The
68th Session of
the Committee on the Rights of the Child
(CRC Committee) took place in Geneva from January 12th to 30th,
2015. The Committee reviewed the progress of the implementation of the Convention on the Rights of the Child
in 11 countries: Colombia, Dominican Republic, the Gambia, Iraq, Jamaica, Mauritius,
Sweden, Switzerland, Tanzania, Turkmenistan and Uruguay. IBFAN submitted alternative
reports on the situation of infant and young child feeding in 10 of the reviewed
countries (Colombia, Dominican Republic, Gambia, Iraq,
Jamaica, Sweden, Switzerland, Tanzania, Turkmenistan and Uruguay). The reports on Colombia,
the Dominican Republic and Uruguay were prepared by the IBFAN groups in the
countries. Spanish summaries of the
alternative reports were prepared in order to inform Spanish-speaking members
of the Committee (Colombia, Dominican Republic, Gambia, Iraq, Jamaica, Sweden, Switzerland, Tanzania, Turkmenistan and Uruguay).
In
its Concluding Observations, the CRC Committee referred specifically to
breastfeeding in 6 out of the 11 countries under review (Colombia, Dominican
Republic, Gambia, Jamaica, Switzerland and Turkmenistan). Sweden, Iraq,
Mauritius, Tanzania and Uruguay did not receive any direct recommendation on
breastfeeding, but they received recommendations on other specific health issues
that are indirectly connected to breastfeeding.
General measures of implementation
The Committee recommended
that most countries under review (Gambia, Iraq, Jamaica, Mauritius, Switzerland,
Tanzania, Turkmenistan and Uruguay) to take all necessary steps to collect
disaggregated data that should cover all areas of the Convention.
Moreover, in light of the CRC General Comment No. 16 on Stateobligations regarding the impact of the business sector on children’s rights, the Committee urged Colombia, the Gambia,
Switzerland and Tanzania to examine, adapt and clearly establish its
legislative framework concerning legal accountability of business enterprises
and their subsidiaries operating in or managed from the State party’s territory.
The Committee specifically recommended Colombia and Tanzania 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. The
Committee also requested the Gambia to establish monitoring mechanisms for the
investigations and redress of violations of children’s rights.
Health resources and budget
The Committee called for the allocation of
adequate resources for health services (Colombia, Gambia, Tanzania), and for
the development and implementation of health-related policies and programmes (Gambia
and Dominican Republic). The importance of creating a monitoring mechanism for
the implementation of such policies was also stressed in the recommendations to
Colombia and the Dominican Republic. Specific concerns over the low percentage
of the federal budget devoted to the healthcare system were expressed by the
Committee in its Concluding Observations related to Iraq. The Committee urged also
Tanzania to allocate sufficient human resources to the health services, in
order to provide trained care at delivery, improved care for newborns and
during the neonatal period, and antenatal care and services for infants and
preschool children at primary health centres.
In addition, the Committee recommended Colombia,
Dominican Republic, Gambia and Tanzania to implement the OHCHR Technical
guidance on the application of a human rights-based approach to the
implementation of policies and programmes to reduce and eliminate preventable
mortality and morbidity of children under 5 years of age (hereafter: OHCHR
Technical guidance on child mortality), which includes specific
recommendations on breastfeeding protection (including the implementation of
the International Code) and promotion.
Preventive health
The importance of preventive health has
been highlighted in several recommendations.
The Committee recommended Colombia, the
Dominican Republic and Tanzania to increase their efforts to reduce neonatal, child
and maternal mortality. In particular, Colombia and the Dominican Republic were
urged to establish an independent mechanism for investigating cases of child
and maternal mortality. The Gambia was specifically asked to improve access to
maternal care services by increasing the availability and accessibility to
emergency obstetric and neonatal care and skilled birth attendants, while Iraq
was recommended to reduce maternal mortality through improving emergency
obstetric care, trained delivery care at home and services at maternal and
child health clinics with trained health care providers. In addition, Jamaica
was recommended to keep strengthening efforts to ensure adequate provision of
prenatal and post natal care, as well as to address the increase in maternal
mortality.
Children’s access to health care was
addressed in 7 countries out of 11 (Colombia, Gambia, Jamaica, Switzerland,
Tanzania, Turkmenistan and Uruguay). In particular, Jamaica was urged to
increase the number and coverage of health care professionals and Turkmenistan
was recommended to ensure a sufficient number of family doctors nurses and
midwifes and to ensure that all
health-care personnel responsible for health care of children is well qualified
and well trained. Furthermore, Switzerland was urged
to ensure that children have access to quality paediatric hospital treatment
and family paediatricians throughout the Swiss territory and Tanzania was recommended
to establish more child and maternal health clinics, and access to safe and
trained delivery services. Additionally, Iraq was recommended to allocate all
necessary human, technical, and financial resources for interventions aimed at
reducing preventable and other diseases among children, particularly diarrhoea,
acute respiratory infections and under nutrition.
Nutrition and safe drinking water
The Committee asked the Dominican Republic,
Gambia, Tanzania and Uruguay to increase efforts to eliminate child
malnutrition, highlighting the problem of poor water quality leading to
neonatal and maternal deaths in the Dominican Republic and asking Gambia and
Tanzania to increase access to safe drinking water and sanitation. Jamaica was specifically
urged to introduce targeted interventions to prevent the undernourishment of
children, including the promotion of proper infant and young child feeding
practices. Besides, obesity and overweight among children were highlighted for
Jamaica and Switzerland as a main reason for promoting healthy eating habits
among young children and adolescents. More generally, the Committee encouraged
Mauritius to improve the nutritional status of infants, children and mothers.
HIV/AIDS
The Committee addressed the issue of
mother-to-child HIV transmission by requesting Colombia to strengthen its
efforts to implement the Strategic Plan to eliminate HIV/AIDS mother-to-child
transmission.
The Dominican Republic was recommended to
ensure the sustainability of the Programme on HIV/AIDS as well as the
availability of universal antiretroviral treatment, and to increase the
capacity for HIV/AIDS testing of pregnant women and children at the Community
Health Centres. The Committee also asked Tanzania to improve follow-up
treatment for HIV/AIDS-infected mothers and their infants to ensure early
diagnosis and early initiation of treatment. Mauritius and Turkmenistan were
both urged to develop a roadmap to ensure the implementation of effective
preventive measures, as well as to improve access and coverage of
antiretroviral therapy and prophylaxis for HIV-infected pregnant women.
Breastfeeding national strategy
In its recommendations to the Gambia, the Committee
stressed the importance of implementing effectively the existing national
nutrition policy and called for the creation of a National Breastfeeding
Committee as well as for the systematic collection of data on breastfeeding
practices.
Turkmenistan was also urged to ensure systematic data
collection on infant and young child feeding practices while Switzerland was
recommended to develop a comprehensive national strategy on infant and young
children feeding practices.
Breastfeeding protection
The Committee urged Colombia, the Dominican Republic,
Gambia, Switzerland and Turkmenistan to adequately implement the International
Code on Marketing of Breast-Milk Substitutes and specifically asked Jamaica to regulate
the marketing of breastmilk substitutes.
With regard to maternity protection, the Gambia was
recommended to provide maternity leave to all working mothers, including
domestic workers, and Switzerland was required to consider extending maternity
leave to minimum six months. The Committee also called Turkmenistan for
ensuring that working mothers have the practical possibility to breastfeed,
including by developing breastfeeding-friendly workplaces and child care
centres at work. More generally, the Dominican Republic was urged to strengthen
its maternity protection.
Breastfeeding promotion
Out of 11 reviewed countries, 6 were recommended to
strengthen efforts to promote breastfeeding. Specifically, Colombia, the
Dominican Republic and Turkmenistan were encouraged to promote breastfeeding
through educational campaigns, while Jamaica was recommended to provide
information and training on breastfeeding to relevant officials, particularly
staff working in maternity units, and parents. The Gambia was urged to promote
exclusive breastfeeding up to the age of six months. Finally, Switzerland was
recommended to strengthen efforts to promote exclusive and continued
breastfeeding by providing access to materials, and raising awareness
concerning the importance of breastfeeding and the risks of formula feeding.
Breastfeeding support
Regarding support to breastfeeding through
the health care system, Colombia and the Dominican Republic were urged to
adequately implement the Baby-Friendly Hospital Initiative (BFHI) while
Switzerland was recommended to further increase the number of hospitals certified
as baby-friendly.
With respect to training on breastfeeding,
4 countries out of 11 received direct recommendations. Such recommendations
included: promote breastfeeding through the training of health professionals
(Colombia and Jamaica); inclusion of breastfeeding in the training of nurses
(Gambia); and review and strengthening of the training of health professionals
on the importance of breastfeeding (Switzerland).
Switzerland was also recommended to ensure that national recommendations on breastfeeding
comply with the relevant WHO recommendations.
Country
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IBFAN report
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Summary of specific recommendations on IYCF
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Session 68 – January 2015
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1
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Colombia
(4th-5th periodic report)
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yes
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Indirect – General measures of implementation (§ 10, 18a-c): examine
and adapt its legislative framework to ensure the legal accountability of
business enterprises and their subsidiaries operating in or managed from the
State party´s territory […] regarding violations of children rights;
require companies to undertake assessments, consultations, and full public
disclosure of the […] health-related
and human rights impacts of their business activities and their plans to
address such impacts; establish monitoring mechanisms for the
investigation and redress of such abuses, with a view to improving
accountability, transparency and the prevention of violations.
Health (§ 40a-c): ensure the availability and accessibility
of health services for all children [...] by allocating adequate
resources and monitoring the implementation of relevant policies; establish independent mechanisms for
investigating cases of child and maternal mortality and ensure legal
sanctions when this happens due to health personnel negligence; increase
its efforts to reduce maternal and child mortality, including by
implementing the OHCHR Technical guidance on the application of a human
rights-based approach to the implementation of policies and programmes to
reduce and eliminate preventable mortality and morbidity of children under 5
years of age.
Direct (§ 40h): strengthen
efforts to promote breastfeeding through educational campaigns and
training to professionals, adequately implement the International Code
of Marketing of Breast-Milk Substitutes and the Child-Friendly Hospital
initiative.
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2
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Dominican Republic
(3rd-5th periodic report)
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yes
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Indirect (§ 50b,c,d):
strengthen efforts to reduce neonatal, child and maternal mortality and, to that aim,
take into account the OHCHR Technical
guidance on the application of a human rights-based approach to the
implementation of policies and programmes to reduce and eliminate preventable
mortality and morbidity of children under 5 years of age (A/HRC/27/31);
establish independent mechanisms for
investigating cases of child and maternal mortality and apply legal sanctions when this happens due
to health personnel negligence; increase efforts to eliminate child malnutrition.
Direct (§ 50e):
enhance efforts to promote breastfeeding through educational campaigns,
adequately implement the Strategic Plan on Breastfeeding (2012-2016), the
International Code of Marketing of Breastmilk Substitutes and the
Child-Friendly Hospital initiative, and strengthen maternity protection.
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3
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Gambia
(2nd-3rd periodic report)
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yes
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Indirect (§ 61a,b,c,d,e): ensure that sufficient
resources are allocated for the health sector and are used effectively;
develop and implement comprehensive
policies and programmes for improving the health situation of children and
facilitating a greater and equal
access to quality primary health services by mothers and children in all
areas of the country; take all effective measures to increase the number of trained medical and other health personnel,
including traditional healers, and facilitate cooperation between trained medical personnel and traditional
healers, especially midwives; improve
access to maternal care services by improving health infrastructure and
increasing the availability and accessibility to emergency obstetric and
neonatal care and skilled birth attendants at lower- and district-level
health facilities; strengthen efforts to address malnutrition and diseases of children, including by strengthening
educational programmes, campaigns to inform parents about basic child health
and nutrition, hygiene and environmental sanitation and reproductive
health, and by providing sufficient drugs, including RDTs, malaria pneumonia
and diarrheal rehydration drugs; strengthen its efforts to increase access to safe drinking water and sanitation.
Direct (§ 65): ensure
the effective implementation of the 2010-2020 National Nutrition Policy,
strengthen its awareness-raising efforts on the importance of
breastfeeding and promote exclusive breastfeeding of children up to the age
of six months. The Committee also recommends that the State party establish
a National Breastfeeding Committee, systematically collect data on
breastfeeding practices, ensure the enforcement of the International
Code of Marketing of Breastmilk Substitutes, include breastfeeding in
the training of nurses, and provide maternity leave to all working
mothers, including domestic workers.
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4
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Iraq
(2nd-4th periodic report)
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yes
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Indirect – General measures of implementation (§ 7d): review the system of data collection with a view to
incorporating all the areas covered by the Convention. Health (§ 61a-b): reduce
maternal mortality by providing access to emergency obstetric
care and ensuring access to trained delivery care at home, services at
maternal and child health clinics with trained health care providers. A
particular focus is needed on displaced communities, rural areas, and the
central and southern regions; allocate all necessary human, technical and
financial resources for interventions aimed at reducing preventable and other
diseases, particularly diarrhoea, acute respiratory infections and under
nutrition.
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5
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Jamaica
(3rd-4th periodic report)
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yes
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Indirect: continue to strengthen efforts to ensure adequate
provision of prenatal and post natal care, as well as address the
increase in maternal mortality;
increase the number and coverage of health care professionals
to ensure access to children of quality health care services; combat obesity
among children and intensify measures to raise awareness of healthy
nutrition among parents, children and the public in general and promote
healthy eating habits particularly among young children and adolescents
(§ 45 a, b, f)
Direct (§ 45 c, d, e): introduce targeted interventions
to prevent the undernourishment of children, including the promotion of
proper infant and young child feeding practices; take action to
improve the practice of exclusive breastfeeding for the first six months,
through awareness-raising measures, including campaigns, providing
information and training to relevant officials, particularly staff working in
maternity units, and parents; regulate the marketing of breast-milk
substitutes;
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6
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Mauritius
(3rd-5th periodic report)
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no
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Indirect – General measures of implementation (§ 12): take measures for the
National Child Protection Strategy and its Action Plan to cover all areas
under the Convention [...] and that it effectively implement the National
Human Rights Action Plan 2012-2020, and ensure monitoring of its
implementation; expeditiously improve collection of updated data and
their regular availability by the Statistics Office. Health (§ 52): take measures to improve
the nutritional status of infants, children and mothers. HIV/AIDS (§ 56a-b): sustain 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 to ensure early initiation of treatment, and improve access
and coverage of antiretroviral therapy and prophylaxis for HIV-infected
pregnant women.
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7
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Sweden
(5th periodic report)
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yes
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Indirect – Health (§ 41): strengthen its
efforts to improve the health status of children from disadvantaged and
marginalised groups and allocate sufficient financial, human and
technical resources to ensure their right to health without discrimination.
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8
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Switzerland
(2nd-4th periodic report)
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yes
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Direct (§ 59): strengthen its efforts to promote
exclusive and continued breastfeeding by providing access to materials,
and raising awareness concerning the importance of breastfeeding and the
risks of formula feeding; review and strengthen training for health
professionals on the importance of exclusive breastfeeding; further increase
the number of hospitals certified as baby-friendly; develop a comprehensive
national strategy on infant and young children feeding practices; ensure
that the International Code of Marketing of Breast-milk Substitute is
strictly enforced; ensure that national recommendations on
breastfeeding comply with relevant WHO recommendations; and consider extending
maternity leave to minimum six months.
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9
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Tanzania, United Republic
of
(3rd-5th periodic report)
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yes
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Indirect – General measures of implementation (§ 10, 16, 22): ensure the effective
implementation of the existing strategies addressing children’s issues,
including the provision of sufficient human, technical, and financial
resources; expeditiously improve its data collection system; the data should
[...] be used for the formulation, monitoring and evaluation of laws,
policies, and programmes; establish clear regulations and a nation-wide
legislative framework, including through the adoption of agreements
between private enterprises and the State party at the local level, requiring
companies domiciled or operating in the State party to adopt measures to
prevent and mitigate adverse child rights impact of their operations in
the country; require companies to undertake child rights assessments,
consultations, and full public disclosure of the environmental,
health-related and child rights impacts of their business activities and
their plans to address such impacts and promote the inclusion of child rights
indicators and parameters for reporting. Health
(§ 54): allocate sufficient financial and human
resources to health services, in particular access to trained care at
delivery, improved care for new-borns and during the neonatal period,
antenatal care and services for infants and preschool children at primary
health centres; establish more child and maternal health clinics and
access to safe and trained delivery services [...] ensuring the
availability of trained health workers, the necessary equipment and medical
supplies; strengthen national strategies to address the critical nutritional
needs of children; improve access to safe drinking water and adequate
sanitation facilities; implement the OHCHR Technical guidance on
the application of a human rights-based approach to the implementation of
policies and programmes to reduce and eliminate preventable mortality and
morbidity of children under 5 years of age. HIV/AIDS (§ 56a-b): strengthen efforts to prevent
mother-to-child HIV transmission; improve follow-up treatment for
HIV/AIDS-infected mothers and their infants to ensure early initiation of
treatment.
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10
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Turkmenistan
(2nd-4th periodic report)
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yes
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Direct (§ 49): enhance its efforts to promote
exclusive breastfeeding practices; enact legislation implementing all
the provisions of the International Code of Marketing of Breast-Milk
Substitutes; raise awareness about optimal breastfeeding practices
among the population; ensure systematic collection of data on infant
and young child feeding; and ensure that working mothers have the
practical possibility to breastfeed, including by developing
breastfeeding-friendly workplaces and child care centres at work.
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11
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Uruguay
(3rd-5th periodic report)
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yes
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Indirect – General measures of implementation (§ 10, 16): take into account
the results of the evaluation of its Plan of action (2010-2015) in the
elaboration of the new plan (2015-2020). The Committee also recommends that
the State party ensure that sufficient human, technical and financial
resources are allocated for the implementation, monitoring and evaluation of
the ENIA and its plan of action; expeditiously establish a comprehensive data
collection system; the data should cover all areas of the Convention and should
be disaggregated [...], shared among the ministries concerned and used
for the formulation, monitoring and evaluation of policies, programmes and
projects for the effective implementation of the Convention. Health (§ 46): strengthen its efforts to ensure access to
quality health services by all children, particularly children living in
the most disadvantaged and remote areas of the country, and encourages the
State party to develop policies and programmes to address chronic
malnutrition and anaemia.
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