III. CONCLUDING OBSERVATIONS, CONTINUED

CERD

•          Slovakia, CERD, A/59/18 (2004) 70 at para. 389.

389. The Committee is concerned about reports of cases of sterilization of Roma women without their full and informed consent. In this respect, the Committee welcomes the assurances given by the delegation that a draft law on health care, which would address shortcomings in the system by specifying the requirement of free and informed consent for medical procedures and guarantee patients’ access to medical files, has been approved by the Government and should shortly be adopted by the Parliament.

The Committee strongly recommends that the State party take all necessary measures to put an end to this regrettable practice, including the speedy adoption of the above-mentioned draft law on health care. The State party should also ensure that just and effective remedies, including compensation and apology, are granted to the victims.

ICCPR

•          Azerbaijan, ICCPR, A/57/40 vol. I (2002) 47 at para. 77(16).

(16) The Committee is concerned that the State party has not undertaken adequate measures to help women prevent unwanted pregnancies and to ensure that they do not undergo life-threatening abortions.

The State party should take adequate measures to help women prevent unwanted pregnancies and avoid resorting to life-threatening abortions, and to adopt appropriate family planning programmes to this effect.

See also:

•          Viet Nam, ICCPR, A/57/40 vol. I (2002) 67 at para. 82(15).

•          Hungary, ICCPR, A/57/40 vol. I (2002) 60 at para. 80(11).

(11) The Committee is concerned at the high maternal mortality rate in Hungary and the fact that the State party does not provide sufficient support for family planning through effective means of contraception.

The State party should take steps to protect women's life and health, through more effective family planning and contraception (article 6 of the Covenant).

•          Republic of Moldova, ICCPR, A/57/40 vol. I (2002) 76 at para. 84(18).

(18) The Committee is concerned that the delegation was unable to respond to the question of whether the practice of relying on abortion as a means of contraception is a cause of the high level of maternal mortality in the State party.

The State party should undertake a careful assessment of the issue of abortion and maternal mortality and take the necessary measures to reduce the high maternal death rate.

•          Mali, ICCPR, A/58/40 vol. I (2003) 47 at para. 81(14).

(14) While noting the considerable efforts made by the State party, the Committee remains concerned at the high maternal and infant mortality rate in Mali, due in particular to the relative inaccessibility of health and family planning services, the poor quality of health care provided, the low educational level and the practice of clandestine abortions (article 6 of the Covenant).

So as to guarantee the right to life, the State party should strengthen its efforts in that regard, in particular in ensuring the accessibility of health services, including emergency obstetric care. The State party should ensure that its health workers receive adequate training. It should help women avoid unwanted pregnancies, including by strengthening its family planning and sex education programmes, and ensure that they are not forced to undergo clandestine abortions, which endanger their lives. In particular, attention should be given to the effect on women’s health of the restrictive abortion law.

•          Slovakia, ICCPR, A/58/40 vol. I (2003) 52 at para. 82(12).

(12) Despite the oral and written answers provided by the delegation, the Committee remains concerned at reports of forced or coerced sterilization of Roma women. In particular, the Committee regrets that in its written answers submitted after the oral consideration of the report, the State party did not clearly deny or admit breaches of the principle of full and informed consent but asserted that an investigation of maternity wards and gynaecology departments of 12 hospitals did not reveal infringements of “medical indication” of sterilization. The reference made, in the same submission, to “the fact that not all administrative acts were fulfilled in every case” appears to amount to an implicit admission of breaches of the requirement of informed consent (arts. 7, 26).

The State party should adopt all necessary measures to investigate all alleged cases of coerced or forced sterilization, publicize the findings, provide effective remedies to victims and prevent any future instances of sterilization without full and informed consent.

•          El Salvador, ICCPR, A/58/40 vol. I (2003) 61 at para. 84(14).

(14) The Committee expresses its concern at the severity of the current law against abortion in the State party, especially since illegal abortions have serious detrimental consequences for women’s lives, health and well-being.

The State party should take steps to bring its legislation into line with the Covenant as regards the protection of life (art. 6), so that women can be helped to avoid unwanted pregnancies and need not to resort to clandestine abortions that may put their lives in danger, as mentioned in the Committee’s general comment No. 28.

•          Sri Lanka, ICCPR, A/59/40 vol. I (2003) 30 at para. 66(12).

(12) The Committee is concerned that abortion remains a criminal offence under Sri Lankan law, except where it is performed to save the life of the mother. The Committee is also concerned by the high number of abortions in unsafe conditions, imperiling the life and health of the women concerned, in violation of articles 6 and 7 of the Covenant.

The State party should ensure that women are not compelled to continue with pregnancies, where this would be incompatible with obligations arising under the Covenant (art. 7 and general comment No. 28), and repeal the provisions criminalizing abortion.

•          Colombia, ICCPR, A/59/40 vol. I (2004) 35 at para. 67(13).

(13) The Committee notes with concern that the criminalization of all abortions can lead to situations in which women are obliged to undergo high-risk clandestine abortions. It is especially concerned that women who have been victims of rape or incest or whose lives are in danger as a result of their pregnancy may be prosecuted for resorting to such measures (art. 6).

The State party should ensure that the legislation applicable to abortion is revised so that no criminal offences are involved in the cases described above.

•          Lithuania, ICCPR, A/59/40 vol. I (2004) 52 at para. 71(12).

(12) While noting the information provided orally by the delegation on sex education in schools, the Committee is concerned at the high rate of unwanted pregnancies and abortions among young women between the ages of 15 and 19, and the high number of these women contracting HIV/AIDS, with consequent risks to their life and health (art. 6).

The State party should take further measures to help young women avoid unwanted pregnancies and HIV/AIDS, including strengthening its family planning and sex education programmes.

•          Albania, ICCPR, A/60/40 vol. I (2004) 25 at para. 82(14).

(14) The Committee is concerned about the high rate of infant mortality and of abortion and the apparent lack of family planning and social care in some parts of the State party (arts. 6, 24 and 26).

The State party should take steps to ensure that abortion is not used as a method of family planning and take appropriate measures to reduce infant mortality.

•          Morocco, ICCPR, A/60/40 vol. I (2004) 35 at para. 84(29).

(29) The Committee notes with concern that abortion is still a criminal offence under Moroccan law unless it is carried out to save the mother’s life.

The State party should ensure that women are not forced to carry a pregnancy to full term where that would be incompatible with its obligations under the Covenant (arts. 6 and 7) and should relax the legislation relating to abortion.

•          Poland, ICCPR, A/60/40 vol. I (2004) 40 at paras. 85(8) and 85(9).

(8) The Committee reiterates its deep concern about restrictive abortion laws in Poland, which may incite women to seek unsafe, illegal abortions, with attendant risks to their life and health. It is also concerned at the unavailability of abortion in practice even when the law permits it, for example in cases of pregnancy resulting from rape, and by the lack of information on the use of the conscientious objection clause by medical practitioners who refuse to carry out legal abortions. The Committee further regrets the lack of information on the extent of illegal abortions and their consequences for the women concerned (art. 6).

The State party should liberalize its legislation and practice on abortion. It should provide further information on the use of the conscientious objection clause by doctors, and, so far as possible, on the number of illegal abortions that take place in Poland. These recommendations should be taken into account when the draft Law on Parental Awareness is discussed in Parliament.

(9) The Committee also reiterates its concern about family planning regulations adopted by the State party. The high cost of contraception, the reduction in the number of refundable oral contraceptives, the lack of free family planning services and the nature of sexual education are also of concern to the Committee (art. 6).

The State party should assure the availability of contraceptives and free access to family planning services and methods. The Ministry of Education should ensure that schools include accurate and objective sexual education in their curricula.

•          Kenya, ICCPR, A/60/40 vol. I (2005) 44 at para. 86(14).

(14) The Committee expresses concern about the high maternal mortality rate prevalent in the country, caused, inter alia, by a high number of unsafe or illegal abortions (article 6 of the Covenant).

The State party should adopt measures to improve access to family planning services for all women. It should review its abortion laws, with a view to bringing them into conformity with the Covenant.

•          Mauritius, ICCPR, A/60/40 vol. I (2005) 52 at para. 88(9).

(9) The Committee notes with concern that section 235 of the Penal Code penalizes abortion even when the mother’s life is in danger, and thus may encourage women to resort to unreliable and illegal abortion, with inherent risks for their life and health (Covenant, art. 6).

The State party should review its legislation to ensure that women are not forced to carry pregnancies to term in violation of the rights guaranteed by the Covenant.

ICESCR

•          Colombia, ICESCR, E/2002/22 (2001) 110 at paras. 773 and 794.

773. The Committee is deeply concerned about the current low status of women’s sexual and reproductive health rights and in particular about the increased incidence of illegal abortions...

...

794. ...The Committee recommends that the State party implement vigorously its national sexual and reproductive health programme.

•          Algeria, ICESCR, E/2002/22 (2001) 116 at paras. 824 and 840.

824. The Committee expresses its concern about the ineffectiveness of programmes to reduce the maternal and infant mortality rate in the State party.

...

840. The Committee urges the State party to take all necessary measures in order to lower maternal and infant mortality rates and to ensure that all forms of health services are available to women and men, especially in rural areas, in particular reproductive health services.

•          Jamaica, ICESCR, E/2002/22 (2001) 130 at paras. 940, 941 and 953.

940. The Committee is concerned about the health of adolescents in the State party, who are at high risk of many diseases, in particular those related to sexual and reproductive health. The Committee also notes with concern the rising incidence of teenage pregnancies, leading to higher mortality rates related to abortion of unwanted pregnancies and to higher dropout rates for girls who leave school to take care of their babies.

941. The Committee is also concerned that clandestine abortion is the cause of a large number of deaths due to infections and complications from procedures performed under unsanitary conditions by untrained personnel and that it is one of the leading factors in the high maternal mortality rate in the State party.

...

953. The Committee urges the State party to ensure the provision of education on sexual and reproductive health, and to facilitate access to contraceptives by adolescents where appropriate. The Committee recommends the establishment of benchmarks in this respect, on the basis of comparative data to be discussed in the next periodic report, and refers the State party to paragraphs 57 and 58 of its General Comment No. 14 (2000) on the right to the highest attainable standard of health (art. 12 of the Covenant).

See also:

•          Trinidad and Tobago, ICESCR, E/2003/22 (2002) 45 at para. 271.

•          Benin, ICESCR, E/2003/22 (2002) 34 at paras. 177 and 196.

177. The Committee is concerned at the inadequate health services and the lack of awareness-raising concerning sexual and reproductive health, as a result of which infant and maternal mortality have not been reduced. It is also concerned at the large number of illegal abortions, which are the principal reason for the high maternal mortality rate in the State party.

...

196. The Committee urges the State party to improve its health services and undertake programmes on sexual and reproductive education. The Committee invites the State party to address the problem of illegal abortions as a matter of priority.

•          Trinidad and Tobago, ICESCR, E/2003/22 (2002) 45 at para. 273.

273. The Committee notes that the State party, in answering questions about specific programmes devoted to reducing and preventing infant mortality and maternal mortality, as well as teenage pregnancies and back-street abortions, did not provide disaggregated data on a comparative basis which would put the Committee in the position to ask focused questions as to how the delineated health programmes have actually been put into practice.

•          Estonia, ICESCR, E/2003/22 (2002) 68 at paras. 513 and 536.

513. While recognizing that affordable contraception is widely available in the State party, the Committee expresses its concern that abortion is still commonly used as a method of birth control, which puts the health of women at risk.

...

536. The Committee recommends that the State party promote a general awareness of safe contraceptive methods, as well as sexual and reproductive health information, and instil awareness about the health risk of using abortion as a method of birth control.

•          Brazil, ICESCR, E/2004/22 (2003) 28 at paras. 134 and 158.

134. The Committee notes with concern the high rate of maternal mortality from illegal abortions, particularly in the northern regions where women have insufficient access to health-care facilities. The Committee is also concerned about the persistence of forced sterilization.

...

158. The Committee requests the State party to undertake legislative and other measures, including a review of its present legislation, to protect women from the effects of clandestine and unsafe abortion and to ensure that women do not resort to such harmful procedures...

•          New Zealand, ICESCR, E/2004/22 (2003) 35 at para. 181.

181. The Committee welcomes the introduction of new legislation providing for a government-funded parental leave scheme, whereby 12 weeks’ paid parental leave is granted to either parent. The Committee also notes the statement made by the State party that it intends to withdraw its reservation under article 10, paragraph 2, of the Covenant.

•          Iceland, ICESCR, E/2004/22 (2003) 39 at para. 217.

217. The Committee notes with appreciation the new Act on Maternity/Paternity Leave and Parental Leave which reconciles family life and work, provides for time for parents to devote to their children, and promotes the sharing of parental responsibilities and gender equality in the labour market.

•          Republic of Moldova, ICESCR, E/2004/22 (2003) 49 at paras. 317 and 339.

317. The Committee is concerned about the continuing high level of infant and maternal mortality. It is also concerned that the number of abortions remains high (15.6 per 1,000 women of fertile age in 2002), notwithstanding the ongoing programmes in the area of reproductive health.

...

339. The Committee urges the State party to reinforce its efforts to reduce infant and maternal mortality by increasing health coverage for women and children. The Committee calls upon the State party to strengthen efforts to promote awareness of sexual and reproductive health, safe contraceptive methods and the health risk of using abortion as a method of birth control...

•          Yemen, ICESCR, E/2004/22 (2003) 55 at paras. 358 and 377.

358. The Committee is concerned about the high rate of infant and maternal mortality and the insufficient availability of health services, especially for women in rural areas. The Committee is also concerned about the lack of a comprehensive sexual and reproductive health programme in the State party.

...

377. The Committee urges the State party to increase its efforts to reduce the rate of infant and maternal mortality by providing adequate access to health services and vaccination programmes, especially for women and children in rural areas. The Committee urges the State party to adopt and implement a national sexual and reproductive health programme.

•          Guatemala, ICESCR, E/2004/22 (2003) 59 at paras. 417 and 435.

417. The Committee is concerned about the current state of sexual and reproductive health of women and that the incidence of child and maternal mortality is relatively high.

...

435. The Committee recommends that the State party take measures to reduce child and maternal mortality, and in particular intensify the implementation of its national programme on reproductive health, provide further assistance and training to midwives, organize educational campaigns regarding women’s sexual and reproductive health, and include such subjects in the school curricula.

•          Russian Federation, ICESCR, E/2004/22 (2003) 64 at paras. 477 and 505.

477. The Committee is concerned about the high levels of infant and maternal mortality in the State party. It also notes with concern that unsafe abortion remains a main cause of maternal mortality.

...

505. The Committee urges the State party to reinforce its efforts to reduce infant and maternal mortality. The State party should promote awareness of safe contraceptive methods and ensure that abortions are carried out under adequate medical and sanitary conditions.

•          Democratic People’s Republic of Korea, ICESCR, E/2004/22 (2003) 71 at paras. 532 and 553.

532. The Committee is concerned about the alarming increase in maternal mortality rates.

...

553. The Committee recommends that the State party take effective measures to improve the conditions of maternal care, including prenatal health services and medical assistance at birth.

•          Lithuania, ICESCR, E/2005/22 (2004) 18 at paras. 94 and 116.

94. The Committee is concerned that the number of young women (aged 19 years and under) who have abortions is increasing, and regrets that the State party has not furnished any information on reproductive health.

...

116. The Committee calls upon the State party to strengthen its efforts to promote awareness of sexual and reproductive health, safe contraceptive methods and the health risk of using abortion as a method of birth control...

•          Kuwait, ICESCR, E/2005/22 (2004) 29 at paras. 196 and 216.

196. The Committee takes note with concern of the statement made by the delegation of the State party that abortion is allowed only when the life of the mother is endangered. The Committee is also concerned about the lack of a comprehensive sexual and reproductive health programme in the State party.

...

216. The Committee recommends that the State party’s legislation on abortion include other motives for performing legal abortion with a view to preventing illegal abortion. The Committee also recommends that the State party develop a comprehensive sexual and reproductive health programme...

•          Spain, ICESCR, E/2005/22 (2004) 34 at paras. 245 and 263.

245. The Committee is concerned about the high abortion rate among adolescent women aged between 15 and 19 years (13.89 per cent in 2001).

...

263. The Committee recommends that the State party monitor closely the incidence of abortions among adolescent women and adopt necessary measures, legislative or otherwise, to address this problem, including by intensifying specific programmes on sexual and reproductive health among adolescent women...

•          Ecuador, ICESCR, E/2005/22 (2004) 39 at paras. 287, 295, 310 and 320.

287. The Committee is concerned that only a limited percentage of the Ecuadorian population is entitled to social security benefits, especially to sickness and maternity insurance.

...

295. The Committee is concerned about the low coverage, quality and insufficient financial resources available to the health system. The Committee notes that, despite improvements, the maternal mortality rate remains high. The Committee expresses concern about the increasingly high rate of teenage pregnancies.

...

310. The Committee urges the State party to increase the coverage of the social security system, especially for self-employed workers and women.

...

320. The Committee urges the State party to allocate a higher percentage of GDP to the health sector. The Committee also recommends the State party to continue with its prevention and care efforts in the field of health by providing sexual and reproductive health services, particularly to women and young people.

•          Malta, ICESCR, E/2005/22 (2004) 45 at paras. 352 and 370.

352. The Committee observes with concern that abortion is illegal in all cases under the law of the State party.

...

370. The Committee urges the State party to review its legislation on abortion and consider exceptions to the general prohibition of abortion for cases of therapeutic abortion and when the pregnancy is the result of rape or incest.

•          Azerbaijan, ICESCR, E/2005/22 (2004) 59 at paras. 495 and 521.

495. The Committee remains concerned about the low level of awareness of the general public in Azerbaijan of sexual and reproductive health issues, in particular with regard to the availability and use of contraceptives. The Committee is particularly concerned that a high proportion of women resort to abortion as the principal method of birth control, and about the high infant and maternal mortality rates. The Committee also regrets that no comprehensive sexual and reproductive health programme exists in the State party...

...

521. The Committee recommends that the State party...develop a comprehensive sexual and reproductive health programme, including a public awareness-raising campaign about safe contraceptive methods. The Committee also urges the State party to take measures to reduce the maternal and infant mortality rates and to ensure that abortions are carried out under adequate medical and sanitary conditions...

•          Chile, ICESCR, E/2005/22 (2004) 67 at paras. 552 and 579.

552. The Committee is concerned about the consequences for women’s health of the legal prohibition on abortion, without exceptions, in the State party. While there are no official statistics on the number of abortions performed annually, the large number of women who are hospitalized for abortion complications every year (34,479 in 2001) gives an indication of the extent of this problem.

...

579. The Committee recommends that the State party revise its legislation and decriminalize abortion in cases of therapeutic abortions and when the pregnancy is the result of rape or incest.

•          Zambia, ICESCR, E/2006/22 (2005) 19 at para. 78.

78. The Committee notes with appreciation the State’s policy of allowing pregnant girls to continue their education.

•          China, ICESCR, E/2006/22 (2005) 25 at paras. 147, 165, 178 and 194.

147. The Committee is deeply concerned about the high rate of abortion of the girl foetus.

...

165. The Committee is deeply concerned about reports of forced abortions and forced sterilizations imposed on women, including those belonging to ethnic minority groups, by local officials in the context of the one-child policy, and about the high maternal mortality rate as a result of unsafe abortions.

...

178. The Committee strongly recommends that the State party undertake effective public education measures, including awareness-raising programmes designed to eliminate gender-based prejudices and traditional practices that are harmful to women and girls...

...

194. The Committee urges the State party to undertake effective measures to ensure that abortions are carried out voluntarily and under adequate medical and sanitary conditions and to ensure that the existing legislation governing the one-child policy does not violate the rights enshrined in article 10 of the Covenant...

•          China (Macao Special Administrative Region), ICESCR, E/2006/22 (2005) 38 at paras. 238 and 248.

238. The Committee is concerned about the differences in the criteria for entitlement to maternity leave for workers in the public and private sectors, and that the entitlement of male workers to five days of paternity leave is only applicable in the public sector.

...

248. The Committee recommends that the Macao Special Administrative Region take effective measures to increase public awareness, especially in the private sector, about the importance of maternity and paternity leaves that reconcile professional and family life for men and women. The Committee further recommends that the Macao Special Administrative Region take immediate measures to ensure the right of private-sector workers to maternity leave, without placing limitations on the number of births, and to ensure that male workers in the private sector are granted the right to five days of paternity leave, as in the public sector.

CEDAW

•          Fiji, CEDAW, A/57/38 part I (2002) 9 at paras. 56, 57, 60 and 61.

56. ...The Committee...notes with concern that pregnancy leave is not mandatory.

57. ...Legal reforms should make pregnancy leave mandatory and deal with sexual harassment in the workplace...

...

60. The Committee notes with concern that an increase in levels of poverty and adverse economic conditions are undermining Fiji's gains in women's education. These conditions have led to a higher incidence of girls dropping out of school, with connected problems of early marriage, teenage pregnancies and sexual exploitation.

61. The Committee recommends the introduction of targeted policies and programmes to reduce poverty, prevent early marriage, teenage pregnancies and girls dropping out of school.

•          Estonia, CEDAW, A/57/38 part I (2002) 13 at paras. 99, 100, 111 and 112.

99. The Committee notes with concern that sexual intercourse with a girl only up to 14 years of age is considered to be rape, and Estonian law permits the marriage of a girl between the ages of 15 and 18 in exceptional circumstances, such as pregnancy.

100. The Committee recommends that the State party amend its law on statutory rape and bring its law on early marriage into conformity with article 16, paragraph 2, of the Convention, and its own policies on the reproductive health of women and girls. It urges the State party to develop preventive optional welfare programmes to address the problem of teenage pregnancy.

...

111. ...The Committee notes with concern the high rate of abortion among women and the significance of this fact with regard to effective access to family planning methods, including contraceptives, especially among women in rural areas and low incomes.

112. The Committee draws attention to its general recommendation 24 on women and health and recommends that comprehensive research be undertaken into the specific health needs of women, including reproductive health, the financial and organizational strengthening of family planning programmes addressed to women and men and the provision of wide access to contraceptives for all women. The Committee urges the State party to reinforce programmes on sexual education for both girls and boys in order to foster responsible sexual behaviour. ..

•          Trinidad and Tobago, CEDAW, A/57/38 part I (2002) 19 at para. 157.

157. The Committee is concerned that child marriages are sanctioned under several of the legal regimes regulating marriage. The Committee notes that such marriages are prohibited by article 16, paragraph 2, of the Convention, and that such marriages have serious consequences for girls, including with regard to health. The Committee is concerned about the high rate of teenage pregnancy and its consequences for girls' enjoyment of the rights guaranteed by the Convention, in particular in the sphere of education.

•          Uruguay, CEDAW, A/57/38 part I (2002) 23 at paras. 196, 197, 202 and 203.

196. The Committee expresses concern that the Penal Code still contains several provisions that discriminate against women. The Committee is concerned at article 116 which provides for mitigation of sentence where a rapist marries his victim. It is also concerned at article 328, which provides that “protecting the honour of the perpetrator, the spouse and a close relative” may be a factor mitigating sentence in cases of induced abortion.

197. The Committee calls on the State party to give priority to the repeal of these articles of the Penal Code so as to bring the Code into line with the Convention on the Elimination of All Forms of Discrimination against Women and its general recommendations, in particular 19 on violence against women, and 24 on article 12 - women and health.

...

202. The Committee notes with concern the high pregnancy rates among adolescents, and that young adolescents make up a high proportion of this group. It also notes the high rate of deaths related to abortion among adolescents.

203. The Committee recommends that the State party examine the situation of adolescents as a matter of priority, and urges it to take action to ensure that effective reproductive and sexual health services are provided and that due attention is paid to the information requirements of adolescents, including through programmes and policies to provide information on the different kinds of contraceptives available and how they are to be obtained, on the basis of the principle that family planning is the responsibility of both the man and the woman...

•          Iceland, CEDAW, A/57/38 part I (2002) 27 at para. 231.

231. The Committee commends the State party for its recognition of the common responsibility of women and men in the promotion of equality and for having taken a number of measures to involve the participation of men in strategies to increase equality between women and men, inter alia, in the area of paternal leave.

•          Sri Lanka, CEDAW, A/57/38 part I (2002) 31 at paras. 271, 282 and 283.

271. ...The Committee...commends the easy access to family planning for women and men and the well-developed maternal and child health care system, which has contributed to a decline in maternal mortality.

...

282. The Committee is concerned that women who become pregnant as a result of rape or incest have to endure significant physical and mental torture.

283. The Committee encourages the State party to reintroduce legislation to permit termination of pregnancy in cases of rape, incest and congenital abnormality of the foetus.

•          Portugal, CEDAW, A/57/38 part I (2002) 35 at paras. 345 and 346.

345. The Committee is concerned about the restrictive abortion laws in place in Portugal, in particular because illegal abortions have serious negative impacts on women’s health and well-being.

346. The Committee urges the State party to facilitate a national dialogue on women's right to reproductive health, including on the restrictive abortion laws. It also urges the State party to further improve family planning services, ensuring their availability to all women and men, including teenagers and young adults...

•          Russian Federation, CEDAW, A/57/38 part I (2002) 40 at paras. 399 and 400.

399. The Committee is concerned at the deterioration of the health-care system, which severely limits women’s access to health care. It is also concerned at the state of women's health, in particular the increase gynaecological problems and pregnancies among teenage girls. The Committee also notes with concern that, although there has been a decrease in the rate of abortions, abortion continues to be used as a method of birth control and the number of women using effective contraceptive measures is low.

400. The Committee recommends in accordance with General Recommendation 24 on article 12 - women and health that the State party fully implement a life-cycle approach to women's health and urges the State party to strengthen family planning programmes and provide affordable access to contraceptive measures for all women in all regions. It also urges the State party to include sex education in the school curriculum.

•          Suriname, CEDAW, A/57/38 part II (2002) 82 at paras. 57-60, 63 and 64.

57. The Committee is concerned that, in some educational institutions, teenage mothers are not always readmitted to junior secondary schools because of the perception that “the young mothers would have a negative influence on other girls”, while teenage fathers are not prevented from attending schools.

58. The Committee requests the State party to include age-appropriate sex education in school curricula and to conduct awareness campaigns so as to prevent teenage pregnancy... The Committee also urges the State party to adopt the necessary legal or administrative measures to prohibit schools from barring young mothers and pregnant teenagers.

59. The Committee expresses concern at discriminatory practices and certain legal labour provisions that could lead to discrimination against women workers with regard to reproductive health and maternity and notes that, in the civil service, women are discriminated against when entering into marriage or becoming pregnant. It notes that regulations on flexible working hours are lacking and that the employer has the right to decrease the number of vacation days during the year in which maternity leave is enjoyed.

60. The Committee recommends that the State party remove discriminatory labour legislation in accordance with article 11 of the Convention and ensure that women workers have working conditions and social security benefits equal to those enjoyed by men, as well as protection for maternity without discrimination under article 4, paragraph 2 of the Convention.

...

63. The Committee notes with concern that there are provisions in the penal code regarding family planning, including prohibiting the display and offering of contraceptives for the prevention of pregnancy, although these provisions are not enforced. Noting that male condom use is very low, the Committee is concerned that only women are targeted with regard to contraception...

64. The Committee recommends that the laws restricting family planning activities be repealed. It urges the State party to provide women and men with information on family planning and to introduce programmes to encourage men to take part in family planning responsibilities. The Committee underlines the importance of article 12 of the Convention and urges the State party to implement policies and programmes in accordance with the Committee’s general recommendation 24...

•          Saint Kitts and Nevis, CEDAW, A/57/38 part II (2002) 90 at paras. 101 and 102.

101. The Committee expresses concern about the high rate of teenage pregnancy.

102. The Committee urges the State party to intensify awareness raising and sexual education aimed at responsible sexual behaviour in the schools and society at large in order to prevent pregnancies. In addition, the Committee also recommends that men be involved in the design and implementation of all family planning strategies, policies and programmes.

•          Belgium, CEDAW, A/57/38 part II (2002) 95 at paras. 157 and 158.

157. ...[T]he Committee is...concerned about the phenomenon of teenage pregnancy and voluntary termination of pregnancy among women as young as 14.

158. The Committee...calls on the State party to formulate policies, strategies and programmes to prevent early pregnancies, including education campaigns addressed to young men as well as young women.

•          Zambia, CEDAW, A/57/38 part II (2002) 107 at paras. 242, 243, 246 and 247.

242. While noting that the State party has made progress in addressing the basic health needs of women in Zambia, the Committee expresses concern at the high level of maternal and infant mortality, low life expectancy, very high teenage pregnancies and unsafe abortions and lack of adequate healthcare facilities and family planning services, particularly in the rural areas.

243. The Committee recommends that the State party formulate polices and allocate adequate resources to improve the status of women’s health, in particular with regard to maternal and infant mortality. It urges the State party to increase women’s access to healthcare and family planning services. It also recommends that national reproductive health programmes be designed and implemented in order to prevent early pregnancy and induced abortions in rural and urban areas.

...

246. Despite the State party’s effort in the area of education, the Committee is concerned at the low rate of female literacy, the low enrolment of girls in school in rural and urban areas and the high dropout rate of girls due to pregnancies...

247. The Committee urges the State party to strengthen its efforts to improve the literacy level of girls and women in rural and urban areas, to ensure equal access of girls and young women to all levels of education and to prevent girls dropping out of school...

•          Ukraine, CEDAW, A/57/38 part II (2002) 114 at paras. 289 and 290.

289. The Committee expresses its concern about the status of women’s health, especially their reproductive health. The Committee is concerned about the high number of abortions and the fact that the maternal and child mortality rates still remain high...

290. The Committee draws attention to its general recommendation No. 24 on women and health and recommends comprehensive research into the specific health needs of women, including their reproductive health, the full implementation of a life-cycle approach to women’s health, the financial and organizational strengthening of family planning programmes and the provision of wide access to contraceptives for all women and men. The Committee urges the State party to reinforce programmes of sexual and reproductive education for both girls and boys in order to foster responsible sexual behaviour and further discourage abortion as a means of birth control...

See also:

•          Hungary, CEDAW, A/57/38 part III (2002) 189 at paras. 329 and 330.

•          Armenia, CEDAW, A/57/38 part III (2002) 150 at paras. 52 and 53.

52. The Committee...is concerned about the status of women’s health, especially their reproductive health, and the increase in the rate of maternal mortality. The Committee is concerned at the widespread use of abortion as a commonly used means of birth control, particularly in rural areas.

53. ...Drawing attention to its general recommendation 24 on women and health, the Committee calls on the State party to ensure the availability and accessibility of affordable contraceptive means to both women and men as part of a comprehensive health policy. The Committee encourages the State party to promote programmes of sex education for both girls and boys. The Committee calls on the State party to take all appropriate steps to foster responsible sexual behaviour and take all appropriate steps to stop the use of abortion as a means of birth control.

•          Czech Republic, CEDAW, A/57/38 part III (2002) 157 at paras. 101 and 102.

101. The Committee is concerned about the status of women’s health, especially their reproductive health. While recognizing the 60 per cent decrease in abortion since 1994 and the progressive increase in the use of intrauterine and hormonal contraceptives, the Committee is concerned that the current abortion rate may suggest that abortion is still being used as a means of birth control. It is also concerned that voluntary sterilization for women is permitted solely for health reasons...

102. The Committee draws attention to its general recommendation No. 24 on women and health and recommends the collection of data disaggregated by sex as well as comprehensive research into the specific health needs of women, including their reproductive health, the full implementation of a life-cycle approach to women’s health, the financial and organizational strengthening of family planning programmes, the provision of wide access to safe and affordable contraceptives for all women and men, and the lifting of the restrictions on voluntary sterilization. The Committee urges the State party to reinforce programmes of sexual and reproductive education for both girls and boys. The Committee calls on the State party to encourage responsible sexual behaviour and further discourage abortion as a means of birth control...

•          Uganda, CEDAW, A/57/38 part III (2002) 164 at paras. 147 and 148.

147. The Committee is concerned about the high rate of teenage pregnancy and its consequences for girls’ enjoyment of the rights in the Convention, particularly in the spheres of education and health. It is also concerned at the high rate of maternal mortality among teenage girls, particularly in the rural areas, frequently as a result of clandestine abortion.

148. The Committee recommends that the State party design and implement national health, including reproductive health, programmes to prevent early pregnancies and induced abortions in rural and urban areas. The Committee also urges the State party to reinforce programmes of sexual and reproductive health education for both girls and boys. It also calls on the State party to provide safe and affordable contraceptives.

•          Guatemala, CEDAW, A/57/38 part III (2002) 171 at paras. 186, 187 and 192-195.

186. ...The Committee notes that, despite the introduction of protections and social security rights in the area of labour, including domestic workers and those working in the maquila industries, this legislation is not complied with or enforced and that some employers in this industry require women seeking employment to undergo pregnancy tests. The Committee notes that non-enforcement of such labour legislation constitutes “discrimination of effect” as defined in article 1 of the Convention.

187. The Committee calls upon the State party to ensure that State authorities implement all current legislation concerning women’s human rights, in particular labour legislation through proactive investigations of alleged violations of female workers’ rights and take measures to strengthen the enforcement powers of labour inspection authorities. The Committee further urges the State party to take appropriate measures, including the promotion of stronger private sector codes of conduct, to ensure compliance with existing legislation, in particular with regard to the rights of women enshrined in the Convention, which forms part of Guatemalan law. The Committee also calls upon the State party to take steps to raise awareness among women of their legal rights and the means by which those rights can be enforced.

...

192. The Committee expresses concern about the high rate of infant and maternal mortality in Guatemala.

193. The Committee recommends that the State party make every effort to increase access to health-care facilities and medical assistance by trained personnel, particularly in rural areas and especially in the areas of pre- and post-natal care.

194. The Committee also expresses concern about the limited autonomy that women have over decisions on the number and spacing of their children, and the limited sex education and knowledge of family planning. The Committee is also concerned about prevalent social attitudes that measure a man’s masculinity by the number of children he fathers.

195. The Committee calls upon the State party to improve its family planning and reproductive health policy and programmes by, inter alia, making affordable contraceptive means widely available and accessible to both women and men, in particular in the rural areas. It encourages the State party to redouble its efforts to eliminate the view that the sole role of women is reproduction, as stated in its combined third and fourth periodic report.

•          Barbados, CEDAW, A/57/38 part III (2002) 177 at paras. 223, 224, 249 and 250.

223. The Committee congratulates the State party on having achieved a maternal mortality rate of zero.

224. The Committee also commends the State party for viewing health care as a fundamental right and for providing a range of family health services in the polyclinic setting, including free ante- and post-natal care for all citizens and residents of the country. It also commends the State party for the services that target women and girls, for example the Maternal and Child Health Programme, which monitors progress throughout pregnancy.

...

249. The Committee is concerned about the increasing number of teenage pregnancies and its consequences for girls’ enjoyment of the rights guaranteed by the Convention, particularly in the spheres of education and health.

250. The Committee recommends that the State party increase efforts to include age-appropriate sex education in school curricula and to conduct awareness campaigns so as to prevent teenage pregnancy...

•          Greece, CEDAW, A/57/38 part III (2002) 184 at paras. 291 and 292.

291. Noting that the rate of abortion has decreased by 30 per cent during the years 1994 through 2000, the Committee is concerned that abortion is still perceived as a means of birth control. It also notes with concern that an unusually high percentage of women deliver through Caesarean section.

292. The Committee recommends that the State party ensure the availability and accessibility of affordable contraceptive means for both women and men as part of a comprehensive health policy, including reproductive health. The Committee encourages the State party to promote programmes of sex education for both girls and boys. It calls on the State party to encourage responsible sexual behaviour and take all appropriate steps to eliminate the use of abortion as a means of birth control. The Committee also recommends that the State party implement awareness-raising programmes on the benefit of natural birth in order to decrease the number of deliveries through Caesarean section.

•          Argentina, CEDAW, A/57/38 part III (2002) 196 at paras. 360 and 361.

360. The Committee is concerned at the high maternal mortality rate and at the fact that, with the increasing deterioration in health services, women, in particular those in situations of vulnerability, are losing their right to comprehensive health care, in particular as regards sexual and reproductive health...

361. The Committee recommends that the State party should guarantee women’s access to health services, including sexual and reproductive health services, and that it should adopt the necessary measures to reduce the high maternal mortality rate...

•          Yemen, CEDAW, A/57/38 part III (2002) 200 at paras. 396 and 397.

396. The Committee notes with concern the high maternal mortality rates.

397. The Committee recommends that the State party take urgent measures to develop health programmes aimed at reducing the maternal mortality rate and to make contraceptives affordable and accessible.

•          Mexico, CEDAW, A/57/38 part III (2002) 205 at paras. 441, 442, 445 and 446.

441. ...The Committee is especially concerned about women working in the informal sector, including domestic workers, and those employed in the maquila industry whose basic labour rights are not respected; in particular, the Committee is concerned about the pregnancy test demanded by employers which exposes women to the risk of being let go or fired in the event that it proves positive.

442. The Committee recommends that the State party speed up the adoption of the reforms that must be made in the Labour Act, including the prohibition of discrimination against women, in an effort to ensure their participation in the labour market on a footing of genuine equality with men. It also urges the State party to give effect to the labour rights of women in all sectors. To that end, it recommends that the State party strengthen and promote the role of INMUJERES in negotiating the Labour Act so as to give special attention to the needs of women workers and to implement the principle of equal pay for work of equal value and prohibit the requirement of a pregnancy test for maquiladora workers.

...

445. The Committee notes with concern the high maternal mortality rate, particularly as a result of abortions among adolescents and the inadequate education, dissemination, accessibility and supply of contraceptive devices especially to poor women in rural and urban areas and to adolescents...

446. The Committee recommends that the State party consider the situation of the adolescent population as a matter of priority and urges it to adopt measures guaranteeing access to reproductive and sexual health services with attention to the information needs of adolescents; it recommends further that it implement programmes and policies to increase the knowledge of the various contraceptive methods and their availability on the understanding that family planning is the responsibility of both partners...

See also:

•          Peru, CEDAW, A/57/38 part III (2002) 212 at paras 482 and 483.

•          Peru, CEDAW, A/57/38 part III (2002) 212 at paras. 484 and 485.

484. The Committee notes with concern that, in the period covered by the report, mention is made of numerous cases of sterilization of women without prior informed consent, using psychological violence or the promise of financial incentives, thus affecting women’s right to decide the number and spacing of their children. The Committee is also concerned that, although the Deputy Defender for Women’s Rights and other organs have condemned these practices, those responsible have not been punished.

485. The Committee recommends that all necessary measures should be taken to continue to provide the service of surgical sterilization so as to give women the right of free choice as regards their reproductive health, after they have been duly informed of the medical details and consequences of the operation and have given their consent. The Committee also recommends that a recurrence of these incidents should be avoided in the future. It further recommends that efforts should be continued to bring before the courts the persons responsible for this violation of the right to health.

•          Switzerland, CEDAW, A/58/38 part I (2003) 20 at paras. 132 and 133.

132. The Committee expresses concern over the delay in introducing paid maternity leave in the State party and notes that several proposals to introduce paid maternity leave have been rejected by popular vote.

133. The Committee calls upon the State party to ensure the speedy enactment of the draft legislation on maternity leave with pay that was adopted by the Federal Council and the National Council in November and December 2002... The Committee recommends the undertaking of awareness-raising campaigns for developing a proper understanding of maternity as a social function and the recognition of the common responsibility of men and women in the upbringing and development of their children. Such campaigns should also stress the role of men and pave the way for a debate on the issue of paternity and parental leave as important factors in the sharing of family responsibilities and guaranteeing equality for women in the labour market and in social life.

•          Congo, CEDAW, A/58/38 part I (2003) 29 at paras. 174 and 175.

174. The Committee notes with concern the existence of very high maternal and infant mortality rates in the Congo. The Committee is further concerned at the low contraceptive prevalence rate among women and men and the lack of access of women to adequate pre-natal and post-natal care and family planning information, particularly in rural areas.

175. The Committee recommends that the State party make every effort to raise awareness of and increase access to health-care facilities and medical assistance by trained personnel, particularly in rural areas and particularly in the areas of post-natal care. The Committee further recommends the speedy review and amendment of the Act of 31 July 1920, which prohibits the advertising of contraceptives, thereby limiting women’s access to family planning.

•          Luxembourg, CEDAW, A/58/38 part I (2003) 47 at para. 295.

295. The Committee commends the State party for adopting new laws in support of the goal of gender equality: the law on pensions, which plays a key role in preventing poverty among older people, particularly women; the law with respect to the burden of proof in cases of discrimination on the basis of sex; the law concerning protection for workers who are pregnant, have recently given birth or are breastfeeding; and the law on protection from sexual harassment in the workforce.

•          Canada, CEDAW, A/58/38 part I (2003) 53 at paras. 381 and 382.

381. ...While appreciating the increase in the number of months of parental leave, the Committee is concerned that the low benefit level of the parental leave may not encourage great numbers of fathers to avail themselves of that leave.

382. The Committee...encourages the State party to consider raising the benefit level for parental leave.

•          Costa Rica, CEDAW, A/58/38 part II (2003) 86 at paras. 68 and 69.

68. The Committee notes with satisfaction the comprehensive health-care programmes for women and the progress achieved, as well as the establishment of the Inter-Institutional Commission on Sexual and Reproductive Health, the 1994 Reproductive and Sexual Health and Rights Counselling Services and the new comprehensive health-care model. Nevertheless, the Committee expresses its concern at the limited dissemination of women’s comprehensive health-care rights and the absence of a national sexual education and family planning information and/or education programme to permit the creation of awareness among women and men of their rights and responsibilities in relation to the reproductive process. It is also concerned that, despite the steps taken and the adoption of the Adolescent Mothers’ Protection Act, there is continued increase in teenage pregnancies and apparent lack of awareness among men, teenage or adult, of their responsibility as fathers.

69. The Committee requests the State party to strengthen its health-care programmes, including those for sexual and reproductive health, and to launch as soon as possible a national programme to provide women and men with timely and reliable information on the available contraceptive methods and those capable of allowing them to exercise their right of free and informed choice of the number and spacing of the children they wish to have, as well as to reinforce the measures for preventing sexually transmitted diseases and HIV/AIDS, including the availability of condoms. It also requests the State party to continue strengthening support programmes for pregnant teenagers and mothers and sex education programmes aimed at preventing pregnancies among the teenage population.

•          Brazil, CEDAW, A/58/38 part II (2003) 93 at paras. 92, 126 and 127.

92. The Committee commends the State party on its Federal Constitution of 1988 that enshrines the principle that men and women have equal rights and duties; prohibits discrimination in the labour market by reason of sex, age, colour or marital status; protects motherhood as a social right by ensuring maternity leave without the loss of job and salary; and establishes the duty of the State to suppress violence within the family.

...

126. The Committee is concerned at the high maternal mortality rate, particularly in the more remote regions where access to health facilities is very limited. The Committee is also concerned at the health condition of women from disadvantaged groups and at the high rate of clandestine abortion and its causes, linked to, among others, poverty, exclusion and a lack of access to information...

127. The Committee recommends that further measures be taken to guarantee effective access of women to health-care information and services, particularly regarding sexual and reproductive health, including young women, women from disadvantaged groups and rural women. Those measures are essential to reduce maternal mortality and to prevent recourse to abortion and protect women from its negative health effects. It further recommends that programmes and policies be adopted to increase the knowledge of and access to contraceptive methods with the understanding that family planning is the responsibility of both partners...

•          Morocco, CEDAW, A/58/38 part II (2003) 101 at paras. 172 and 173.

172. Although progress has been made in reducing maternal and infant mortality rates and in increasing access to means of family planning, the Committee is concerned about the insufficient number of health-care facilities and particularly about the situation of rural women who have little or no access to health-care services and health-care professionals.

173. The Committee calls upon the State party to increase women’s access to primary health-care services, including reproductive health care, particularly for rural women, and to further increase access to affordable means of family planning for women and men. It also calls upon the State party to increase awareness campaigns on the importance of health and reproductive rights, including information on the spread of sexually transmitted diseases (STDs), including the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS).

•          Slovenia, CEDAW, A/58/38 part II (2003) 109 at paras. 199, 214 and 215.

199. The Committee commends the State party for adopting new laws in support of the goal of gender equality, including the Act on Equal Opportunities for Women and Men, which, inter alia, introduces a legal basis for the elaboration of temporary special measures to promote de facto equality between women and men; the Employment Relationships Act, which provides for equal opportunities and equal treatment of women and men in employment; the Parental Care and Family Income Act, providing parental leave for fathers; and the special provision guaranteeing non-sexist use of language in legislation.

...

214. The Committee is concerned at the high maternal mortality rate in Slovenia.

215. The Committee recommends that the State party take urgent measures to reduce the maternal mortality rate, in consultation with the World Health Organization, as necessary...

•          Ecuador, CEDAW, A/58/38 part II (2003) 122 at paras. 317 and 318.

317. The Committee is concerned that, although there is a National Education Plan for Love and Sexuality, it is not applied consistently and little is done to publicize women’s right to sexual and reproductive health care, which would help to make both sexes aware of their rights and responsibilities in the area of reproduction. The Committee is also concerned at the high rate of pregnancy and abortion among teenagers, particularly in rural areas.

318. The Committee urges the State party to implement the National Education Plan for Love and Sexuality and to strengthen its health-care programmes, including sexual and reproductive health, and, as soon as possible, to implement a national programme that provides women and men with adequate and reliable information on available contraceptive methods and methods that can enable them to exercise their right to make a free and informed decision concerning the number and spacing of their children and to strengthen methods for preventing sexually transmitted diseases and HIV/AIDS, including the availability of condoms. It also requests the State party to continue strengthening support programmes for pregnant teenagers and teenage mothers and sexual education programmes to prevent pregnancies among the teenage population...

•          Japan, CEDAW, A/58/38 part II (2003) 130 at para. 352.

352. The Committee notes with appreciation the law reform undertaken by the State party in several areas, including the revision of the Equal Employment Opportunity Law that prohibits discrimination against women from recruitment to retirement and obliges managers to give consideration to the prevention of sexual harassment in the workplace; the 2001 revision of the Child Care and Family Care Leave Law that prohibits disadvantageous treatment of employees because of their taking childcare leave...

•          New Zealand, CEDAW, A/58/38 part II (2003) 138 at paras. 400, 411 and 412.

400. The Committee appreciates the State party’s establishment of a paid parental leave scheme and the stated intention to improve it.

...

411. While acknowledging the efforts undertaken by the State party to address discrimination faced by women in the labour market, the Committee is concerned that women remain disadvantaged in the labour market, that prerequisites and criteria [to] qualify for paid parental leave may add to women’s difficulties in entering the labour market and that the level of benefits does not provide an incentive for men to take up parental leave. The Committee is concerned about the persistence of a gender pay gap, occupational segregation, the high number of women in part-time work and in temporary jobs, affecting their eligibility for paid maternity leave, and the low wages paid to women. The Committee is also concerned about the difficulties women face in reconciling their personal and family lives with their professional and public responsibilities.

412. The Committee recommends that the State party ensure equal opportunities for women and men in the public and private sectors, including through the use of temporary special measures in accordance with article 4, paragraph 1, of the Convention. It also recommends that the State party design and implement targeted job-training programmes for different groups of unemployed women. The Committee further recommends that efforts be made to eliminate occupational segregation, through education and training, the application of the principle of equal pay for work of equal and comparable value, and the promotion of additional wage increases in female-dominated sectors of employment. The Committee recommends that the State party consider further amending the Parental Leave and Employment (Paid Parental Leave) Amendment Act with a view to ensuring that pregnancy under no circumstances creates an obstacle for women entering the labour market, and to removing the specific time limit which is required to qualify for paid parental leave, and to increasing the benefits level so that men are encouraged to take parental leave.

•          Bhutan, CEDAW, A/59/38 part I (2004) 21 at para. 120.

120. The Committee calls upon the State party to increase the access of women and adolescent girls to affordable health-care services, including reproductive health care, and to increase access to affordable means of family planning for women and men. It also calls upon the State party to step up its efforts to implement awareness-raising campaigns targeting women and men on the importance of family planning and related aspects of women’s health and reproductive rights.

•          Kyrgyzstan, CEDAW, A/59/38 part I (2004) 28 at paras. 157 and 158.

157. The Committee is concerned about the status of women’s health and the deterioration of the health-care system. It is concerned about the continuing high rates of maternal and infant mortality, anaemia during pregnancy, the still high number of abortions, including among women under the age of 19, underweight girls, the increase in tuberculosis and sexually transmitted diseases among women and the problem of alcoholism and drug addiction among women...

158. The Committee recommends that, in accordance with general recommendation 24 on women and health, the State party fully implement a holistic, life cycle approach to women’s health. It recommends that the State party strengthen measures to reduce the maternal and infant mortality rates and to address alcoholism and drug addiction among women as well as the spread of tuberculosis and other diseases among women. It urges the State party to reinforce programmes of sexual and reproductive education for both girls and boys to foster responsible sexual behaviour...

•          Nepal, CEDAW, A/59/38 part I (2004) 34 at paras. 192, 212 and 213.

192. The Committee commends the State party for identifying gender equality as a priority in its national development plan and welcomes new laws and legal reforms, such as...the Legal Aid Act, under which free legal aid is available in cases of abortion, trafficking, sexual exploitation and domestic violence...

...

212. ...The Committee is concerned that women have a lower life expectancy than men and that there are high maternal and infant mortality rates. It is also concerned that women’s health is adversely affected by factors such as early marriage and early pregnancy, inadequate family planning services and illiteracy, which is an obstacle to obtaining and effectively using health-related information...

213. The Committee recommends that the State party take further measures to improve the access of women, particularly rural women, to health-related services and information, including in regard to sexual and reproductive health, in an effort to reduce maternal mortality. It also recommends that programmes and policies be adopted to increase knowledge of and access to contraceptive methods, bearing in mind that family planning should be the responsibility of both partners. It further recommends that sex education be widely promoted, particularly targeting boys and girls, with special attention to the prevention and further control of sexually transmitted diseases and HIV/AIDS...

•          Ethiopia, CEDAW, A/59/38 (2004) 42 at paras. 257 and 258.

257. The Committee is concerned about the very low level of life expectancy for women, the high rate of maternal mortality and the high prevalence of HIV/AIDS among women. The Committee is also concerned at the high rate of clandestine abortion and its causes, which include poverty, a lack of access to information on women’s reproductive health and rights and low prevalence of contraceptive use.

258. The Committee recommends the adoption of measures to guarantee effective access for women, including young women, to health-care information and services, in particular regarding reproductive health, with the aim of reducing clandestine abortions. It further recommends that programmes and policies be adopted to increase knowledge about and access to affordable contraceptive methods, as well as to increase the understanding that family planning is the responsibility of both partners. The Committee also recommends that sex education be widely promoted and provided, targeting men, women and adolescent boys and girls, with special attention to the prevention and further control of HIV/AIDS.

•          Nigeria, CEDAW, A/59/38 part I (2004) 49 at paras. 307 and 308.

307. The Committee expresses concern at the precarious situation of women’s health, the insufficient and inadequate health-care facilities and family planning services and the lack of access to such facilities and services. The Committee is concerned about the high rates of maternal mortality as a result of unsafe abortions...

308. The Committee urges the State party to allocate adequate resources to improving the status of women’s health, in particular with regard to maternal and infant mortality. It urges the State party to increase women’s and adolescent girls’ access to affordable health-care services, including reproductive health care, and to increase access to affordable means of family planning for women and men. It urges the State party to take measures to assess the impact of its abortion laws on women’s health...

•          Latvia, CEDAW, A/59/38 part II (2004) 103 at paras. 69 and 70.

69. While noting a steady decrease in the number of abortions, the Committee is concerned that the abortion rate remains high.

70. The Committee recommends that further measures be taken to guarantee effective access of women to health-care information and services, particularly regarding sexual and reproductive health, in order to prevent recourse to abortion and protect women from its negative health effects. It further recommends that programmes and policies be adopted to increase the knowledge of and access to contraceptive methods with the understanding that family planning is the responsibility of both partners.

•          Angola, CEDAW, A/59/38 part II (2004) 118 at paras. 161-163.

161. The Committee urges the State party to ensure equal opportunities for women and men in the labour market in accordance with article 11 of the Convention, and the full implementation of the provisions of the General Labour Law by the public and private sectors, including with regard to maternity protection as provided in article 4, paragraph 2 of the Convention...

162. While welcoming the priority placed by the State party on the rehabilitation of the health sector, the Committee is concerned about the poor health infrastructure, which results in women’s lack of access to health services and their low health status. The Committee is especially concerned about women’s low life expectancy, high maternal mortality and morbidity rates, high fertility rates and inadequate family planning services, low rates of contraceptive use and lack of sex education...

163. The Committee urges the State party to continue its efforts to improve the country’s health infrastructure. It calls on the State party to integrate a gender perspective in all health sector reforms, while also ensuring that women’s sexual and reproductive health needs are adequately addressed. In particular, the Committee recommends that the State party undertake appropriate measures to improve women’s access to health care and health-related services and information, including access for women who live in rural areas. It calls on the State party to improve the availability of sexual and reproductive health services, including family planning information to reduce maternal mortality. It also recommends that programmes and policies be adopted to increase knowledge of and access to affordable contraceptive methods, so that women and men can make informed choices about the number and spacing of children. It further recommends that sex education be widely promoted and targeted at girls and boys, with special attention to the prevention of early pregnancies and the control of sexually transmitted diseases and HIV/AIDS...

•          Equatorial Guinea, CEDAW, A/59/38 part II (2004) 126 at paras. 193, 194, 205 and 206.

193. The Committee is concerned at the low rate of female literacy, the low rate of enrolment of girls in schools and the high dropout rate of girls due to pregnancy, early marriages and the low priority given to girls’ education by families...

194. The Committee urges the State party to raise awareness of the importance of education as a fundamental human right and as a basis for the empowerment of women and to take steps to overcome traditional attitudes that constitute obstacles to girls’ education. It also recommends that the State party prioritize efforts to improve the literacy level of girls and women, ensure equal access of girls and young women to all levels of education, retain girls in school and strengthen the implementation of re-entry policies providing for girls to return to school after pregnancy...

...

205. The Committee expresses concern about the lack of access of women and girls to adequate health-care services, including pre-natal and post-natal care and family planning information, particularly in rural areas. The Committee is also concerned about the alarming rate of teenage pregnancy, which presents a significant obstacle to girls’ educational opportunities and economic empowerment.

206. The Committee recommends that the State party make every effort to raise awareness of and increase access to health-care facilities and medical assistance by trained personnel, particularly in rural areas, and in pre- and post-natal care. The Committee urges the State party to take immediate steps to make family planning information available to women and girls, including in rural areas.

•          Bangladesh, CEDAW, A/59/38 part II (2004) 134 at paras. 253 and 254.

253. The Committee...is...concerned that women working in the private sector and industry do not enjoy the same maternity leave benefits of women working in the public sector.

254. The Committee recommends that the State party establish a monitoring mechanism to ensure the enforcement of legislation requiring employers to provide equal pay for equal work, ensure that maternity leave is available in all public and private employment, especially through the enactment of a law on maternity leave, and expand the number of crèches available for working mothers.

•          Dominican Republic, CEDAW, A/59/38 part II (2004) 141 at paras. 303 and 306-309.

303. The Committee urges the State party to ensure de facto equal opportunity for men and women in the labour market through a review of labour legislation to ensure that it is consistent with article 11 of the Convention and is implemented in compliance thereof...It recommends the adoption of legislative, administrative and other measures guaranteeing access to social security and other labour benefits, including paid maternity leave, for female domestic workers, temporary employees and workers in the informal and rural sectors.

...

306. The Committee is deeply concerned about the situation of women working in the free-trade zones, who make up 53 per cent of the total workforce in this sector, in view of the persistence of discriminatory practices, such as the exclusion of women on the grounds of pregnancy, compulsory pregnancy tests as a condition for employment and the incidence of violent acts such as sexual harassment in contravention of Article 209 of the Penal Code, which protects women from sexual harassment in the workplace, and in contravention of Act No. 24-97, which protects women against all types of violence...

307. The Committee recommends that steps be taken to ensure the implementation of labour legislation in free-trade zones, in accordance with article 11 of the Convention and to prohibit, subject to the imposition of sanctions, dismissal on the grounds of pregnancy. The Committee also recommends the institution of measures for the implementation and enforcement of legislation on sexual harassment and other forms of violence against women, in order to guarantee the protection of women employed in free-trade zones and the punishment of the perpetrators.

308. ...The Committee expresses concern about the high rates of female mortality and morbidity, of which unsafe abortions are among the primary causes.

309. The Committee recommends the adoption of measures to ensure that women, especially young women, the disabled and women living in rural areas, have access to information and health services, particularly those relating to sexual and reproductive health and cancer prevention. Such measures are essential in order to reduce the rate of maternal mortality, prevent women from resorting to unsafe abortion and protect women against the negative effects on their health. In this regard, the Committee recommends that the State health services should provide an abortion when the pregnancy is a result of rape or when the mother’s health is in danger. It also recommends the development of programmes and policies to increase knowledge of and access to contraception, bearing in mind that family planning is the responsibility of both members of the couple. The Committee also recommends promoting sex education widely, particularly for adolescents, with special emphasis on combating sexually transmitted diseases and HIV/AIDS...

•          Argentina, CEDAW, A/59/38 part II (2004) 155 at paras. 380 and 381.

380. While appreciating the establishment of the National Programme for Sexual Health and Responsible Parenthood, the Committee is concerned about the lack of information on the State party’s efforts to evaluate the effectiveness of that Programme. The Committee also expresses concern about the high pregnancy rate among adolescents, the high rate of maternal mortality, one third of which is caused by illegal abortion, and the increase in sexually transmitted diseases, including HIV/AIDS. The Committee is also concerned that the crisis is having a negative impact on women’s and adolescent girls’ access to comprehensive health services, particularly for reproductive and sexual health.

381. The Committee urges the State party to ensure that women’s and adolescent girls’ access to health services, including sexual and reproductive health services, is fully ensured at the present time. It calls upon the State party to ensure that education on sexual and reproductive health is undertaken in all schools. It also urges the State party to adopt all necessary measures to reduce the high maternal mortality rate, as well as the rate of sexually transmitted diseases, including HIV/AIDS, among women...

•          Samoa, CEDAW, A/60/38 part I (2005) 9 at paras. 54-57.

54. ...The Committee is concerned that existing legislation is discriminatory or has significant gaps with respect to articles 11 and 13, such as lack of provisions on equal pay for work of equal value, on protection against discrimination on the basis of pregnancy and against sexual harassment in the workplace. The Committee is also concerned about the extremely limited provision of paid maternity leave in the private sector and the lack of adequate childcare services.

55. The Committee calls upon the State party to bring its legislation into compliance with article 11 of the Convention without delay and to ensure compliance with such legislation. The Committee also requests the State party to step up its efforts to address the impediments women face in entering the labour force and to implement measures to promote the reconciliation of family and work responsibilities between women and men. The Committee also urges the State party to use temporary special measures in accordance with article 4, paragraph 1, of the Convention and general recommendation 25 so as to enhance implementation of article 11 of the Convention...

56. The Committee expresses concern that complications of pregnancy and childbirth remain one of the leading causes of morbidity for women. It is also concerned about the rising incidence of teenage pregnancy, the limited family-planning efforts, the low contraceptive prevalence rate and the lack of sex education in schools, despite comprehensive access for women to health services, including reproductive health services...

57. The Committee urges the State party to increase its efforts to improve the provision of sexual and reproductive health services to reduce fertility rates and maternal morbidity. It calls upon the State party to step up the provision of family-planning information to women and girls and to promote widely sex education targeted at girls and boys, with special attention to the prevention of teenage pregnancy and the control of HIV/AIDS...

•          Lao People’s Democratic Republic, CEDAW, A/60/38 part I (2005) 16 at paras. 96 and 97.

96. While noting improvement during the past few years, the Committee is seriously concerned about the very high maternal and infant mortality rates and the high fertility rate, especially among women in rural and remote areas and among ethnic minorities. The Committee is concerned about the lack of health-care facilities and medical professionals in rural villages and remote areas as well as the lack of awareness among women and adolescents regarding reproductive health and family planning, including the use of contraceptives and birth spacing.

97. The Committee recommends that the State party accelerate the implementation of its national population policy, focusing on expanding its network of health-care facilities and personnel throughout the nation and reaching out to rural and remote areas, inter alia to the benefit of ethnic minority women; that it enhance its educational programmes, not only for women, but also for men and adolescents, on reproductive health and family planning; and that it make contraceptives easily available.

•          Croatia, CEDAW, A/60/38 part I (2005) 30 at paras. 194 and 195.

194. The Committee expresses concern about the serious disadvantages women face in the labour market, as reflected in women’s high unemployment rate, the persistence of strong vertical and horizontal segregation, wage differentials between women and men and the predominance of women in low-wage sectors. The Committee expresses its particular concern about the situation of women older than 40 years, as well as the discriminatory treatment of pregnant women in the labour market...

195. The Committee urges the State party to ensure de facto equal opportunities for women and men in the labour market through, inter alia, effective implementation of labour legislation and the use of temporary special measures in accordance with article 4, paragraph 1, of the Convention and the Committee’s general recommendation 25 on temporary special measures. It urges the State party to encourage women to use existing complaints mechanisms in cases of possible labour market discrimination...

•          Paraguay, CEDAW, A/60/38 part I (2005) 44 at paras. 287 and 288.

287. The Committee remains concerned about the persistent high maternal mortality rates, particularly deaths due to illegal abortions, the limited access of women to health care and family planning programmes and the apparently unmet need for contraceptives.

288. The Committee reiterates the recommendation made in its previous concluding comments and urges the State party to act without delay and implement effective measures to deal with the high maternal mortality rate, to prevent women from having to resort to unsafe abortions and to protect them from the negative effects on their health, in line with the Committee’s general recommendation No. 24 on women and health and the Beijing Declaration and Platform for Action. The Committee urges the Government to strengthen the implementation of programmes and policies aimed at providing effective access for women to health-care information and services, in particular regarding reproductive health and affordable contraceptive methods, with the aim of preventing clandestine abortions. It further recommends holding a national consultation with civil society groups, including women’s groups, to address the issue of abortion, which is illegal under the current law and is a cause of women’s high mortality rates.

•          Turkey, CEDAW, A/60/38 part I (2005) 58 at paras. 375 and 376.

375. The Committee notes with concern the persistence of high maternal and infant mortality rates in the State party.

376. The Committee recommends that the State party allocate adequate resources to improve the status of women’s health, in particular with regard to maternal and infant mortality, and make every effort to increase access to health-care facilities and medical assistance from trained personnel, particularly in rural areas and particularly for post-natal care.

•          Democratic People’s Republic of Korea, CEDAW, A/60/38 part II (2005) 101 at para. 32.

32. The Committee welcomes the availability of such support services as nurseries, kindergartens, children’s wards, kitchens in workplaces and breastfeeding breaks for working mothers, as well as the use of temporary special measures to increase the number of women in certain management positions.

•          Lebanon, CEDAW, A/60/38 part II (2005) 109 at paras. 111 and 112.

111. While welcoming the incorporation of reproductive health services into the primary health-care system, the Committee remains concerned that not all women have access to such services, especially in the rural areas. It is also concerned about women’s deaths resulting from clandestine abortions.

112. The Committee urges the Government to strengthen, especially in the rural areas, the implementation of programmes and policies aimed at providing effective access for women to health-care information and services, in particular regarding reproductive health and affordable contraceptive methods, with the aim also of preventing clandestine abortions. The Committee further urges the State party to decriminalize abortion where there are mitigating circumstances. The Committee recommends the implementation of measures to protect women from the negative effects on their health of unsafe abortions, in line with the Committee’s general recommendation 24 on women and health and the Beijing Declaration and Platform for Action.

•          Benin, CEDAW, A/60/38 part II (2005) 116 at paras. 155-158.

155. ...The Committee expresses its concern about the low rate of enrolment of girls in schools, preference for the education of boys and the high dropout rate of girls due to pregnancy and early and forced marriage...

156. The Committee...recommends that the State party take steps to ensure equal access of girls and young women to all levels of education, to retain girls in school and to strengthen the implementation of re-entry policies providing for girls to return to school after pregnancy...

157. While noting the efforts made by the State party to improve reproductive health care to women, the Committee remains concerned about the lack of access to adequate health care for women and girls, particularly in rural areas. It is concerned about the causes of morbidity and mortality in women, particularly the number of deaths due to illegal abortions, and about inadequate family planning services and the low rates of contraceptive use. The Committee expresses its concern that women require the permission of their husbands to obtain contraceptives and family planning services.

158. The Committee recommends that the State party take measures, in accordance with general recommendation 24 on women and health, to improve and increase women’s access to health care and health-related services and information, particularly in rural areas. It calls on the State party to improve the availability of sexual and reproductive health services, including family planning, with the aim also of preventing clandestine abortions, and to make available, without requiring the permission of the husband, contraceptive services to women and girls. It further recommends that sex education be widely promoted and targeted at girls and boys, with special attention to the prevention of early pregnancies and sexually transmitted diseases.

•          Gambia, CEDAW, A/60/38 part II (2005) 122 at paras. 203-206.

203. While recognizing the progress made in lowering maternal mortality from 1,050 per 100,000 live births in 1990 to 730 per 100,000 live births in 2001, and infant mortality from 92 per 1,000 live births in 1990 to 84 live births in 2001, the Committee remains concerned that these rates continue to be very high. The Committee is particularly concerned about the lack of access of women to adequate prenatal and post-natal care.

204. The Committee recommends that the State party make every effort to decrease the high maternal and infant mortality rates, and increase women’s access to health services, including health-care facilities and medical assistance by trained personnel, especially with regard to prenatal and post-natal care. It also calls upon the State party to implement awareness-raising campaigns to enhance women’s knowledge of health issues.

205. ...The Committee is further concerned that women lack access to information and services related to reproductive health and that, although contraceptive use increased from 6.7 per cent in 1990 to 13.4 per cent in 2001, it continues to remain low. The Committee regrets that women’s access to family planning services is, in general, dependent on several social and cultural factors.

206. ...The Committee calls upon the State party to implement measures to guarantee effective access for women, including young women, to reproductive health-care information and services. It further recommends that programmes and policies be adopted to increase knowledge about, and access to, affordable contraceptive methods and to increase the understanding that family planning is the responsibility of both partners. It also encourages the State party to ensure that women have easy access to family planning services. The Committee also recommends that sex education be widely promoted and provided, targeting men and women, and adolescent boys and girls, and including information on the prevention of HIV/AIDS.

•          Israel, CEDAW, A/60/38 part II (2005) 129 at paras. 257 and 258.

257. The Committee is concerned about the number of incidents at Israeli checkpoints which have a negative impact on the rights of Palestinian women, including the right of access to health-care services for pregnant women.

258. The Committee calls upon the State party to ensure that the Israeli authorities at the checkpoints are instructed to ensure access to health-care services for pregnant women, while protecting the security of Israel.

•          Burkina Faso, CEDAW, A/60/38 part II (2005) 144 at paras. 349 and 350.

349. While noting the efforts made by the State party to improve reproductive health care for women, including through subsidizing contraceptives, the Committee remains concerned about the limited access for women to adequate health-care services, including those related to family planning. It is particularly concerned about high rates of fertility, infant and maternal mortality, and death due to clandestine abortions, inadequate family planning services and low rates of contraceptive use. The Committee is further concerned that the report contained insufficient information on the impact of measures taken to reduce infant and maternal mortality rates, and improve access to family planning services. The Committee is concerned about the limited information provided on the prevalence of HIV/AIDS and trends in the spread of the epidemic.

350. The Committee recommends that the State party take measures to improve women’s access to health care and health-related services and information, in accordance with article 12 of the Convention and the Committee’s general recommendation 24 on women and health. It calls upon the State party to improve the availability of sexual and reproductive health services, including family planning, with the aim also of preventing clandestine abortions. It encourages the State party to enhance the availability of contraceptive services. It further recommends that sex education be widely promoted and targeted at girls and boys, with special attention to the prevention of early pregnancies and sexually transmitted diseases...

•          Ireland, CEDAW, A/60/38 part II (2005) 151 at paras. 396 and 397.

396. While acknowledging positive developments in the implementation of article 12 of the Convention, in particular the Strategy to Address the Issue of Crisis Pregnancy (2003) that addresses information, education and advice on contraceptive services, the Committee reiterates its concern about the consequences of the very restrictive abortion laws, under which abortion is prohibited except where it is established as a matter of probability that there is a real and substantial risk to the life of the mother that can be averted only by the termination of her pregnancy.

397. The Committee urges the State party to continue to facilitate a national dialogue on women’s right to reproductive health, including on the very restrictive abortion laws. It also urges the State party to further strengthen family planning services, ensuring their availability to all women and men, young adults and teenagers.

CAT

•          Latvia, CAT, A/59/44 (2003) 48 at para. 98.

98. The Committee notes with appreciation the ongoing efforts by the State party aimed at strengthening human rights in Latvia. In particular, the Committee welcomes the following:

(a) Legislative measures:

...

(vii) The draft new Amnesty Law, providing either for the release or the reduction of the term of imprisonment of those groups at risk, such as minors, pregnant women, women with infant children, disabled persons and the elderly;

...

•          Chile, CAT, A/59/44 (2004) 28 at paras. 54, 56 and 57.

54. The Committee notes the following positive developments:

...

(h) Assurances by the representatives of the State party that mechanisms have been created to ensure that any testimony obtained under torture will not be admissible in court, and their recognition of the serious problem of coercing confessions from women who seek life-saving treatment in public hospitals after illegal abortions;

...

56. The Committee expresses concern about the following:

...

(j) Reports that life-saving medical care for women suffering complications after illegal abortions is administered only on condition that they provide information on those performing such abortions. Such confessions are reportedly used subsequently in legal proceedings against the women and against third parties, in contravention of the provisions of the Convention;

...

57. The Committee recommends that the State party should:

...

(m) Eliminate the practice of extracting confessions for prosecution purposes from women seeking emergency medical care as a result of illegal abortion; investigate and review convictions where statements obtained by coercion in such cases have been admitted into evidence, and take remedial measures including nullifying convictions which are not in conformity with the Convention. In accordance with World Health Organization guidelines, the State party should ensure immediate and unconditional treatment of persons seeking emergency medical care;

...

•          Czech Republic, CAT, A/59/44 (2004) 42 at paras. 86 and 87.

86. The Committee expresses concern about the following:

...

(k) Allegations regarding some incidents of uninformed and involuntary sterilizations of Roma women, as well as the Government’s inability to investigate due to insufficient identification of the individual complainants.

...

87. The Committee recommends that the State party:

...

(n) Investigate claims of involuntary sterilizations, using medical and personnel records, and urge the complainants, to the extent possible, to assist in substantiating the allegations;

...

CRC

•          Kenya, CRC, CRC/C/111 (2001) 21 at paras. 124 and 125.

124. The Committee notes the efforts of the State party to improve health care for children through, inter alia, the Health Policy Framework, the Expanded Programme on Immunization, and the National Plan of Action for Nutrition. However, the Committee is concerned about the insufficient numbers of trained medical personnel; the high maternal, infant, and under-five mortality rates...

125. ...[T]he State party should take all effective measures to increase the numbers of trained medical and other health personnel, including traditional healers; facilitate cooperation between trained medical personnel and traditional healers, especially midwives; reduce the incidence of maternal, infant and under-five mortality...

•          Oman, CRC, CRC/C/111 (2001) 36 at paras. 185 and 186.

185. Noting significant achievements in the reduction of infant and child mortality, and the high levels of immunization coverage, the Committee is concerned that:

...

(b) Thirty per cent of pregnant women and 20 per cent of children under 5 still suffer from anaemia;

(c) Thirty-nine per cent of breastfeeding mothers have vitamin A deficiency; and

...

186. The Committee recommends that the State party:

(a) Make greater efforts to address these issues through continued allocation of the required resources;

(b) Strengthen health and nutrition education such as through public-information campaigns and its inclusion in the curricula; and

(c) Seek assistance from UNICEF and WHO.

•          Portugal, CRC, CRC/C/111 (2001) 48 at paras. 242 and 243.

242. Noting the establishment of a network functioning in cooperation with the Ministries of Health and Education toward education on adolescent health, the Committee remains concerned that the incidence of teenage pregnancies remains high and at the absence of data on abortions.

243. The Committee recommends that the State party:

(a) Take steps to address adolescent health concerns, including teenage pregnancy and sexually transmitted diseases, through, inter alia, sex education, including about birth control measures such as the use of condoms;

(b) Strengthen its mental health and counselling services, ensuring that these are accessible and sensitive to adolescents.

See also:

•          Spain, CRC, CRC/C/118 (2002) 117 at paras. 505 and 506.

•          Paraguay, CRC, CRC/C/111 (2001) 103 at paras. 512 and 513.

512. ...[T]he Committee...notes with concern that pregnant girls are not allowed to stay in school.

513. In light of articles 28 and 29 of the Convention, the Committee recommends that the State party:

...

(b) Ensure regular attendance at schools and the reduction of drop-out rates;

...

•          Uzbekistan, CRC, CRC/C/111 (2001) 117 at paras. 572 and 573.

572. While noting efforts to strengthen the primary health sector, the Committee is nevertheless concerned at the deterioration in the health of the most vulnerable groups, especially women and children, and in particular at:

The high infant mortality rates;

...

The high maternal mortality rates;

...

573. The Committee recommends that the State party:

...

(b) Continue and strengthen implementation of the WHO Promoting Effective Perinatal Care strategy, to address high maternal, infant and child mortality;

...

(d) Implement WHO recommendations and guidelines, such as "Essential newborn care and breastfeeding", "First action plan for food and nutrition", and "Feeding and nutrition of infants and young children", to address nutritional deficiencies;

...

•          Cape Verde, CRC, CRC/C/111 (2001) 135 at paras. 646 and 647.

646. ...The Committee is concerned...at the high rates of teenage pregnancy, the incidence of sexually transmitted diseases, the potential spread of HIV/AIDS and the incidence of unsafe abortions occurring outside the health service structure.

647. The Committee recommends that the State party:

(a) Ensure that its child rights policy takes into consideration the risks faced by adolescents and that every effort is made to ensure that adolescents have access to appropriate health, including mental health, care and legal assistance;

...

(c) Give special attention to teenage pregnancy, sexually transmitted diseases, HIV/AIDS and unsafe abortions, including through the provision of sex education for all adolescents;

(d) Ensure the provision of child-sensitive health assistance, education and counselling, in full respect of the child's right to privacy;

(e) Seek technical assistance from, among others, UNFPA and WHO.

•          Lebanon, CRC, CRC/C/114 (2002) 11 at paras. 70, 73 and 74.

70. The Committee urges the State party:

...

(d) To make greater efforts in the area of prevention [of disabilities] by reviewing, inter alia, health programmes and policies relating to pregnancy, birth and child health; and

...

73. With reference to its previous recommendation ([CRC/C/15/Add.54], paras. 34, 38) the Committee notes the difficulties acknowledged by the State party in enforcing a law prohibiting the free distribution of milk substitutes and notes that the commercial marketing of infant formula is still widespread. It also notes with deep concern that one in every five married women is married to her maternal or paternal cousin or another relative, and that 30 per cent of disabled children are born to consanguineous marriages.

74. The Committee recommends that the State party:

(a) Strengthen its efforts to promote breastfeeding and encourage the introduction of adequate maternity leave for all working mothers in the spirit of article 18(2); and

(b) To disseminate information on the risks to the health of children born to consanguineous marriages and encourage premarital testing.

•          Gabon, CRC, CRC/C/114 (2002) 47 at paras. 217 and 218.

217. While taking note of the adoption of the Ordinance No. 001/95 on health and the establishment of a National Health Plan of Action, and while finding encouraging the new data on mortality rates, the Committee is deeply concerned at the still high infant and under-5 mortality rates and low life expectancy in the State party...Concern is also raised at the very low rate of breastfeeding...

218. The Committee recommends that the State party:

...

(b) Facilitate greater access to primary health services; reduce the incidence of maternal, child and infant mortality; prevent and combat malnutrition, especially among vulnerable and disadvantaged groups of children; and promote proper breastfeeding practices;

...

•          Mozambique, CRC, CRC/C/114 (2002) 65 at para. 295, 296 and 299-302.

295. The Committee is deeply concerned that:

...

(b) Infant and under-5 mortality rates are extremely high;

(c) Maternal mortality is very high, owing in part to insufficient prenatal care and assistance at birth and to the large number of clandestine abortions and the poor conditions in which they are carried out;

(d) The incidence of low birth weight, stunted growth, malaria, diarrhoea respiratory infections and malnutrition is very high.

296. While recognizing the significant progress achieved in the past 10 years and noting recent increases in health investment and immunization rates, the Committee urgently recommends that the State party:

...

(b) Give urgent attention to and design practical measures for reducing infant, under-5 and maternal mortality rates, addressing malnutrition, malaria, diarrhoea and respiratory infections, and ensuring that abortions can be conducted with all due attention to minimum standards of health safety;

(c) Make every effort to improve public knowledge of basic health-care measures, including in the areas of prevention and reproductive health, and provide for the availability of affordable contraception in order to ensure that unwanted pregnancies do not occur.

(d) Seek technical assistance from UNICEF and WHO in this regard.

...

299. While noting the State party’s efforts to establish the “Adolescent and Youth Programme”, the Committee remains concerned at:

(a) The high incidence of adolescent pregnancy and related health concerns;

(b) The high incidence of medical problems related to abortions by adolescent mothers;

...

300. The Committee recommends that the State party:

...

(b) Improve the provision of health care for adolescents, giving particular attention to reproductive health concerns, including in the context of family planning, abortion and sexually transmitted diseases, to mental health and to concerns relating to adolescent development;

...

301. While noting the State party’s efforts in this domain, including the establishment of the National AIDS Council (NAC) in 2000 and the adoption of a comprehensive multisectoral strategic plan to combat HIV/AIDS, the Committee remains deeply concerned at:

...

(c) Mother to child transmission of HIV/AIDS and related factors, such as the lack of access of mothers to affordable breast-milk substitute, which would help reduce the risk of transmission;

...

302. The Committee recommends that the State party:

...

(f) Strengthen efforts to reduce mother to child transmission of HIV/AIDS including through voluntary prenatal HIV/AIDS testing of mothers and assistance to infected mothers in obtaining breast-milk substitutes for their children;

...

•          Chile, CRC, CRC/C/114 (2002) 90 at paras. 369 and 370.

369. The Committee...notes with concern the important number of pregnant children who are excluded from school and that government measures to avoid this situation are not implemented, especially in private schools.

370. In light of articles 28 and 29 of the Convention, the Committee recommends that the State party:

...

(c) Ensure that measures are effectively implemented in order for pregnant girls to continue attending school both during and after their pregnancy;

...

•          Niger, CRC, CRC/C/118 (2002) 37 at paras. 171 and 172.

171. While taking note of the adoption of the National Health Development Plan 1994-2000, and while finding encouraging the new data on mortality rates, the Committee is deeply concerned at the still high infant, under-5, and maternal mortality rates and low life expectancy in the State party. The Committee also remains concerned that health services in the districts and local areas continue to lack adequate resources (both financial and human) and that medicines and care are too expensive and not easily accessible. In addition, the Committee is concerned that the survival and development of children in the State party continue to be threatened by early childhood diseases and that malnutrition is an acute problem. Concerns also exist at the low coverage of vaccination and at the lack of prenatal health care

172. The Committee recommends that the State party:

...

(b) Facilitate greater access to primary health services; reduce the incidence of maternal, child and infant mortality; prevent and combat malnutrition, especially among vulnerable and disadvantaged groups of children; and promote proper breastfeeding practices;

...

(e) Establish midwifery training programs to assure safe home delivery;

...

•          Belarus, CRC, CRC/C/118 (2002) 54 at paras. 241 and 242.

241. The Committee, while noting efforts to reorganize maternity and child care services and various programmes to improve children's health, is concerned about the increase in child morbidity, including the increase of HIV in newborns, the almost epidemic scope of tuberculosis, and the high incidence of iodine deficiency and nutrition problems, especially among children from low-income households and families with three and more children...

242. The Committee recommends that the State party:

(a) Continue to implement the WHO Strategy on Promoting Effective Perinatal Care in order to further decrease maternal, perinatal and infant mortality;

...

(d) Address the increase in HIV in newborns, focusing on the prevention of mother-to-child transmission;

...

•          Saint Vincent and the Grenadines, CRC, CRC/C/118 (2002) 101 at paras. 451 and 452.

451. The Committee is concerned that:

...

(b) The rate of teenage pregnancy is high.

452. The Committee recommends that the State party:

(a) Increase its efforts to promote adolescent health, including mental health, policies, particularly with respect to reproductive health and substance abuse and health education in schools, ensuring the full participation of adolescents;

(b) Consider means of reducing teenage pregnancy, including strengthening reproductive health education for adolescents, and ensure the provision of full health and counselling support for pregnant girls and that these girls are able to continue their formal education.

•          The Netherlands (Antilles), CRC, CRC/C/118 (2002) at paras. 567, 568, 575 and 576.

567. ...[T]he Committee is concerned at the insufficient number of trained medical personnel; the inaccessibility of health services to children not enrolled in the health care system; the very low rates of breastfeeding and the inadequate education of health workers and the general public on the advantages of breastfeeding...

568. The Committee recommends that:

...

(b) Every effort be made to improve public knowledge of basic health-care measures, including prevention and reproductive health, and provide for the affordable availability of contraception so that unwanted pregnancy does not occur;

...

(d) The State party develop a national campaign to inform parents and train professionals on the advantages of breastfeeding and continue and expand to all islands its initiative to introduce “baby friendly” hospitals;

...

575. The Committee welcomes and is encouraged by the introduction of the Foundation Based Education in August 2002, which includes in its curriculum subjects such as Human Rights, Healthy Lifestyles, Reproductive Health and Social Development, and which provides a more participatory approach for children within school life. The Committee remains concerned, however, at:

...

(e) Various forms of discrimination and exclusion which affect the right to education of certain groups of children, such as pregnant adolescents, undocumented children and children with disabilities, reflecting insufficient attention to articles 28 and 29 of the Convention.

576. The Committee recommends that the State party:

...

(e) Ensure that pregnant girls of compulsory school age stay in school and are provided with adequate support mechanisms to continue their education after the child is born;

...

•          Argentina, CRC, CRC/C/121 (2002) 8 at paras. 71, 72, 75 and 76.

71. While noting the decrease in the infant, child and maternal mortality rates, the Committee is nevertheless concerned that the rates remain high and that there are great disparities in these rates, in particular with regard to children from a lower socio-economic background, those living in rural areas, in particular in the northern provinces, and indigenous children. It also notes that 6 out of 10 infant deaths could be avoided by low-cost actions.

72. The Committee recommends that the State party:

...

(b) In order to further decrease child mortality and morbidity and maternal mortality rates, take measures to implement the Reproductive Health and Responsible Procreation Act of July 2000;

(c) Provide adequate antenatal and post-natal health-care services and develop campaigns to inform parents about basic child health and nutrition, the advantages of breastfeeding, hygiene and environmental sanitation, family planning and reproductive health, especially in the provinces.

...

75. The Committee notes with concern the growing number of cases of HIV/AIDS among the youth, notwithstanding the existing National Plan of Action for HIV/AIDS, and reiterates its concern ([CRC/C/15/Add.36], para. 12) about the number of teenage pregnancies, in particular in some of the provinces.

76. The Committee recommends that the State party:

(a) Review and reactivate its programmes against HIV/AIDS and increase its efforts to promote adolescent health policies. Due attention should be given to reproductive health, and the programme of health and sexual education in schools should be further strengthened;

...

(c) Take further measures, including the allocation of adequate human and financial resources, to evaluate the effectiveness of training programmes in health education, in particular as regards reproductive health, and to develop youth-sensitive and confidential counselling, care and rehabilitation facilities that are accessible without parental consent when this is in the best interests of the child;

(d) Seek technical cooperation from, among others, UNFPA, UNICEF, WHO and UNAIDS.

•          United Kingdom of Great Britain and Northern Ireland, CRC, CRC/C/121 (2002) 23 at paras. 133-136.

133. While welcoming the decline in infant mortality rates and the new focus on children in the planning of the national health service, the Committee remains concerned at persisting inequalities in health and access to health services, including mental health services, across the State party linked to socio-economic status and ethnicity (e.g. the high rates of infant mortality among the Irish and Roma travellers), at the relatively low rate of breastfeeding and at the persistence of female genital mutilation despite its illegality.

134. The Committee recommends that the State party take all appropriate measures to reduce inequalities in health and access to health services, to promote breastfeeding and adopt the International Code for Marketing of Breast-milk Substitutes, and to enforce, through educational and other measures, the prohibition of female genital mutilation.

135. While noting the efforts undertaken by the State party to reduce the number of teenage pregnancies, the Committee remains concerned at the high rate of teenage pregnancies in the State party...

136. In line with its previous recommendations ([CRC/C/15/Add.34], para. 30), the Committee recommends that the State party:

(a) Take further necessary measures to reduce the rate of teenage pregnancies through, inter alia, making health education, including sex education, part of the school curricula, making contraception available to all children, and improving access to confidential and adolescent-sensitive advice and information and other appropriate support (as recommended by the independent Advisory Group on Teenage Pregnancy);

(b) Review its policies for young mothers under the age of 16 years with regard to allowance entitlements and parenting courses;

...

•          Seychelles, CRC, CRC/C/121 (2002) 41 at paras. 205 and 206.

205. The Committee is concerned that:

...

(b) The rate of teenage pregnancies and illegal abortions is high;

(c) Adolescents do not have full access to reproductive health counselling and services.

206. The Committee recommends that the State party:

(a) Increase its efforts to promote adolescent health, including mental health, by focusing, in particular, on the issues of reproductive health, substance abuse and health education in schools and institutions;

(b) Consider means of reducing teenage pregnancy, including through strengthened reproductive health education and access to contraception without parental consent for adolescents;

(c) Ensure the provision of comprehensive health services, counselling and support for pregnant girls.

•          Sudan, CRC, CRC/C/121 (2002) 53 at paras. 256 and 257.

256. The Committee is concerned that:

...

(b) The severe legal penalties applied to women who become pregnant outside of marriage are such that many women and adolescent girls seek to conceal their pregnancies and then abandon their newborn children, and that the survival rate of these children is extremely low.

257. The Committee recommends that the State party:

...

(b) Give particular attention to the protection of children born out of wedlock and ensure that their mothers receive protection and support.

•          Ukraine, CRC, CRC/C/121 (2002) 70 at paras. 350 and 352.

350. ...The Committee is...concerned about the large number of teenage abortions, this being the principal cause of maternal mortality.

...

352. The Committee recommends that the State party:

...

(b) Ensure that adolescents have access to and are provided with education on reproductive health and other adolescent health issues, including mental health, as well as with child-sensitive and confidential counselling services;

...

•          Poland, CRC, CRC/C/121 (2002) 120 at paras. 531, 532, 535 and 536.

531. While encouraged that health indicators of children are good and continuously improving, the Committee is nevertheless concerned at the increase in unhealthy behaviours and lifestyle trends, as well as at the low percentage of mothers continuing to breastfeed.

532. The Committee recommends that the State party:

...

(b) Take steps to encourage and educate mothers on the benefits of exclusive breastfeeding of infants for the first six months and of continued breastfeeding for two years.

...

535. The Committee is concerned that:

(a) The rate of teenage pregnancies is relatively high and that adolescents have limited access to reproductive health education or services;

...

536. The Committee recommends that the State party institute health education and awareness programmes specifically for adolescents on sexual and reproductive health and the dangers of smoking and drug and alcohol abuse in schools, community clubs, family centres and other institutions working with children.

•          Republic of Korea, CRC, CRC/124 (2003) 24 at paras. 126 and 127.

126. The Committee is encouraged by the very positive health indicators for children...The Committee is...concerned that the proportion of mothers breastfeeding their children declined significantly during the 1990s...

127. The Committee recommends that the State party:

...

(b) Take steps to encourage and educate mothers on the benefits of exclusive breastfeeding of infants during the first six months and adopt a national code on breastfeeding;

(c) Take effective measures to counteract any negative impact on the employment of women who breastfeed their children;

...

•          Italy, CRC, CRC/124 (2003) 36 at paras. 182 and 183.

182. The Committee is concerned at the high prevalence of psychological disorders among adolescents (especially eating disorders) and the relatively high incidence of abortions among adolescents, notably those of foreign origin.

183. The Committee recommends that the State party:

...

(b) Take further necessary measures to reduce the rate of teenage pregnancies through, inter alia, making health education, including sex education, part of the school curricula and strengthening the campaign of information on the use of contraceptives.

•          Romania, CRC, CRC/124 (2003) 49 at paras. 244 and 245.

244. The Committee is concerned at:

...

(c) The high number of young mothers and of abortions among teenage girls;

...

245. The Committee recommends that the State party:

...

(b) Establish comprehensive family planning programmes, as well as undertake measures to ensure that abortion is neither perceived nor practised as a method of contraception, such as through campaigns to raise awareness of the importance of contraceptive use to reduce the number of unwanted pregnancies;

...

•          Viet Nam, CRC, CRC/C/124 (2003) 67 at paras. 304 and 305.

304. The Committee notes with appreciation the extremely high rate of immunization coverage in the State party. While the maternal mortality rate is declining, the Committee is nevertheless concerned at the persistently high rates of maternal mortality, infant mortality and under-5 mortality, as well as the high rates of malnutrition among children, the frequency of anaemia amongst pregnant women, and the low proportion of women who breastfeed their children exclusively for the first six months. In general, it appears that antenatal care is inadequate, primarily because of a lack of access to such services and clinics...

305. The Committee recommends that the State party:

...

(b) Take steps to encourage and educate mothers, as well as village health workers and traditional birth attendants, on the benefits of exclusive breastfeeding of infants for the first six months and take measures to limit the distribution of infant formulas, for instance through the formulation of a national marketing code;

(c) Increase the resources available to district health centres and commune health stations and ensure that they have adequate human and material resources, in particular for maternal health and care of newborns;

...

•          Haiti, CRC, CRC/124 (2003) 95 at paras. 436 and 437.

436. The Committee welcomes the efforts undertaken by the State party in the area of basic health and welfare, such as the expanded programme of immunization, the participation in the Integrated Management of Childhood Illness and the Baby Friendly Hospital Initiative and the promotion of breastfeeding, but remains deeply concerned at the high infant, under-5 and maternal mortality rates and low life expectancy in the State party...

437. The Committee recommends that the State party, by, inter alia, implementing as soon as possible its National Health Plan:

...

(b) Facilitate greater access to primary health services, notably in rural areas; reduce the incidence of maternal, child and infant mortality; prevent and combat malnutrition, especially among vulnerable and disadvantaged groups of children; and continue to promote proper breastfeeding practices;

...

(d) Establish midwifery training programmes to assure safe home delivery;

...

•          Sri Lanka, CRC, CRC/C/132 (2003) 48 at paras. 265 and 266.

265. While acknowledging the improvements in mortality rates and immunization coverage, the Committee remains concerned at the high levels of child malnutrition, the significant proportion of children born with low birth weight, the prevalence of mosquito-borne diseases, including malaria, and the lack of access to safe drinking water and sanitation, particularly in conflict-affected areas.

266. The Committee recommends that the State party:

(a) Ensure universal access to maternal and child health-care services and facilities throughout the country with special attention to conflict-affected areas;

...

(c) Strengthen ongoing efforts to prevent malnutrition, malaria and other mosquito-borne diseases and continue to promote exclusive breastfeeding for the first six months of an infant’s life, and extend these programmes to all conflict-affected areas;

(d) Seek technical assistance from, among others, UNICEF.

•          Solomon Islands, CRC, CRC/C/132 (2003) 58 at paras. 323-326.

323. The Committee is deeply concerned:

...

(d) At the unavailability of accurate and updated health indicators due to poor birth and death registrations;

(e) At the high incidence of malnutrition/undernutrition.

324. The Committee urgently recommends that the State party:

...

(c) Establish appropriate mechanisms to assess important health indicators, inter alia, the infant mortality rate;

(d) Take measures to address malnutrition and undernutrition in children, pregnant women and breastfeeding mothers;

...

325. The Committee is concerned that:

...

(b) Adolescents remain extremely vulnerable to STIs and that girls are not protected from the risk of pregnancy;

...

326. The Committee recommends that the State party:

...

(b) Address the needs of adolescent mothers and those who have contracted STIs;

...

•          Jamaica, CRC, CRC/C/132 (2003) 86 at paras. 436 and 437.

436. The Committee is concerned that:

...

(b) The rate of teenage pregnancy and number of very young mothers are disturbingly high.

437. With reference to the concluding observations of the Committee on Economic, Social and Cultural Rights (E/C.12/1/Add.75) and the Committee on the Elimination of Discrimination against Women (A/56/38, paras. 195-233), the Committee recommends that the State party:

...

(b) Consider means of reducing teenage pregnancy, including by strengthening reproductive health education and education in family planning for adolescents as well as campaigns and education programmes to change attitudes towards fertility and sexuality, and ensure the provision of full health and counselling support for pregnant girls and that these girls are able to continue their formal education.

•          Syrian Arab Republic, CRC, CRC/C/132 (2003) 116 at paras. 566 and 567.

566. The Committee welcomes the adoption of the Integrated Management of Childhood Illnesses strategy and the State party’s support for various initiatives, such as the Community School Initiative and “healthy villages” and notes the achievements in child and maternal health, as indicated in recent multiple indicator cluster surveys. But it is still concerned:

...

(b) That about 14 per cent of births are not attended by trained health personnel;

...

567. The Committee recommends that the State party:

(a) Ensure that its commitment to public primary health care is matched by adequate allocations of human and financial resources and that all children, especially in rural areas, have access to health care;

...

•          Kazakhstan, CRC, CRC/C/132 (2003) 129 at paras. 621 and 622.

621. The Committee welcomes the information contained in the State party’s report that principles of legislation governing the family have been brought into line with the principles and provisions of the Convention; it also welcomes the expansion in recent years of advice centres for families. The Committee shares the serious concern of the State party relating to the extremely large number of abandoned children becoming de facto orphans because of the rising number of families experiencing difficulties due to socio-economic circumstances. In addition, the Committee is also concerned that limiting the duration of maternity leave, abolishing family leave, as well as abolishing or failing to pay many benefits to women with small children, put additional strain on families.

622. In light of article 18, the Committee recommends that the State party:

(a) Take all effective measures, including the development of strategies and awareness-raising activities, to reduce and prevent the abandonment of children;

(b) Promote the family as the best environment for the child and provide counselling and community-based programmes to assist parents to keep children at home;

(c) Improve social assistance an support to families through advice and parenting education to promote positive child-parent relationships and increase financial support and other benefits for families with children, in particular for those living in poverty.

•          New Zealand, CRC, CRC/C/133 (2003) 27 at paras. 155 and 156.

155. ...The Committee is...concerned that the policy on exclusions, as well as increasing hidden costs of education are limiting access to education, particularly for Maori children, pregnant girls, children with special educational needs, lower-income families, non-citizens and new immigrants.

156. The Committee recommends that the State party:

...

(b) Enforce legislation on compulsory education and prohibit exclusions on arbitrary grounds such as pregnancy, and ensure that students of the age of compulsory education who have legitimately been excluded from a school are enrolled elsewhere;

...

            •          Pakistan, CRC, CRC/C/133 (2003) 37 at paras. 218 and 219.

218. The Committee notes the efforts of the State party in the area of basic health and welfare, such as the immunization and control of diarrhoeal diseases programmes and the consequent decreases in polio and the infant mortality rate. The Committee also welcomes the promulgation of the Protection of Breastfeeding and Young Child Nutrition Ordinance (2002). Nonetheless, the Committee is extremely concerned at the very poor health situation of children and the unavailability of health-care services in the State party for them. Particular matters of concern are:

...

(c) The still very high infant, under-5 and maternal mortality rates, due partly to weak antenatal and postnatal care and maternal malnutrition;

...

219. The Committee recommends that the State party:

...

(c) Continue and strengthen efforts to decrease the infant, under-5 and maternal mortality rates by, inter alia, providing adequate ante- and post-natal care;

(d) Expand programmes to alleviate widespread child and maternal malnutrition and its serious consequences on health and psychological development, notably by promoting breastfeeding;

...

•          Singapore, CRC, CRC/C/133 (2003) 84 at para. 421 and 422.

421. The Committee notes with appreciation the excellent level of health indicators for children and the wide availability of high-quality health-care services... However, it remains concerned that the incidence of exclusive breastfeeding is relatively low and that youth suicide rates are on the rise.

422. The Committee recommends that the State party:

(a) Strengthen its efforts to promote exclusive breastfeeding during the first six months of an infant’s life through, inter alia, the adoption and implementation of the International Code of Marketing of Breast Milk Substitutes, obtaining certification for hospitals as baby-friendly hospitals and extending maternity leave;

...

•          Bangladesh, CRC, CRC/C/133 (2003) 93 at paras. 483 and 484.

483. The Committee notes with appreciation the efforts undertaken and the achievements made by the State party to reduce infant and under-5 mortality rates, as well as the eradication of polio and the improved immunization coverage. Nevertheless, the Committee remains deeply concerned:

...

(b) At the unhygienic practices surrounding childbirth, which results in, among other things, tetanus, and at the lack of prenatal care;

(c) At the low level of exclusive breastfeeding, which contributes to malnutrition;

...

484. The Committee recommends that the State party:

...

(b) Facilitate greater access to free primary health services throughout the country as well as prevent and combat malnutrition, paying particular attention to pre- and antenatal care for both children and their mothers;

(c) Enhance its efforts to promote proper breastfeeding practices;

...

•          Indonesia, CRC, CRC/C/137 (2004) 8 at paras. 75, 77, 81 and 83.

75. While acknowledging the improvements in budget allocations to the health-care sector, the Committee remains concerned at the high maternal mortality rate, incidence of child malnutrition, proportion of children born with low birth weight and prevalence of infectious and, mosquito-borne diseases, including malaria...

...

77. The Committee recommends that the State party:

(a) Ensure universal access to primary health care, especially maternal and child health-care services and facilities, including in rural and conflict-affected areas;

...

(c) Strengthen existing efforts to prevent malnutrition, malaria and other mosquito-borne diseases, to immunize as many children and mothers as possible, to make condoms and other contraceptives available throughout the country and to promote breastfeeding, and extend these programmes to all conflict-affected areas;

...

81. ...[T]he Committee is very concerned:

...

(c) That married children and pregnant teenagers do not generally continue their education;

...

83. The Committee recommends that the State party:

...

(e) Provide education opportunities for married children and pregnant teenagers;

...

•          Guyana, CRC, CRC/C/137 (2004) 26 at paras. 157-159 and 163.

157. The Committee recommends that the State party:

(a) Take all necessary measures to reduce mortality rates by improving prenatal care and preventing communicable diseases;

...

(d) Continue to encourage exclusive breastfeeding for six months with appropriate introduction of infant diet thereafter, taking into account the support needed for working mothers.

158. The Committee is concerned at the high rate of teenage pregnancies...among adolescents.

159. The Committee recommends that the State party set up adequate services for adolescents, including mental health and reproductive health services...

...

163. The Committee recommends that the State party:

...

(b) Ensure that pregnant teenagers are given an opportunity to complete their education;

...

•          Armenia, CRC, CRC/C/137 (2004) 36 at paras. 222-225.

222. While welcoming the adoption in March 2003 of a programme to provide free medical care, including dental care, for children up to the age of 15 and free inpatient medical care to children belonging to underprivileged groups up to the age of 18, the Committee reiterates its concern regarding the deterioration in the health system in the State party following cuts in public expenditure on the health system. In this regard, the Committee notes with concern that infant and maternal mortality rates remain high...

223. The Committee urges the State party to:

(a) Increase allocation of resources towards an effective primary health-care system;

(b) Facilitate greater accessibility of health services, in particular in rural areas, including access to prenatal clinics and maternity hospitals;

(c) Take measures to reduce child and infant mortality rates and combat tuberculosis;

(d) Take measures to improve children’s nutrition, including education on proper breastfeeding practices among mothers, and to remedy inequalities in access, availability and affordability of nutritious food;

...

224. The Committee reiterates its concern regarding the high incidence of teenage pregnancies and the consequent high rate of abortions among girls under 18, especially illegal abortions... The Committee welcomes, in this regard, the legislative measures taken in the area of reproductive health and HIV/AIDS prevention in 2002, such as the Reproductive Health and Human Reproductive Rights Act...

225. The Committee recommends that the State party reinforce its efforts to reduce the number of teenage pregnancies and combat HIV/AIDS and other sexually transmitted diseases, including by ensuring that adolescents are provided with reproductive health education and child-friendly counselling services.

•          Germany, CRC, CRC/C/137 (2004) 51 at paras. 285, 293 and 294.

285. The Committee notes with appreciation the adoption of the third law to amend the federal law on child benefits (entered into force on 1 January 2001) which improves the possibility for both parents to take parental leave...

...

293. The Committee expresses its concerns at the widespread abuse of drugs, alcohol and tobacco among children; at the high incidence of infants born with the foetal alcohol syndrome...

294. The Committee recommends that the State party take all necessary measures to combat the abuse of drugs and alcohol among children and parents by, inter alia, undertaking intensive education campaigns and setting up adequate rehabilitation services.

•          The Netherlands (Netherlands and Aruba), CRC, CRC/C/137 (2004) 63 at paras. 362-365.

362. The Committee welcomes the low infant and child mortality rates in all parts of the State party, but is concerned about the relatively low vaccination rates among some religious groups. The Committee is also concerned that HIV/AIDS infection rates for mothers and children are on the rise.

363. The Committee recommends that the State party:

...

(b) Take all necessary measures to reduce mother-to-child transmission of HIV/AIDS, including but not limited to the use of antiretroviral drugs for pregnant mothers who are HIV-positive.

364. The Committee is...concerned that teenage pregnancies and sexually transmitted infections are on the rise in the Netherlands, and that in Aruba there are limited services for teenage mothers, who are sometimes excluded from schools.

365. The Committee recommends that the State party:

...

(c) Strengthen programmes on sex education, including in schools, and reproductive health counselling for adolescents and take effective measures to prevent early pregnancy;

(d) Provide teenage mothers in Aruba with the appropriate assistance and ensure that they can finish their education.

•          India, CRC, CRC/C/137 (2004) 75 at paras. 381, 411, 412, 430 and 431.

381. The Committee welcomes the many activities undertaken at the federal and State level for the implementation of the Convention, inter alia:

...

(b) The adoption of the 2003 amendment to the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994;

...

411. The Committee notes the 2003 amendment to the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994, but remains deeply concerned that the sex ratio in the age group 0-6 years has worsened over the past decade.

412. In addition to its recommendations regarding gender discrimination, the Committee strongly recommends that the State party:

(a) Take all necessary steps to ensure the implementation of the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994;

(b) Further develop massive awareness campaigns, involving parents, communities, law enforcement officers, etc., and take the necessary measures, including imposing sanctions to end the practice of selective abortions and female infanticide; and

(c) Undertake gender impact studies when planning programmes relating to economic and social policies.

...

430. The Committee notes the numerous national plans and programmes initiated during the 9th and 10th five-year plans to address health issues. Nevertheless, it remains seriously concerned at the unavailability and/or inaccessibility of free, high quality primary health care; the slow decline in infant mortality; the worsening maternal mortality rates, due in part to the high increase of unattended home deliveries; the low immunization rate; the high incidence of low-birth-weight babies; the high number of children with stunting, wasting, or who are underweight; the prevalence of micronutrient deficiencies; and the low rate of exclusive breastfeeding and appropriate introduction of infant diet...

431. The Committee recommends that the State party reinforce its efforts in developing effective policies and programmes to improve the health situation of children. It also recommends that the State party ensure access for all children to primary, free and quality health services; regulate and monitor traditional and modern medicinal practice; combat malnutrition; promote healthy nutrition habits, including breastfeeding; improve immunization rates; increase access to safe drinking water and adequate sanitation; and address the issue of environmental pollution effectively. Additionally, the Committee encourages the State party to pursue additional avenues of cooperation and assistance for child health improvement with, inter alia, WHO and UNICEF.

•          Papua New Guinea, CRC, CRC/C/137 (2004) 94 at paras. 510-513.

510. While noting the encouraging downward trend in infant mortality rates and the improvement in vaccination coverage, the Committee is concerned at the high maternal mortality rate due in part to the high number of unattended deliveries, the inaccessible and unsatisfactory health-care facilities, the prevalence of malaria, the high incidence of malnutrition and micronutrient deficiencies among mothers and children, and the limited availability of safe drinking water and adequate sanitation.

511. The Committee recommends that the State party:

(a) Strengthen its efforts to provide all communities with accessible and high-quality health-care facilities;

(b) Improve training efforts of local midwives, thereby promoting safe deliveries;

(c) Address the issue of malnutrition and micronutrient deficiencies through education and promotion of healthy feeding practices, including breastfeeding;

...

512. The Committee is concerned that insufficient attention has been given to adolescent health issues, including access to information and services related to adolescent health in general and reproductive health in particular. It is also concerned that adolescents remain extremely vulnerable to contracting sexually transmitted diseases, that girls are not protected from the risk of pregnancy and at the practice of clandestine abortions involving adolescent girls.

513. The Committee recommends that the State party undertake all necessary measures to formulate and implement adequate health policies and programmes by making available reproductive health services, including education and the promotion of safe sexual practices.

•          Slovenia, CRC, CRC/C/137 (2004) 104 at paras. 575 and 576.

575. While acknowledging the measures taken by the State party to ensure that basic health care is provided for the most vulnerable groups in society and the overall good health indicators in Slovenia, the Committee is concerned at the relatively poor health situation of some children, particularly those belonging to the Roma community, and the relatively high maternal mortality rate...

576. The Committee recommends that the State party give priority attention to identifying and addressing the causes of the poor health situation of some children, particularly Roma children, and the high maternal mortality rate...

•          El Salvador, CRC, CRC/C/140 (2004) 8 at paras. 71 and 72.

71. The Committee welcomes the improvement of primary health care, which has led to a decrease in infant mortality from 35 per thousand live births in 1998 to 25 in 2003. It is, however, concerned that infant mortality rates and other health indicators are significantly worse in some departments of the State party...Furthermore, the Committee is concerned at the low prevalence of breastfeeding.

72. The Committee recommends that the State party continue to strengthen its efforts in improving the health situation of children in the State party and eliminating all restrictions on the access to quality health services in all areas of the country, in particular rural areas, so as to level out health disparities. Furthermore, the State party is requested to improve the nutritional status of children and to encourage exclusive breastfeeding for six months after birth with the addition of appropriate infant diet thereafter.

•          Panama, CRC, CRC/C/140 (2004)23 at paras. 114, 115, 136 and 137.

114. The Committee expresses its concern that the Family Code allows marriage to be contracted by children as young as 14 if they have reached puberty or have had a child together or if the girl is pregnant.

115. The Committee recommends that the State party review the rules governing the contracting of marriage between children under 18, with a view to increasing the minimum age for marriage between under-age children who have had children together. This age should be the same for boys and girls. Awareness-raising campaigns and other measures should be undertaken to prevent early marriages.

...

136. The Committee welcomes the considerable reduction in levels of child mortality and the eradication of several communicable diseases, but is concerned that this progress has not been accompanied by a similar reduction in the rate of maternal mortality and that there is a significant discrepancy in the mortality indicators between urban and rural areas. The Committee is concerned that breastfeeding is not widely used.

137. The Committee strongly recommends that the State party continue to strengthen its efforts in health reform, in particular with regard to primary health care, ensuring accessibility of quality health care in all areas in the country, including far-reaching programmes, training of local villagers in safe midwifery and providing adequate prenatal care. The Committee further recommends that the State party encourage exclusive breastfeeding for six months after birth, with the addition of an appropriate infant diet thereafter.

•          Rwanda, CRC, CRC/C/140 (2004) 36 at paras. 207 and 208.

207. While taking note of the adoption of, inter alia, the National Health Policy 2002 and Vision 2020, the Committee is deeply concerned at the still high infant, under-five, and maternal mortality rates and the low life expectancy in the State party... Concerns also exist at the lack of prenatal health care.

208. The Committee recommends that the State party:

...

(b) Facilitate greater access to primary health services; reduce the incidence of maternal, child and infant mortality; prevent and combat malnutrition, especially among vulnerable and disadvantaged groups of children; and promote proper breastfeeding practices;

...

(d) Establish midwifery training programmes to ensure safe home delivery;

...

•          Sao Tome and Principe, CRC, CRC/C/140 (2004) 54 at paras. 285 and 286.

285. The Committee notes with interest the Reproductive Health Programme. However, the Committee is concerned that:

...

(c) The rate of teenage pregnancies is high;

...

286. The Committee recommends that the State party:

...

(b) Promote collaboration between State agencies and NGOs in order to establish a system of formal and informal education on HIV/AIDS and STIs, on sex education and on family planning;

...

(d) Ensure access to reproductive health counselling and information and services for all adolescents;

...

•          Dominica, CRC, CRC/C/140 (2004) 101 at paras. 499 and 500.

499. ...[T]he Committee is deeply concerned about the quality of education, access to education by pregnant girls and teenage mothers and the high drop-out rate, in particular among boys.

500. The Committee recommends that the State party, in the light of the Committee’s General Comment No. 1 (2001) on the aims of education:

...

(d) Provide education opportunities for pregnant girls and teenager mothers so that they can complete their education;

...

•          Democratic People’s Republic of Korea, CRC, CRC/C/140 (2004) 111 at paras. 561 and 562.

561. While noting that health services are free and cover all areas of the country, the Committee is concerned about increasing infant and child mortality rates, high rates of malnutrition and stunting in children, alarming increases in maternal mortality rates and due to the high rate of voluntary termination of pregnancy...

562. The Committee recommends that the State party:

(a) Take all necessary measures to improve the quality of its health system and its health expenditures, reducing infant, child and maternal mortality rates, preventing communicable diseases by stepping up immunization programmes, preventing and treating diarrhoeal diseases and acute respiratory tract infections and malaria, among others;

(b) Improve accessibility to information on family planning and availability of contraceptives;

...

•          France, CRC, CRC/C/140 (2004) 124 at paras. 621-624.

621. The Committee welcomes the information contained in the State party’s report related to the protection of mothers, infants and school-age children. However, the Committee notes that this aspect of health care and services is the responsibility of departments, and, in this respect, is concerned at possible inequalities among the various regions. The Committee is concerned, in particular, at the:

...

(c) Lack of a national body to promote and encourage exclusive breastfeeding.

622. The Committee recommends that the State party:

...

(b) Establish a national mechanism for the promotion of breastfeeding, including evaluation and coordination.

623. The Committee welcomes the Conference on the family focusing on adolescents scheduled to take place in June 2004 and the legislative measures and other actions of the State party, such as that to reduce the use of tobacco, in particular among children under 16 years of age. It notes the concern of the State party with respect to the...relatively high number of teenage pregnancies, insufficient mental health services and to the fact that health services provided may not be tailored to the need of adolescents, thus reducing their willingness to access primary health services.

624. The Committee recommends that the State party increase its efforts to promote adolescent health policies and strengthen the programme of health education in schools. It further recommends measures, including the allocation of adequate human and financial resources, to evaluate the effectiveness of training programmes in health education, in particular as regards reproductive health, and to develop youth-sensitive and confidential counselling, care and rehabilitation facilities that are accessible without parental consent when this is in the best interests of the child...

•          Botswana, CRC, CRC/C/143 (2004) 25 at paras. 149, 150 and 153-156.

149. The Committee notes with appreciation the developments in the primary health care strategy, notably the decentralization and mobile units as well as the dialogue conducted with traditional leaders to ensure that health care strategies are complementary. Nevertheless, it remains concerned at the regional disparities in the health service provisions as well as the still high maternal mortality rates.

150. The Committee recommends that the State party continue to strengthen its primary health care strategy by ensuring adequate staffing and providing the highest attainable standard of health for all children. The Committee recommends that the State party reduce regional disparities and lower maternal mortality rates by improving prenatal care services and providing training of birth attendants in healthy midwifery practices.

...

153. The Committee is concerned at the high incidence of teenage pregnancies, the inadequate reproductive health services and at the lack of mental health services for adolescents.

154. In the light of general comment No. 4 on adolescent health and development in the context of the Convention on the Rights of the Child (CRC/GC/2003/4), the Committee recommends that the State party establish adequate health care services for adolescents, focusing on reproductive and mental health programmes.

155. ...The Committee is...concerned that primary education is not compulsory and at the high dropout rates in particular of girls in secondary schools, partly due to pregnancies.

156. The Committee recommends that the State party:

...

(b) Continue to strengthen the activities providing pregnant girls with ongoing access to education (before and after giving birth);

...

•          Croatia, CRC, CRC/C/143 (2004) 36 at paras. 218 and 219.

218. The Committee...is also concerned about the effective implementation of breastfeeding programmes and that the “happy baby package” contains material that is not consistent with the International Code of Marketing of Breastmilk Substitutes...

219. ...The Committee...recommends that the State party enhance its efforts to promote proper breastfeeding practices, including by complying with the International Code of Marketing, and ensure the effective implementation of breastfeeding programmes in accordance with international standards...

•          Angola, CRC, CRC/C/143 (2004) 78 at paras. 419-422.

419. The Committee expresses its deep concern at the alarming levels of mortality among children, with 25 per cent of children dying before they reach the age of 5. It notes that the main causes of child mortality are related to malaria, diarrhoeal diseases, acute respiratory diseases and vaccine-preventable diseases. The Committee is also concerned about the fact that a majority of children do not have access to adequate heath services, the high level of malnutrition among children, the lack of access to safe drinking water and proper sanitation, and inadequate breastfeeding practices among women.

420. The Committee urges the State party to strengthen its efforts to improve the health situation of children in the State party, including through:

(a) A continuation and strengthening of its efforts to ensure that all children have access to basic health-care services;

(b) Strengthening vaccination programmes;

(c) Improving the nutritional status of children;

(d) Active promotion of exclusive breastfeeding for six months after birth, with the addition of appropriate infant diet thereafter.

421. The Committee is concerned at the lack of adolescent health services and the large number of teenage pregnancies.

422. The Committee recommends that the State party pay close attention to adolescent health, taking into account the Committee’s general comment No. 4 on adolescent health and development. In particular, the State party should strengthen sexual and reproductive health education for adolescents, including family planning measures, especially in schools and out-of-school programmes, with a view to reducing the incidence of teenage pregnancy, and provide pregnant teenage girls with the necessary assistance and access to health care and education...

•          Antigua and Barbuda, CRC, CRC/C/143 (2004) 93 at paras. 510 and 511.

510. The Committee is...concerned that a significant number of pregnant teenagers do not generally continue their education, and that the Golden Opportunity Programme initiated by the Ministry of Education seems to have had little success. The Committee is also concerned that girls and young women are often forced to leave school because of pregnancy.

511. The Committee recommends that the State party carefully examine the budgetary allocations for and measures taken within the field with regard to their impact on the progressive implementation of the child’s right to education and leisure activities. In particular, the Committee recommends that the State party:

...

(c) Provide education opportunities for pregnant teenagers;

...

•          Sweden, CRC, CRC/C/146 (2005) 8 at paras. 57 and 58.

57. The Committee welcomes the efforts taken with regard to sex education in schools, drug and tobacco use and alcohol abuse. However, the Committee remains concerned about the sharp increase in 2002 in abortions among teenagers...

58. The Committee recommends that the State party increase its efforts to promote adolescent health policies and strengthen the programme of health education in schools. It further recommends measures, including the allocation of adequate human and financial resources, to evaluate the effectiveness of training programmes in health education, in particular as regards reproductive health, and to develop youth-sensitive and confidential counselling, care and rehabilitation facilities that are accessible without parental consent when this is in the best interests of the child...

•          Albania, CRC, CRC/C/146 (2005) 19 at paras. 131 and 132.

131. The Committee...notes the concern of the State party that abortion may still be used as a family planning method and that the abortion rates are alarmingly high.

132. The Committee recommends that the State party:

...

(d) Provide access to information on reproductive health and family planning with a view to improving the practice in these areas, including the reduction of recourse to abortion as a method of family planning;

...

•          Luxembourg, CRC, CRC/C/146 (2005) 36 at para. 159.

159. The Committee notes with appreciation:

...

(d) The following legislative measures:

...

(iv) Act of 1 August 2001 on the protection of pregnant workers and workers who have recently given birth or are breastfeeding;

...

•          Belize, CRC, CRC/C/146 (2005) 59 at paras. 344, 345, 353 and 354.

344. The Committee welcomes the revised and expanded Care and Growth Chart, which provides a detailed and personal health and development record for all children under 5 years of age. While noting with appreciation the State party’s efforts to improve the primary health care, including the establishment of the National Health Insurance Scheme and the School Health and Physical Education Services (SHAPES) programme, the Committee is nevertheless concerned at the regional disparities in accessibility to health services, the high number of infant deaths and regional differences in this respect, and the situation of malnutrition among infants and children... Furthermore, the Committee reiterates its concern at the low prevalence of breastfeeding.

345. The Committee recommends that the State party:

...

(b) Continue its efforts to improve prenatal care, including training programmes for midwives and traditional birth attendants, and take all necessary measures to reduce infant mortality rates, especially in rural areas;

(c) Improve the nutritional status of infants and children, inter alia, through the SHAPES programme;

...

(e) Strengthen its efforts to implement the National Breastfeeding Policy, adopted in 1998, and encourage exclusive breastfeeding for six months after birth with the addition of an appropriate infant diet thereafter;

(f) Seek international assistance, including from UNICEF and WHO, to that effect.

...

353. The Committee is concerned at the discrepancies in the implementation of national policies and principles on education in public and private schools, including the church-based schools. With respect to the treatment of pregnant students and teenage mothers in schools, the Committee expresses its grave concern that the State party does not have a policy to prevent and combat the school-based practices of educational exclusion of these students...

354. The Committee recommends that the State party allocate adequate financial, technical and human resources in order:

...

(e) To address the educational needs of pregnant students and teenage mothers in schools and to introduce a national policy on equal treatment of all students in respect of their right to education at all levels;

...

•          Togo, CRC, CRC/C/146 (2005) 104 at paras. 543, 544, 563, 564, 567 and 568.

543. The Committee is deeply concerned about reports of killing, in certain areas, of children born with disabilities, malformations, skin discoloration, as well as of children born with teeth, or from mothers who died during delivery.

544. While taking note of the discussions that took place with the authors of these killings, the Committee urges the State party urgently to take all necessary measures to prevent their occurrence, to prosecute those responsible for such crimes and to raise awareness among the population at large of the need to eradicate such practices.

...

563. While acknowledging the improvements in the health-care sector, in particular the establishment of clinics in rural areas and the activities implemented to improve the nutrition of children, the Committee is particularly concerned at the increasing infant mortality rate, the high child and maternal mortality rates, the low birth weight, child malnutrition, the low breastfeeding rate, the low rate of immunization, the prevalence of infectious diseases, mosquito-born diseases, including malaria, and the lack of access to safe drinking water and sanitation...

564. The Committee recommends that the State party:

(a) Develop and implement a long-term comprehensive policy with a strong emphasis on early childhood development and community health in which measures will be taken:

(i) To decrease reduce significantly infant and maternal mortality rates;

(ii) To ensure universal access to maternal and child health-care services and facilities, including in rural areas;

...

(vii) To promote exclusive breastfeeding until the age of 6 months;

(b) Seek in this regard technical assistance from, among others, UNICEF.

...

567. While noting the existence of a family planning information programme, the Committee remains concerned at the large number of early pregnancies. The Committee is further concerned that this issue remains a problem for adolescents and that there is no organized system of reproductive health counselling and services, nor education on sexually transmitted infections for youth.

568. The Committee recommends that the State party develop a comprehensive policy on adolescent health that promotes collaboration between State agencies and NGOs in order to establish a system of formal and informal education on HIV/AIDS and sexually transmitted infections, and ensures access to reproductive health counselling and services for all adolescents, even when married.

•          Bolivia, CRC, CRC/C/146 (2005) 121 at paras. 640-643.

640. The Committee...remains deeply concerned that post-natal health care is still inadequate and that mortality rates and other health indicators are significantly worse in rural areas. The Committee is further concerned that, despite a significant decrease, infant mortality rates remain very high, and well above the regional average. Furthermore, the Committee is deeply concerned at the high levels of malnutrition among children in the State party and at the limited use of breastfeeding...

641. The Committee recommends that the State party continue to strengthen its efforts in improving the health situation of children in the State party and their access to quality health services in all areas of the country, particularly rural areas... Furthermore, the State party should ensure that mothers are encouraged to rely exclusively on breastfeeding for six months after birth, with the addition of appropriate infant diet thereafter...

642. The Committee is concerned about the large number of teenage pregnancies and sexually transmitted infections (STIs), as well as the lack of programmes on sexual and reproductive health...

643. The Committee recommends that the State party pay close attention to adolescent health, taking into account the Committee’s general comment No. 4 (2003). In particular, the State party is encouraged to strengthen sexual and reproductive health education for adolescents, especially in schools, with a view to reducing the incidence of teenage pregnancies and STIs, and to provide teenage pregnant girls with the necessary assistance and access to health care and education...

•          Nigeria, CRC, CRC/C/146 (2005) 135 at paras. 712, 713, 718, 719, 727 and 728.

712. The Committee takes note of efforts made by the State party to improve its health system, including the Baby Friendly Hospital Initiative and the Integrated Management for Childhood Illness, as well as the establishment of the National Programme on Immunization Agency. Nevertheless, the Committee remains gravely concerned at the alarmingly high rate of infant, child and maternal mortality, and the high incidence of major illnesses affecting children, including polio, malaria and diarrhoea as well as the low rate of immunization coverage in the country, particularly in the northern regions, and of malnutrition and the low rates of exclusive breastfeeding...

713. The Committee recommends that the State party:

(a) Address, as a matter of urgency, the very high mortality rates among infants, children and mothers, by, inter alia, stepping up the immunization programmes and improving antenatal and post-natal care;

...

(c) Take measures to introduce awareness-raising programmes for women, on the importance of, inter alia, prenatal and post-natal health care, preventive measures and treatment for common illnesses; immunization and balanced diet for the healthy development of children;

...

718. While acknowledging that the minimum age of marriage is set federally at 18 years, the Committee notes with concern that the legislation of most states and the customary law allows for early marriages, and girls can be forced into marriage as soon as they reach puberty. The Committee is particularly concerned at the reports of a large number of young women suffering cases of vesico-vaginal fistula, a condition caused by giving birth when the cervix is not well developed. The Committee is further concerned that such girls, once married, are not afforded protection and that the enjoyment of their rights as children is not ensured as enshrined in the Convention.

719. The Committee recommends that the State party amend existing legislation to prevent early marriages. It also recommends to the State party that it take measures to ensure that when underage girls are married, they continue fully enjoying their rights as set out in the Convention. The Committee also recommends that the State party develop sensitization programmes, involving community and religious leaders and society at large, including children themselves, to curb the practice of early marriages.

...

727. ...The Committee is particularly concerned about reports of sexual exploitation of refugee girls and women within and outside of the camps, including female teenagers who are forced into prostitution. The Committee is also concerned that the incidence of teenage pregnancy is high in the camp.

728. The Committee recommends that the State party:

...

(b) Take measures to ensure that appropriate reproductive health education and child-sensitive counselling services are provided to adolescents living in camps;

...

•          Saint Lucia, CRC, CRC/C/150 (2005) 10 at paras. 82, 83, 86 and 88.

82. The Committee... notes with concern the high rate of teenage pregnancies and the fact that the State party does not pay sufficient attention to adolescent health issues, including developmental, mental and reproductive health concerns.

83. The Committee recommends that the State party:

...

(b) Strengthen developmental and mental health counselling services as well as reproductive counselling and make them known and accessible to adolescents;

(c) Ensure the inclusion of reproductive health education in the school curriculum and fully inform adolescents of reproductive health rights, including the prevention of teenage pregnancies and sexually transmitted diseases, including HIV/AIDS;

(d) Continue to provide support to pregnant teenagers, including through community structures and ensure the continuation of their education.

...

86. While the Committee is encouraged that the State party has developed “Education Sector Development Plan 2000 to 2005 and Beyond” and that there has been an increase in secondary school enrolment, it remains concerned that the State party does not provide universal access for children in particular to secondary school. It is further concerned at the lack of continued education of school-aged teen mothers...

...

88. In the light of articles 28 and 29 of the Convention and its general comment No. 1 (2001) on the aims of education, the Committee recommends that the State party allocate adequate human and financial resources in order to:

...

(d) Ensure that teenage mothers continue their education.

•          Philippines, CRC, CRC/C/150 (2005) 24 at paras. 161, 162, 165 and 166.

161. The Committee is encouraged by the progress achieved by the State party in the field of health and health services, particularly with regard to immunization, such as polio eradication and the elimination of neonatal tetanus and it notes with appreciation the Health Sector Reform Agenda. Noting that 8 out of 10 births in rural areas are delivered without professional health facilities and that infant, under-five and maternal mortality rates are relatively high, the Committee expresses its deep concern about insufficient prenatal and post-natal health care, particularly in the rural areas of the country. The low prevalence of breastfeeding, malnutrition among children, including micronutrient malnutrition problems among schoolchildren and in general, children’s limited access to quality health services in the remote areas of the country give cause for serious concern...

162. The Committee recommends that the State party:

...

(c) Implement measures to guarantee access to quality prenatal and post-natal health services and facilities, including training programmes for midwives and traditional birth attendants, by paying particular attention to the rural areas of the country;

(d) Take all necessary measures to lower infant, under-five and maternal mortality rates;

(e) Strengthen existing efforts to immunize as many children and mothers as possible by effectively implementing immunization programmes;

(f) Encourage exclusive breastfeeding for six months after birth with modifications for an appropriate infant diet thereafter and take measures to improve the nutritional status of children through education and promotion of healthy feeding practices;

...

165. The Committee notes with appreciation the State party’s efforts to promote adolescent health, including through implementation of the Reproductive Health Programme and a joint project on adolescent health in collaboration with the Population Commission and UNFPA. The Committee is concerned about alcohol, tobacco and drug abuse among adolescents, early pregnancies and in this respect adolescents’ limited access to reproductive health counselling and accurate and objective information about, for example contraception...

166. The Committee recommends to the State party that it:

(a) Implement national policies and plans on adolescent health, such as the Reproductive Health Programme and develop new policies and plans to cover all fields of adolescent health by taking into account general comment No. 4 (2003) on adolescent health and development;

(b) Ensure access to reproductive health counselling and provide all adolescents with accurate and objective information and services in order to prevent teenage pregnancies and related abortions;

(c) Strengthen formal and informal education on sexuality, HIV/AIDS, sexually transmitted diseases and family planning;

...

•          Ecuador, CRC, CRC/C/150 (2005) 91 at paras. 441 and 442.

441. The Committee remains concerned at the increasing number of teenage pregnancies and the number of very young mothers...

442. The Committee recommends that the State party pay particular attention to adolescent health, taking into account the Committee’s general comment No. 4 (2003) on adolescent health and development in the context of the Convention on the Rights of the Child. The Committee recommends that the State party strengthen the existing laws and programmes and in particular:

(a) Undertake measures to reduce the rate of teenage pregnancies, in particular through reproductive health education and child-sensitive counselling services;

(b) Undertake measures to reduce the rate of teenage pregnancies through, inter alia, the effective implementation of the Sex Education and Love Act in a gender- and child-sensitive manner;

...

•          Mongolia, CRC, CRC/C/150 (2005) 113 at paras. 558 and 559.

558. While noting with appreciation the State party’s efforts to improve primary health care, in particular the prevention of infectious diseases such as measles, meningitis and diphtheria as a result of the successful implementation of the National Immunization Programme 1993-2000, the Committee is nevertheless concerned at the regional disparities in access to health services, the high rates of both maternal mortality and under-5 mortality and regional differences in this respect, and the prevailing situation of malnutrition among children. The Committee notes with concern that the exclusive breastfeeding rate is declining and that the State party has not yet adopted the International Code of Marketing of Breastmilk Substitutes...

559. The Committee strongly recommends that the State party undertake all necessary measures:

...

(b) To continue its efforts to improve prenatal care and to significantly reduce maternal and under-5 mortality rates, paying particular attention to mothers and children living in remote areas of the country;

(c) To adopt the International Code of Marketing of Breastmilk Substitutes and to encourage exclusive breastfeeding for six months after birth, with the addition of an appropriate infant diet thereafter;

....

•          Nicaragua, CRC, CRC/C/150 (2005) 132 at paras. 640-643.

640. While the Committee welcomes the enactment of Act No. 238 on the Protection and Defence of Human Rights in the presence of AIDS, as well as the Strategic National Plan against STDs and HIV/AIDS and it is concerned that antiretroviral treatment is not yet guaranteed to the newborn from seropositive mothers and that post-natal care is not provided to the seropositive mother...

641. The Committee recommends that the State party:

...

(b) Strengthen its measures to prevent mother-to-child transmission, inter alia, through coordination with the activities aimed at reducing maternal mortality;

(c) Guarantee antiretroviral treatment to newborns from HIV/AIDS seropositive mothers as well as post-natal monitoring of seropositive women;

...

642. The Committee is concerned at the high rate of teenage pregnancies and at the lack of adequate sexual and reproductive health services. In this regard, the Committee is also concerned at the information that the authorities reportedly prohibited in 2003 the publication of a manual elaborated by experts on sexual education and reproductive health (“Manual for life”).

643. In the light of the Committee’s general comment No. 4 (2003) on adolescent health and development in the context of the Convention (CRC/GC/2003/4), the Committee recommends that the State party ensure access to reproductive health services to all adolescents and immediately adopt a manual on sexual education and reproductive health which would take into account the above-mentioned general comment of the Committee.

•          Costa Rica, CRC, CRC/C/150 (2005) 149 at paras. 712 and 713.

712. The Committee notes with appreciation the measures taken by the State party to implement its recommendation to develop adolescent-sensitive health policies and strengthen reproductive health education and services in order, inter alia, to prevent and reduce teenage pregnancies, and to enhance the prevention of substance abuse among adolescents. The Committee is concerned however that the number of teenage pregnancies remains significantly high.

713. The Committee recommends that the State party continue to strengthen reproductive health education in secondary schools such as “Young Love” to prevent teenage pregnancies. The Committee also recommends that professional and administrative staff be adequately trained in order to improve their interactions with teenage mothers.

•          Yemen, CRC, CRC/C/150 (2005) 161 at paras. 785 and 786.

785. The Committee notes the efforts undertaken by the State party in the area of basic health and welfare, such as the immunization programme and control of diarrhoeal diseases, and the consequent improvements such as, inter alia, the decrease in the infant and under-five mortality rates...Particular matters of concern are:

...

(c) The still-high infant, under-five, and maternal mortality rates, partly due to the weak antenatal and post-natal care and maternal malnutrition;

...

(f) The high population growth rate.

786. The Committee recommends that the State party:

...

(c) Continue to strengthen the efforts to decrease the infant, under-five, and maternal mortality rates through, inter alia, providing adequate ante- and post-natal care;

...

(e) Improve access to family planning involving both men and women.