The
65th Session of the Committee on the Rights of the Child
(CRC Committee) took place in Geneva from 13 to 31 January 2014. The
Committee reviewed the progress of the implementation of the Convention on the Rights of the Child
in 6 countries: Congo Brazzaville, Germany,
Holy See, Portugal, Russian Federation and Yemen. IBFAN submitted 5 alternative reports on
the situation of infant and young child feeding for Congo, Germany, Portugal,
Russian Federation and Yemen. The reports were written in collaboration with
IBFAN groups in the countries. In its Concluding Observations, the CRC
Committee referred specifically to breastfeeding in only 4 out of the 6 countries (Congo, Germany, Portugal and
Yemen). The Holy See and the Russian Federation did not receive any direct
recommendation on breastfeeding.
The right of the child to health
A particular emphasis has been put on the importance of respecting the right of the child to the
enjoyment of the highest attainable standard of health. The CRC Committee
referred to its 2013 General Comment N° 15 on the right to health (art. 24) in its recommendations to all reviewed countries, including the
Holy See. The General Comment N° 15 explicitly recognizes the importance of breastfeeding for the
achievement this right. This General Comment urges States, to devote particular attention to neonatal mortality in their effort to
diminish infant and child mortality, and suggests, inter alia, to “pay particular attention to ensuring full protection
and promotion of breastfeeding practices”. Moreover, “exclusive
breastfeeding for infants up to 6 months should be protected and promoted and breastfeeding
should continue together with appropriate complementary foods preferably until two years of age as feasible.”
States’ obligations in this area are defined in the “protect, promote and
support” framework, adopted unanimously by the World Health Assembly” in its 2002 Global Strategy for Infant and Young Child Feeding. The Global Strategy calls, among other, for the improvement of the quality and availability of
sex-disaggregated data, an issue that has been included in recommendations
to Congo, Germany, Portugal and Yemen.
Protect
A great focus was placed on the need to
regulate the impact of the business sector on children’s rights. In its
recommendations to Congo, Germany and the Russian Federation, the CRC Committee
expressly drew attention to its
2013 General Comment N° 16 on State obligations regarding the
impact of the business sector on children’s rights, which
specifically calls on States Parties to “implement and enforce internationally
agreed standards concerning children’s rights, health and business including
the [...] International Code of
Marketing of Breast-milk Substitutes and relevant subsequent World Health
Assembly resolutions”
(hereafter referred as “the International
Code”). Therefore, these three reviewed countries are recommended to ensure the compliance by companies of both international and
national health and environmental standards and ensure appropriate
sanctions in cases of violations. Congo
and the Russian Federation are also recommended to require companies to undertake assessments of the environmental health-related and human rights
impact of their business activities.
In addition,
the CRC Committee expressly urged Germany to take every necessary measure to ensure
the access to breastfeeding through the control of infant formula. More specifically, the CRC Committee urged
Yemen, Congo and Germany to respectively implement
and strictly enforce the International Code, while Portugal is asked to strengthen the monitoring of its marketing
regulations related to breastmilk substitutes.
Promote
In the case of Congo, the CRC Committee stressed that
preventable diseases, including diarrhoea, continue to impact negatively on
child mortality rate. Thus, it urged the government to promote infant and young
child feeding practices, in particular
breast milk, and to adopt a holistic early childhood development strategy covering
healthcare, nutrition and breastfeeding.
Furthermore,
the CRC Committee raised the issue of new morbidity related to attachment
disorders in Germany, which could be related to declines in exclusive
breastfeeding practices. It underlined the decline of exclusive breastfeeding
rates of children between four and six months and the aggressive marketing of
breastmilk substitutes in Portugal. In the case of Yemen, it showed concern
about the high rates of chronic malnutrition (stunting), acute malnutrition
(wasting) and communicable diseases, especially diarrhoea, among children,
linked to the lack of awareness about exclusive breastfeeding practices.
Accordingly, the CRC Committee recommended Germany, Portugal and Yemen
to promote exclusive breastfeeding.
In regard of
General Comment N°15, Germany is specifically requested to better promote healthy
eating habits and to pay special attention to children in vulnerable
situations.
Support
Congo is
urged to ensure provision of primary health care services for all pregnant
women and children within accessible health care service with trained health
care providers. It is specifically recommended to increase the quality
and coverage of training to staff at socio-health units.
The CRC Committee also focused on the need
to prevent mother-to-child HIV/AIDS transmission by ensuring the
implementation of effective HIV/AIDS preventive measures (Congo), by expanding
the coverage of the National HIV/AIDS Prevention and Control Programme (Yemen)
and by providing sufficient amount of breastmilk substitutes and
anti-retroviral drugs in all regions (Russia).
Table 1. CRC
Committee - Session 65 / 2014 -Summary of Concluding Observations on IYCF
Country
|
IBFAN report
|
Summary of specific recommendations on IYCF
|
1
|
Congo
(2nd to 4th periodic report)
|
yes
|
Indirect – Data collection (para 19): improve data collection
system. The data should cover all areas of the Convention and should be
disaggregated by age, sex, geographic location, ethnic and national origin
and socioeconomic background in order to facilitate analysis on the situation
of all children, particularly those in situations of vulnerability. Children’s rights and the business sector (para 27): establish a
clear regulatory framework for the industries operating in the State party to
ensure that their activities do not negatively affect human rights,
especially those relating to children’s and women’s rights; ensure effective
implementation by companies, especially industrial companies, of
international and national environmental [...] health standards, effective monitoring of
implementation of these standards and appropriately sanctioning and providing
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 impact; be guided by the United Nations “Protect,
Respect and Remedy” Framework. Health
care (para 59 a): ensure provision of primary health care services
for all pregnant women and children with focus on development of accessible
health care services with trained health care providers, intervention to
reduce preventable and other diseases, particularly diarrhoeas, acute
respiratory infections and undernutrition; strengthen and expand access to
preventive health care, and therapeutic services for all pregnant women and
children, particularly infants and young children under five years old;
continue to disseminate health information and promotion of health education;
increase quality and coverage of training to staff at socio-health units and
ensure units are adequately staffed and have essential facilities, including
obstetric supplies and emergency medicines for children and pregnant women;
sustain the measures in place to prevent mother-to-child transmission of HIV.
Direct (para 59 b; 66 b): promote IYCF practices, particularly breast milk
and infant food based on local foods; adopt a holistic early childhood
development (ECD) strategy and invest in the training of ECD teachers and
provision of integrated formal and community-based programmes involving
parents and covering healthcare, nutrition and breastfeeding, early
stimulation and early learning for children for birth to the first year of
school.
|
2
|
Germany
(3rd and 4th periodic report)
|
yes
|
Indirect – Data collection (para 16): establish a comprehensive
and integrated data collection system on children covering all Länder and the
entire period of childhood up to the age of 18, and to introduce indicators
on children’s rights on which progress in the realization of those rights
could be analysed and assessed. The data should be disaggregated by age, sex,
disability, geographical location, ethnicity, migration status and
socio-economic background. Children’s rights and the business sector (para 23): establish a clear regulatory framework for the industries operating in
the State party to ensure that their activities do not negatively affect
human rights [...], especially those relating to children’s rights; examine
and adapt its legislative framework (civil, criminal and administrative) to
ensure the legal accountability of business enterprises and their
subsidiaries operating in or managed from the State party’s territory,
regarding violations of child and human rights; comply with international and
domestic standards on business and human rights with a view to protecting
local communities, particularly children, from any adverse effects resulting
from business operations, in line with the UN “Protect, Respect and Remedy”
Framework and the Guiding Principles on Business and Human Rights and by the
Committee’s own general comment N° 16. Health
care (para 57): advocate and raise awareness through programmes
targeting schools and families, emphasizing [...] healthy eating habits.
Direct (para 57; 63): [in regard
of General Comment 16] take every necessary legislative and structural
measure to ensure that every child within the State party has access to
breastfeeding through the control of infant formula which will promote better
bonding between infants and mother; strengthen efforts to promote exclusive
and continued breastfeeding by providing access to materials, and educating
and raising awareness of the public on the importance of breastfeeding and
the risks of formula feeding; strictly enforce the International Code of
Marketing of Breast-milk Substitutes.
|
3
|
Holy See
(2nd periodic report)
|
no
|
none
|
4
|
Portugal
(3rd and 4th
periodic report)
|
yes
|
Indirect – Data collection (para 18): establish a more
comprehensive and integrated data collection system on children covering the
entire period of childhood up to age 18, and to introduce indicators on
children’s rights on which progress in the realization of those rights could
be analysed and assessed. The data should be disaggregated by age, sex,
geographic location, ethnicity, migration status and socio-economic
background to facilitate the determination of the overall situation of
children. Health care (para 48): [in regard to General
Comment 15] minimize the impact of financial restrictions in the area of
health care; austerity measures in the area of health should be evaluated on
the basis of a child’s right’s impact assessment to ensure that such measures
do not have a negative impact on child health and well-being.
Direct (para 56): take action 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; strengthen the monitoring of existing marketing regulations relating
to breast milk substitutes.
|
5
|
Russian Federation
(4th and 5th
periodic report)
|
no
|
Indirect - Children’s rights and the business sector (para 21): pray attention to General Comment 16 on State obligations regarding the
impact of the business sector on children’s rights and recommends that the
State party establish and implement regulations to ensure that the business
sector complies with international and national human rights, particularly
with regard to children’s rights; ensure effective implementation by
companies, especially industrial companies, of international and national
health standards, effective monitoring of the implementation of these standards
and appropriately sanctioning and providing remedies when violations occur,
as well as ensure that appropriate international certification is sought;
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 impact; be guided
by the United Nations “Protect, Respect and Remedy” Framework. Health care (para 52; 54): pray attention to General Comment 15 on the
right of the child to the enjoyment of the highest attainable standard of
health, and recommends that the State party take measures to regularly assess
the health conditions of children deprived of parental care and children in
difficult situations in order to prevent irreparable damage to their health;;
take all necessary measures to prevent mother to child transmission of
HIV/AIDS throughout the country by providing sufficient amount of breast milk
substitutes and anti-retroviral drugs in all regions, irrespective of their
legal status in the country.
|
6
|
Yemen
(4th periodic
report)
|
yes
|
Indirect – Data collection (para 18): improve its data
collection system. The data should cover all areas of the Convention and
should be disaggregated by age, sex, geographic location, ethnic and national
origin and socioeconomic background in order to facilitate analysis on the
situation of all children, particularly those in situations of vulnerability.
Health care (para 16; 56; 64):
establish a budgeting process, which includes child rights perspective and
specifies clear allocations to children in the relevant sectors and agencies,
including specific indicators and a tracking system; increase substantially
the allocations in the areas of health and education; ensure that appropriate
resources be allocated to the health sector, with particular attention to
specific maternal and child health care and develop and implement
comprehensive policies and programmes to improve the health situation of
children, in particular to respond to high rates of malnutrition and
diarrhoea infections; expedite the process to join as a full member the Scale
Up Nutrition Initiative (SUN) and to take effective measures to address the
widespread and serious undernourishment affecting children; strengthen its
efforts to develop outreach services, including a network of mobile
health-care facilities in conflict-affected areas, particularly targeting
children and pregnant women, as an interim measure, and ensure that
health-care facilities are rehabilitated and not re-occupied for military
purposes by either the armed forces or non-State armed groups; ensure universal coverage for HIV testing and free antiretroviral drug
provision; pay particular attention to pregnant adolescents in rural areas,
pregnant mothers with HIV and children born to mothers with HIV.
Direct (para 56): enhance efforts to promote
exclusive breastfeeding practices, by ensuring the implementation and
compliance with the International Code of Marketing of Breast-milk
Substitutes, and establish a monitoring and reporting system to identify
violations of the Code. This includes the establishment of baby-friendly
hospitals with the promotion of breastfeeding from birth.
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