On the
5th of June 2014, the Committee on the
Rights of the Child completed its consideration of the
combined 3rd and 4th periodic
reports of
Indonesia on the implementation of the provisions of the Convention on the
Rights of the Child in the country.
IBFAN
presented an alternative report to inform the CRC Committee on the
situation on the issue of infant and young child feeding in Indonesia.
General
overview of breastfeeding
IBFAN’s
alternative report highlighted that inadequate infant feeding
practices co-exist with high rates of child mortality in Indonesia.
Indeed, the rate of early breastfeeding initiation is low (less then 30 %) and
more than half of the children are not breastfed until 6 months of age, while a
third of the children under five years old are stunted. Besides, complementary
foods are introduced too early to almost 45% of the children. The lack of any
policy or programme on infant and young child feeding has also been emphasized,
as well as an absence of sanctions in case of violations of the International Code of
Marketing of Breastmilk Substitutes, despite the implementation of many
provisions of this Code into national legislation. The absence of data on the number and quality of Baby-friendly hospitals has also been shown as problematic. Finally,
the absence of maternity protection for women working in the informal sector,
as well as the lack of public awareness about HIV/AIDS and infant feeding,
have been emphasized.
Discussion
on infant and young child feeding
The
Committee noted that while in the 1990s, Indonesia had made progress in
reducing neonatal and infant mortality, this advancement had slowed down
in recent years. In addition, in regard to the high infant mortality rate in
certain provinces, the expert has asked about the implementation of the Baby-friendly Hospital
Initiative in Indonesia. In general, the expert has asked about the actions
taken by State party to promote breastfeeding.
The Indonesian
delegation responded by stating that there had been a national
breastfeeding programme in place since 1990 promoting breastfeeding up
until six months of age. Nevertheless, the delegation admitted that the
rate of early breastfeeding in Indonesia still remains low, and added that the
provision of lactation rooms for breastfeeding mothers is scheduled in the
government agenda.
Concluding Observations
In its Concluding Observations, regarding the general implementation of
the Convention, the Committee urged Indonesia to upgrade its system of data collection (para 7 (a)).
Regarding
the issue of health, the Committee specifically requested the country to substantially
increase the allocations in the area of
health to adequate levels and to expand access to primary health-care
services across all provinces (para 16 (a) and 48). It also emphasized the need
to “ensure the provision of primary
health-care services for all pregnant women, including access to postnatal care, and children, focusing
on interventions to reduce preventable
and other diseases, particularly diarrhoea, acute respiratory infections
and undernutrition”, and called for the promotion of good infant and young child feeding practices (para 48
(a)). In addition, Indonesia has been urged to “strengthen and expand access to preventive
health care for all pregnant women and children, particularly infants and
children under the age of 5”. They should include preventive health
interventions such as universal immunization services, oral rehydration therapy
and treatment for acute respiratory infections (para 48 (b)). According to the
Committee, the country should also “take
all necessary efforts […] to reduce
maternal mortality” (para 48
(c)). Regarding the issue of HIV/AIDS, the government was requested to “sustain the measures in place to prevent mother-to-child transmission as well as
provide for counselling and improve follow-up treatment for HIV/AIDS-infected
mothers and their infants to ensure early
diagnosis and early initiation of treatment” (para 52).
Besides, the Committee emphasized the low
rate of exclusive breastfeeding in the country and issued direct recommendations
related to infant and young child feeding: it recommended Indonesia to “strengthen the promotion of breastfeeding, including by establishing a programme
to promote and enable all mothers to successfully breastfeed exclusively for
the first six months of the infant’s life” and to “adopt the International Code of
Marketing of Breast Milk Substitutes” (para 56).
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