Sao Tome and Principe to address maternal deaths and business impact on child rights

Sao Tome and Principe presented its consolidated 2^nd to 4^th periodic reports on the situation of the implementation of the Convention on the Rights of the Child in the country. The 5^th and 6^th periodic reports are expected by June 2018.

IBFAN did not present any alternative report.

Discussion on infant and young child feeding

The Committee did not address issues related to breastfeeding. However, it tackled the question of maternal mortality in relation to HIV/AIDS infections. The delegation of Sao Tome and Principe explained that it is currently taking steps to eradicate these infections by 2015. Counseling centers for sexual health have been established in schools and awareness-raising activities are being organized for young persons.

Concluding Observations

No recommendation specifically refers to breastfeeding in the Concluding Observations. The CRC Committee instead mentioned the importance of a good health care system. It drew attention to its General Comment no. 15 (2013) on the right of the child to enjoy the highest attainable standard of health. It therefore recommended Sao Tome and Principe to: “(a) allocate adequate human, technical and financial resources to improve the quality of health care and provide quality training for the health care personnel, particularly at local levels; (b) Undertake surveys and studies on the extent and root causes of maternal mortality throughout the country and apply the findings therein for formulating and implementing comprehensive programmes for addressing maternal deaths: and, (c) Seek financial and technical assistance from UNICEF and the World Health Organization (WHO), among others, in this regard” (para 48-49).

The CRC Committee also insisted on improving the access to safe drinking water. It recommended the State party to: “(a) intensify its efforts to improve access to safe drinking water and sanitation, and in doing so pay particular attention to rural and outlying areas” (Para 54-55).

Another paragraph was dedicated to HIV/AIDS. The Committee recognized the efforts of Sao Tome and Principe to decrease the mother-to-child transmission of HIV/AIDS rate by spreading HIV/AIDS testing for pregnant women. However, the Committee noticed that regular follow-up on infected mothers and children remain inadequate and that the access to antiretroviral treatment limited. Therefore, the CRC Committee recommends Sao Tome and Principe to: “(a) Sustain the measures in place to prevent the Mother-to-Child transmission of HIV/AIDS and develop a roadmap to ensure the implementation of effective preventive measures; (b) Improve follow-up treatment for HIV/AIDS-infected mothers and their exposed infants[...] and (d) Improve access and coverage of Antiretroviral Therapy and Antiretroviral prophylaxis for HIV infected pregnant women. In doing so, the Committee recommends that the State party seek technical assistance from, inter alia, the United Nations Joint Programme on HIV/AIDS (UNAIDS) and UNICEF” (para 52-53).

Finally, the CRC Committee drew Sao Tome and Principe’s attention to the General Comment No. 16 (2013) on State obligations regarding the impact of the business sector on children’s rights and recommended Sao Tome and Principe to have a clear regulatory framework and effective implementation and monitoring mechanisms to ensure that business activities do not negatively affect the rights of the child. Concerning that issue, the Committee recommended in particular Sao Tome and Principe to: “(b) Ensure effective implementation by companies, especially those of the extractive industries, of international and national environment and health standards, effective monitoring of implementation of these standards and appropriately sanctioning and providing remedies when violations occur, as well as ensure that appropriate international certification is sought; (c) 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; and, (d) Be guided by the United Nations “Protect, Respect and Remedy” Framework, accepted unanimously in 2008 by the Human Rights Council, while implementing these recommendations” (para 23- 24).

Breastfeeding situation reported by Guinea not confirmed by data

The situation of the implementation of the Convention for the Rights of the Child in Guinea has been reviewed by the CRC at the 62^nd session, on January 18^th 2013.

IBFAN submitted its alternative report on the situation of breastfeeding in Guinea (also in French). The report highlights the fact that a 1997 draft legislation for the implementation of the Code on Marketing of Breastmilk Substitutes is still stuck in the legislative process and has therefore not yet been adopted. It also notes that, even though mothers continue breastfeeding for an average duration of 2 years, there is a sharp drop in exclusive breastfeeding after the 3^rd month of age leading to an 18% rate of exclusive breastfeeding between the 3^rd and the 6^th month of child’s life.

The CRC Committee raised questions about the alarming maternal and children under-5 mortality rates. The high incidence of child malnutrition and of diseases linked to malnutrition and poverty – such as noma – has also been an issue of concern. The Guinea delegation explained the high mortality rates of both mothers and children by the lack and the poor quality of health services and health personnel. 

Questions about malnutrition have not been addressed in detail, but the Guinean delegation did mention the issue of breastfeeding. The delegation considered that exclusive breastfeeding for the first 6 months of life is considerably promoted in Guinea. It also noted the little presence of breastmilk substitutes on the Guinean market. The delegation reported that working mothers are aware of the importance of breastfeeding and thus they prefer staying at home in order to breastfeed. In health centers there are both prenatal and postnatal support, where mothers are advised to feed their children by exclusively breastfeeding for the first six months. Whenever mother cannot breastfeed because of infections they have and  could transmit to their children,  babies are treated at the infant nutrition centre in order to feed them. 

Data presented in the IBFAN alternative report seem to contradict with the positive picture described by the delegation. We regret that the CRC Committee did not address further questions on this issue to the delegation.

Women with their babies at a community health centre in Conakry, Guinea. Image via IRIN.