insufficient formal health services in all parts of the
states concern the Committee as they are factors influencing the still high infant and under 5 child mortality
levels and very high maternal mortality rate. Therefore, the Committee
called Timor-Leste to increase the
quantity and coverage of health care professional and midwives for child birth
to ensure access to children to of quality health services and expand the
community birth preparedness initiative to increase the number of deliveries at
health care facilities.
Malnutrition and safe drinking water
Regarding Bangladesh, the Committee asked
the state party to pay specific attention to anaemia and malnutrition,
particularly in rural and remotes areas, as well as in slums. The Committee specifically recommended Brazil to
ensure that children affected by malnutrition receive adequate food and safe
drinking as indigenous children, particularly the Guarani, continue to be
subjected to contaminated water and food.
As there are high levels of obesity among children in Brazil and their vulnerability to
unregulated advertising promoting unhealthy food, the CRC Committee requested
Brazil to take all necessary measures to address obesity by promoting healthy
lifestyles and raising awareness of healthy nutrition. Moreover, the Committee
recommended the state party to establish a regulatory
framework for advertisement with a view to protecting children from misleading
advertising.
Regarding Timor-Leste, the Committee
expressed concern over the persistent high
levels of malnutrition, micronutrient
deficiencies, and stunting rates, the high number of children not fully
immunized and the insufficient access to safe drinking water, basic sanitation
and. In consequence, the Committee called for strengthened efforts and increase
resources to ensure that homes, schools and public facilities have adequate
WASH facilities, in particular in rural areas, as well as continuation of
interventions to prevent stunting, wasting and undernourishment. It also
recommended the state party to raise awareness of nutrition issues and promote
overall nutrition education,
including through the revised National Nutrition Strategy. Finally, regarding safe drinking water the Committee
called Timor-Leste to improve the access to clean water facilities by
strengthening government coordination, developing an action plan and providing
the Department of Water Supply of the Ministry of Public Works with adequate
staff and budget, in particular for rural communities.
HIV/AIDS
The Committee addressed the issue of mother-to-child HIV transmission by
requesting Bangladesh to promote the measures in place to prevent it and
develop a roadmap, and to improve the follow-up treatment
for HIV/AIDS infected mothers and their infants in order to ensure early
diagnosis and early initiation of treatment. Besides, it also called for
improvement of access and coverage of antiretroviral therapy and prophylaxis for
HIV-infected pregnant women, and access to
quality, age-appropriate HIV/AIDS, sexual and reproductive health services.
Breastfeeding national strategy
Timor-Leste was commended for its plans to implement
the Health Sector Strategic Plan, as well as various strategies relating to immunization,
nutrition and child and adolescent health. However it highlighted the low
levels of exclusive breastfeeding and recommended the state party to approve
and implement the Timor-Leste Breastfeeding Policy.
Breastfeeding protection
The Committee noted with appreciation that Bangladesh
adopted a new law on banning of marketing of breastmilk substitutes in 2013.
The Committee further recommended Brazil to strengthen
the monitoring of existing marketing regulations relating to breastmilk
substitutes as the Committee is alarmed by the widespread marketing of formula
for infants and inadequacies in monitoring compliance with legislation on
marketing of breastmilk substitutes.
Timor-Leste was urged to approve and implement the
Code of Marketing of Breastmilk Substitutes, Breastmilk Supplements and related
Products as well as increase the number of health centres supporting these
practices while United Arab Emirates was requested to regulate the marketing on
unhealthy food, especially when such marketing is focused on children and
regulate their availability in schools and other places.
Finally, Timor-Leste was encouraged to increase the
current maternity leave from three months to six months
Breastfeeding promotion
The Committee urged Brazil to improve the practice of
exclusive breastfeeding for the first six months, through awareness-raising
measures including campaigns, information and training for relevant officials,
particularly staff working in maternity units and parents, while Timor-Leste
was called to continue targeted interventions to prevent stunting, wasting and
undernourishment, including the promotion of infant and young child feeding
practices.
Finally, United Arab Emirates was called to continue
to promote positive breastfeeding practices while refraining from imposing
obligations on mothers whose free choice to breastfeed or not should always be
respected.
Breastfeeding support
As mentioned above, Brazil was urged to provide
information and training for relevant officials, particularly staff working in
maternity units and parents, in order to improve the practice of exclusive
breastfeeding for the first six months, while Timor-Leste was called to improve
training and access to healthcare professional and midwives for child birth, to
continue ensuring adequate financial and human resources with respect to neonatal,
prenatal and postnatal case, especially in rural areas, and to increase the
number of health centres supporting Timor Leste Breastfeeding Policy and Code
of Marketing.
Table 1. CRC
Committee - Session 70/2015 – Summary of Concluding Observations on IYCF
|
Country
|
IBFAN report
|
Summary of specific
recommendations on IYCF
|
Session 70 – September - October 2015
|
1
|
Bangladesh
(5th periodic report)
|
yes
|
Indirect – General measures of
implementation (§13a,15,55a-c): Substantially increase
budget allocations to all social sectors, in particular, education, health
and child protection, including earmarked resources for children in
disadvantaged or vulnerable situations who may require affirmative social
measures […];
the data should cover all areas of the Convention and
should be disaggregated,
among others, by age, sex, disability, geographic location, ethnic origin and
socioeconomic background in order to facilitate analysis on the situation of
all children, particularly those in situations of vulnerability
[…] ;
allocate
sufficient financial and human resources to health services in all regions and
upazilas to eliminate regional disparities in the provision of health
services […];
implement and apply the OHCHR Technical
guidance on child mortality (A/HRC/27/31); develop and implement policies to improve
health infrastructures, and intensify
training programmes
for all
health professionals. HIV/AIDS
(§63a-d): promote the measures in place to prevent mother-to-child
transmission of HIV/AIDS and develop
a roadmap to ensure the implementation of effective preventive measures;
improve
follow-up treatment for HIV/AIDS-infected mothers and their infants […] ; improve
access and coverage of antiretroviral therapy and prophylaxis for
HIV-infected pregnant women; improve access to
quality, age-appropriate HIV/AIDS, sexual and reproductive health services.
Nutrition (§55b) […] pay
specific attention to anemia and malnutrition, in particular in rural and
remote areas, as well as in slums.
|
2
|
Brazil
(2nd-4th periodic report)
|
yes
|
Indirect –
General measures of implementation (§12b, 12d,14): in the light of its general
comment No. 5 (2003) on General measures of implementation, the Committee urges the State party to improve its data
collection system […];
conduct a comprehensive assessment of the budget
needs of children and increase the budget allocated to social sectors
[…];
define specific budgetary lines
for indigenous children, children living in marginalized urban areas, including favelas, and rural
areas in the North and Northeast of the State party, as well as children with
disabilities […].
Children’s rights and the business sector (§22 a-c) : establish
a regulatory framework for the impact of the business sector on children´s
rights, particularly the mining and construction sector, agribusinesses, food
enterprises, and large-scale sporting/entertainment events […]
to ensure that their activities do not negatively
affect human rights or endanger environmental and other standards […];
ensure effective implementation by
companies of international and national environment and health standards,
effective monitoring of implementation of these standards, and appropriate sanctions and/or remedies
when violations occur; require
companies to undertake assessments, consultations, and full public disclosure
of the environmental, health-related and human rights impacts of their
business activities and their plans to address such impacts. Health and Health Services (§54,
56a-c): increase investment in existing programmes aimed
at improving the reach and quality of health services with a view to ensuring
access to quality health services for indigenous children, Afro-Brazilian
children, children living in rural areas as well as for children living in
marginalized urban areas; provide the Special Secretariat for Indigenous Health
(SESAI) with
adequate human, technical and financial resources to
guarantee access to quality health services for all indigenous women and
children, including those living in informal settlements; strengthen its efforts to ensure that
Family Health Support Units (NASF) are accessible for indigenous children; allocate adequate human,
technical and financial resources to the Indigenous Nutritional Supervision
System (SISVAN)
in order to ensure that children affected by malnutrition receive adequate
food and safe drinking water. Nutrition
(§58): […] take all necessary measures to address
obesity among children, including by promoting
healthy lifestyles and raising awareness of healthy nutrition […] establish
a regulatory framework for
advertisement, with a view to protecting children from misleading
advertising. HIV/AIDS
(§62a) : improve access to quality, age-appropriate HIV/AIDS, sexual
and reproductive health services. Environmental Health (§66a-e): ensure that existing laws and regulations concerning the use of agrochemicals are strictly
enforced […] expedite the evaluation of agrochemicals by
allocating the necessary human, technical and financial resources to the Agência Nacional de
Vigilância Sanitária (Anvisa) and expeditiously ban agrochemicals that have been widely banned in
other countries; improve water supply infrastructure and guarantee
access to safe drinking water […]; expeditiously end illegal mining
activities, particularly in the Tapajós-Xingu area, and design and
implement measures to mitigate the negative effects of these activities[…]; undertake awareness-raising
programmes for communities living in affected areas to minimize the risks of
being exposed to contaminated water and food and for
users of such agrochemicals; conduct a comprehensive assessment of the effects of polluted air,
water and soil on children’s health and use
it as a basis for developing and implementing
a strategy to remedy the situation and monitor the levels of air, water and soil pollutants as well as
pesticide residues in the food chain.
Direct (§ 68): […] improve the practice of exclusive breastfeeding for the first six
months, through
awareness-raising measures
including campaigns, information and training for relevant officials,
particularly staff working in maternity units, and parents […] strengthen the monitoring of existing marketing regulations relating
to breast milk substitutes.
|
3
|
Timor-Leste
(2nd-3rd periodic report)
|
yes
|
Indirect - General
measures of implementation (§ 14a, 14c, 17): establish a budgeting process, which includes child
rights perspective and specifies clear allocations to children in the
relevant sectors […];
establish mechanisms to monitor and evaluate the
efficacy, adequacy and equitability of the distribution of resources
allocated to the implementation of the Convention; […] expeditiously improve its data collection system. The data
should cover all areas of the Convention and be disaggregated by age, sex,
disability, geographic location, ethnic origin and socioeconomic background […].
Health and Health Services (§47a,
47e-g) continue to
strengthen efforts to ensure adequate financial and human resources, in
particular with respect to the provision of neonatal, prenatal and post natal
care, especially in rural areas; strengthen efforts and increase resources to ensure
that homes, schools, and other public facilities have adequate WASH facilities,
in particular in rural areas […] ; improve access to clean water facilities by
strengthening government coordination […]
Nutrition (§47c): continue targeted interventions to prevent the stunting, wasting and undernourishment
of children […] continue to raise
awareness of nutrition issues, as well as promote overall nutrition education, including through the
revised National Nutrition Strategy;
Direct (§47b, 47c, 47d, 47h): improve training and access to
healthcare professional and midwives for child
birth, and expand the community birth
preparedness initiative to increase the number of deliveries at health
care facilities; […] the promotion
of proper infant and young child feeding practices […]; increase the quantity and coverage of health care professionals to ensure access to children of quality health care services, including
immunizations in all districts […]; approve and implement the Timor
Leste Breastfeeding Policy and the Code of Marketing of Breastmilk Substitutes, Breastmilk Supplements
and Related Products, increase the
number of health centres supporting these practices, and increase the current maternity leave
from three months to six months to support appropriate infant feeding.
|
The
70th Session of the Committee on the Rights of the Child
(CRC Committee) took place in Geneva from September 14 to October 2, 2015. The
Committee reviewed the progress of the implementation of the Convention on the Rights of the Child
in 7 countries: Bangladesh, Brazil, Chile, Kazakhstan, Poland, Timor-Leste and
United Arab Emirates. IBFAN submitted alternative reports on the situation of
infant and young child feeding in 3 of the reviewed countries (Bangladesh, Brazil and Timor-Leste). All reports were prepared by the IBFAN groups in the countries. Spanish
and French summaries of the alternative reports were prepared in order to
inform Spanish- and French-speaking members of the Committee (see http://ibfan.org/reports-on-the-un-committee-on-the-rights-of-the-child).
