The
66th Session of the Committee on the Rights of the Child
(CRC Committee) took place in Geneva from 26 May to 13 June 2014. The
Committee reviewed the progress of the implementation of the Convention on the Rights of the Child
in 5 countries: India, Indonesia,
Jordan, Kyrgyzstan and Saint Lucia. IBFAN submitted alternative reports on
the situation of infant and young child feeding for each of the reviewed
countries. The reports on India and Indonesia were written in collaboration
with IBFAN groups in the countries. In its Concluding Observations, the CRC
Committee referred specifically to breastfeeding in only 3 out of the 5 countries (India, Indonesia and Kyrgyzstan).
Jordan
and Saint Lucia did not receive any direct recommendation on breastfeeding,
although they received recommendations on various topics indirectly related to
breastfeeding.
General measures of implementation
The Committee has put an emphasis on the
improvement of the data collection
system in all of the 5 countries under review (India, Indonesia, Jordan and
Kyrgyzstan), stressing the importance of collecting disaggregated data for the
formulation, evaluation and monitoring of policies, programmes and projects for
the effective implementation of the Convention.
The Committee also called for the development of a national plan for action in
India and Saint Lucia, and insisted on the necessity to include time-bound and
measurable goals and targets to effectively monitor progress in the
implementation of child’s rights at national level (Saint Lucia).
Health resources and budget
The Committee also called for strengthening of resources allocated to
health by urging Indonesia to substantially increase its allocations in the
area of health to adequate levels and by recommending India to ensure that appropriate resources be allocated to
health sector in order to improve the health situation of children, in
particular to respond to high rates of acute respiratory infections,
malnutrition and diarrhoea.
Besides, the Committee urged India to
provide all professionals working with children, including health workers, with
adequate and systematic training in
children’s rights.
Preventive health
The importance of preventive health care
has been highlighted in several recommendations.
Indonesia has been requested to ensure
provision of postnatal care for all
women with the focus of reducing preventable and other diseases, particularly
diarrhoea, acute respiratory infections and undernutrition, and to promote good infant and young child feeding
practices. It has also been requested to strengthen and expand access to preventive health for all pregnant women
and children, and to take all necessary efforts to reduce maternal mortality.
Kyrgyzstan has been asked to take measures
to prevent deaths of children as a result of preventable and curable diseases.
Saint Lucia has been recommended to ensure
adequate provision of postnatal care,
as well as address the issues of low birth
weight, increasing infant mortality
rate, and obesity among children
through awareness-raising efforts, and to continue dissemination of health information and the promotion of health education regarding basic child health to all
segments of society.
Malnutrition
While India has been urged to ensure
effective implementation of its National Security Food Act (2013) which contains provisions aiming at
combating children’s undernourishment, Jordan has been asked to address child malnutrition and infectious
diseases and Kyrgyzstan has been recommended to ensure that no child in the
country is undernourished and that all children have access to adequate and sufficient food.
HIV/AIDS
The Committee has issued specific
recommendations on the prevention of
mother-to-child HIV/AIDS transmission (India, Indonesia) as well as a
recommendation on antiretroviral therapy
and prophylaxis for HIV-infected pregnant women and children (India).
In addition, general recommendations on
the prevention of HIV/AIDS transmission
by raising awareness of the public have been issued (Jordan, Kyrgyzstan).
Breastfeeding protection
Full
implementation of the International Code on Marketing of Breastmilk Substitutes
has proven to be an effective intervention to protect breastfeeding and to
ensure that mothers are provided with adequate information on the best way to
feed their infants and young children. Therefore, the Committee has insisted on
the need for Indonesia and Kyrgyzstan to adopt the Code, and has
requested India to ensure effective implementation of, and compliance with,
the Code, as well as establish a monitoring and reporting system to
identify Code violations and implement stringent measures against
identified violators.
More
generally, in the light of the CRC General Comment No. 16 on State obligations regarding
the impact of the business sector on children’s rights, India has
been requested to establish a clear regulatory framework for the industries
to ensure that their activities do not negatively affect human rights,
especially in relation to children’s rights. Yet, it is of serious
concern that despite the systematic infringements of
the Code committed by baby food companies in India, the Committee urged the
country to implement more partnerships
with the private sector with focus on health. According to IBFAN-GIFA, this
call for an increase in number and thus importance of health projects and
programmes modeled as “public-private partnerships”, is likely to lead to risks
of conflicts of interest in both policy-making sphere as well as in programme
implementation and, most importantly, may undermine the existing legally binding
instruments and threaten development of clear and comprehensive regulatory
framework. Therefore, the
recommendations of the Committee regarding the role of the private sector can
be seen as conflicting.
Breastfeeding promotion
The Committee expressed concern over the insufficient rates of
exclusive breastfeeding in India and Indonesia, and the poor implementation of
the law on the promotion of breastfeeding in Kyrgyzstan, leading to inadequate
information as well as free samples of baby food products provided to mothers.
Therefore, India has been specifically requested to promote
exclusive breastfeeding practices, including the promotion of breastfeeding
from birth, complementary feeding strategies with or without provision of food
supplements as well as micronutrient interventions for mothers. Meanwhile, Indonesia
has been urged to strengthen the promotion of breastfeeding, including
by establishing a specific programme on the topic. Finally, Kyrgyzstan
has been recommended to implement its legislation on the promotion of
breastfeeding practices and ensure that mothers receive adequate
information on the benefits of their breastmilk.
Breastfeeding support
However, no specific recommendation on
breastfeeding support (e.g. inclusion of knowledge on optimal breastfeeding
practices in health curricula) has been issued by the Committee following its
66th session.
Table 1. CRC
Committee - Session 66 / 2014 -Summary of Concluding Observations on IYCF
Country
|
IBFAN report
|
Summary of
specific recommendations on IYCF
|
|
7
|
India
(3rd-4th periodic report)
|
yes
|
Indirect
– General measures of implementation (para 14 (a); 20; 26; 30 (a)): prioritize
the development of the National Plan
of Action to implement the 2013
National Policy for Children; expeditiously improve its data collection system; provide all
professionals working for and with children with adequate and
systematic training in children’s rights.
This includes in particular […] health
workers […]; establish a clear
regulatory framework for the industries operating in the State party to
ensure that their activities do not negatively affect human rights or
endanger […] other standards, especially those relating to children’s rights.
Health (para 63; 64; 68): strengthen its efforts to address […] the
existing disparities in access to and quality of health services, including
by establishing partnerships with the private sector […]; ensure that appropriate
resources be allocated to the health sector, with particular attention to
specific maternal and child health care policies, programmes and schemes to
improve the health situation of children, in particular to respond to high
rates of acute respiratory infections, malnutrition and diarrhoea; ensure
the effective implementation of the
National Food Security Act.
Direct (para 54): enhance efforts to promote exclusive breastfeeding practices,
including the promotion of breastfeeding from birth, complementary feeding
strategies with or without provision of food supplements as well as
micronutrient interventions for mothers; ensure the effective
implementation of, and compliance with, the International Code of Marketing
of Breast-milk Substitutes, and establishment of a monitoring and
reporting system to identify violations of the Code, as well as of stringent
measures in all situations of violations of the Code. Violations include
the promotion and distribution of samples and promotional materials by the
private sector institutions involved in the Infant Formula marketing and
distribution.
|
8
|
Indonesia
(3rd-4th periodic report)
|
yes
|
Indirect
– General measures of implementation (para 7): continue to upgrade its
system of data collection to cover all areas of the Convention; ensure
that all data and indicators are used for the formulation, monitoring and
evaluation of policies, programmes and projects for the effective
implementation of the Convention. Health
(para 48; 52): increase its health budget and expand access to primary health-care services
across all provinces; ensure the provision of
primary health-care services for all pregnant women, including […] postnatal
care, and children, focusing on interventions to reduce preventable and other diseases, particularly diarrhoea, acute
respiratory infections and undernutrition, as well as promote good infant and young child
feeding practices; strengthen and expand access to preventive health care […] for all pregnant women and children,
particularly infants and children under the age of 5; take all necessary
efforts, including emergency obstetric care, to reduce maternal mortality; sustain the measures in place to prevent mother-to-child transmission of
HIV/AIDS as well as provide for counselling and improve follow-up
treatment for HIV/AIDS-infected mothers and their infants.
Direct (para 54): 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; adopt the International
Code of Marketing of Breast Milk Substitutes.
|
9
|
Jordan
(4th-5th periodic report)
|
no
|
Indirect – General measures of implementation (para 8 (b)): strengthen its
mechanisms for data collection by establishing a central database on
children and ensure that data are collected on all areas of the Convention
and disaggregated. Health
(para 44; 48): ensure equal access to quality health services by all children
[…] by addressing child malnutrition and infectious disease; improve access to
quality, age-appropriate HIV/AIDS, sexual and reproductive health
information and services.
|
10
|
Kyrgyzstan
(3rd-4th periodic report)
|
yes
|
Indirect – General measures of implementation (para 7 (b)): develop a
comprehensive system for collecting disaggregated data to cover all
those under the age of 18 years. Health
(para 48; 50): take measures to prevent deaths of children as a result of
preventable and curable diseases, by educating parents and providing easy
access to early medical intervention; take measures to ensure that no child
in the country is undernourished and that
all children have access to adequate and sufficient nutritious food; take
all necessary measures to prevent
transmission of HIV/AIDS by raising awareness of the public.
Direct (para 54): take all necessary measures to implement its legislation promoting
breastfeeding practices and ensure that all mothers receive adequate
information on the benefits of their breast-milk; adopt the International Code for
Marketing of Breast-Milk Substitutes.
|
11
|
Saint
Lucia
(2nd-4th periodic report)
|
no
|
Indirect – General measures of implementation (para 11; 13; 17): develop and implement a comprehensive national plan of action for the full implementation of
the Convention; to establish the Central Database Registry […] ensuring a
comprehensive and integrated data
collection system on children. Health (para 43(a) and (b)): ensure adequate
provision of prenatal and post natal
care, as well as address the increasing number of children born with low birth weight, the increasing infant mortality rate, and
obesity among children, through awareness-raising efforts, and the
reasons for these trends; dissemination of health information and the promotion of health education
regarding basic child health to all segments of society.
|
