Implementing child s rights in early childhood: Guaranteeing the rights to survival and development of young children, including the rights to health, nutrition and education. CRC GENERAL DISCUSSION, 17 SEPTEMBER 2004 PART 2: THE CONVENTION ON THE RIGHTS OF THE CHILD: NGOS MAKING A DIFFERENCE CASE STUDIES OF IBFAN GROUPS USING CRC COMMITTEE RECOMMENDATIONS LINKED TO BREASTFEEDING AND RELATED ISSUES (2002-2004) Argentina India Italy Pakistan United Kingdom 1
INTRODUCTION: WORKING AT LOCAL LEVEL The CRC is an extraordinary instrument inasmuch as, through the CRC Committee, NGOs in any State party have the possibility to directly influence policy as well as monitor progress on children s rights. More specifically, the COs are means or tools to trigger action. The role of NGOs at country level is therefore to encourage and spur the government into following the Committee recommendations. Monitoring implementation of Committee recommendations at country level is a long-term objective that depends on the capacity of NGOs and, in our case, of breastfeeding groups, at national level. For the past two years, IBFAN-GIFA has been making efforts to involve groups more concretely, encouraging them to attend CRC sessions, introducing them to Committee members, speaking about human rights and the CRC at large conferences and meetings, suggesting concrete actions and activities based on Committee recommendations In future, much of our work will continue to focus on raising the awareness and building the capacity of these groups in relation to the CRC. At the same time we have to encourage and support their actions at government level. In relation to improving breastfeeding policies and practice, due primarily to lack of political commitment, the five-year interval between country reviews is unfortunately often insufficient for States parties in the area of infant and young child feeding to set up the necessary infrastructure, to procure funds, to raise awareness and to implement policy. In the following pages, breastfeeding groups in countries that have recently been reviewed by the CRC Committee explain how, concretely they have or have not been using the CRC recommendations related to breastfeeding and nutrition, made to their government. There are five case studies: Argentina, India, Italy, Pakistan and the United Kingdom. Only in the case of Italy, were there no CRC recommendations related to our issue. I - ARGENTINA (2002-2004) Report prepared by Dr. F. Vallone, Fundacion LACMAT, July 2004 a) IBFAN-LACMAT In Argentina, the International Baby Food Action Network (IBFAN) is coordinated by the LACMAT Fundación, an NGO that began working informally in 1995, and that was officially established in 1998. LACMAT aims to defend the rights of both boys and girls, as well as of their mothers and families, to reach the highest attainable quality of life. Our activities belong to three main poles: training, communication, and advocacy; and to the following thematic areas: breastfeeding and complementary feeding; sexual and reproductive health; monitoring of the WHO/UNICEF International Code of Marketing of Breast-milk Substitutes; Codex Alimentarius; pregnancy and birthing practices; child development. Therefore, since its outset, IBFAN-LACMAT has been working on issues that are directly linked to those of the Convention on the Rights of the Child. However, for several years we were doing this without really knowing the process by which States Parties were reviewed and recommendations made, nor had we taken the opportunity to contact the organisations that were involved in the area of child s rights in our country. This lack of communication can be explained by two elements. 1) Because of the political situation that our country underwent during the 1990s, the constitutional structure took over all responsibility related to CRC (Constitutional reform of 1994). Moreover, during this period, human rights and basic liberties were forfeited to a point rarely encountered before, leading to such levels of poverty that one can only speak of lack of sensitivity and conclude that there were no public policies defending child s right during those years. 2) Our 2
association did not have, at its beginnings, the organisational capacity to undertake many tasks, and so we decided to focus our attention on activities that would lead quickly to concrete results. b) IBFAN-LACMAT s input in Argentina s reviews Thus, when in 1995, Argentina was reviewed for the first time by the CRC Committee, we did not present an IBFAN report because our organisation was just starting. With time, our colleagues from IBFAN-GIFA, in Geneva, started informing us about the CRC, and we began to better understand its mechanisms and processes, as well as the important role that we as an NGO could play in its implementation and monitoring at country level. When on 17 September 2002, Argentina was reviewed for the second time, our organisation sent a report based on the model prepared by our colleagues in IBFAN-GIFA. A few months later, during the World Health Assembly in May 2003, we were able to meet with the Committee member from Argentina, with whom we have since continued to work here in Argentina. We have also contacted the Argentinian CRC Follow-up Committee, and offered to assist with our assessment. Unfortunately, we feel that breastfeeding and related themes are not considered by this committee as important as we were hoping. c) CRC Recommendations The recommendations made by the CRC Committee to the Argentine government have been particularly useful to us. They have allowed us to evaluate our own work and its importance which corresponds precisely to the aims of the CRC. Moreover, they have also served as guidelines to orient our efforts in the future, with the aim of monitoring the government s actions. The Committee recommended that the State Party: Recomendation 47: a. Allocate appropriate resources and develop comprehensive policies and programmes to improve the health situation of all children without discrimination, in particular by focusing more on health promotion and prevention. 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 reproducticve health, especially in the provinces. Recomendation 49: a. Undertake a study on child malnutrition and create a comprehensive system of statistics to keep a record of malnuitrition cases in order to assess the extent, scope and nature of this phenomenon. b. Develop a comprehensive nutritional programme in order to prevent and combat malnutrition. d) IBFAN-LACMAT s work in relation to the CRC Committee recommendations Presently Argentina is in the process of implementing a publicly funded monitoring programme on themes related to maternal and infant/child health. More precisely, the government is beginning to use a World Bank loan to implement a 10-year programme 3
aiming to diminish child mortality in the poorest provinces of the country. We are particularly interested in following how the programme will be using these funds. Since 1994 we have been acting as an advisor on the Breastfeeding Committee which runs under the Ministry of Health. We have been trying to push for the implementation of several measures related with the CRC. For example: - Monitoring of the WHO/UNICEF International Code of Marketing of Breast-milk Substitutes. In 1997, 2000 and 2003, the LACMAT Foundation conducted the first three monitoring exercises at national level - the first two with the support of UNICEF and the MOH of Buenos Aires. We also organized two training courses addressed to official inspectors to transfer our experience and expertise on the issue. Unfortunately the compliance of the International Code by baby food companies is still very weak, but recently the government has become more receptive to the issue. - In 1998, IBFAN-LACMAT and the MOH developed the first national breastfeeding indicators (thanks to free database that our foundation had developed and the training course we had given). At present we are asking the authorities to develop an annual indicator on breastfeeding using information from public health services. - LACMAT-IBFAN advises the MOH on themes related to the WHO/UNICEF International Code and Codex Alementarius in preparation for national and international meetings such as WHA. Our intention is to achieve that the Ministry of Health puts these issues on the top of the political agenda. - Together with Dando la Luz, an Argentine NGO involved in pregnancy and birthing practices and Sexual and Reproductive Health, IBFAN-LACMAT has participated in several meetings with governmental authorities asking for changes in health facilities aiming to respect human rights and specially the CRC. - Each year IBFAN-LACMAT, with the MOH and other NGOs, organizes different meetings and campaigns related to breastfeeding, with the aim to improve the government support. - In 2003, IBFAN-LACMAT worked with UNICEF to hold a technical meeting the government team belonging to the HIV-AIDS National Programme, to update national guidelines on HIV and infant feeding. - At present, we are requesting that the government nominate a National Breastfeeding Coordinator, thus following the Innocenti Declaration recommendation of 1990. - Because of IBFAN s commitment to the WHO Global Strategy for Infant and Young Child Feeding (Res. WHA55.25), we have participated in numerous activities and meetings with MOH technical teams responsible for implementation of the Strategy in our country. e) Conclusions - IBFAN s fundamental principles coincide completely with those of the CRC. - IBFAN-GIFA s work has allowed us to better understand the CRC process and aims, and to act more precisely upon the issues related to the CRC. - The recommendations made by the CRC Committee have been particularly useful because they have helped us understand the real use and impact of many of our advocacy activities, and have helped us to focus on other activities to develop in the future. - We hope that in the near future we will work more closely with the Follow-up Committee in Argentina, and that breastfeeding will be seen as a priority in the government s political agenda. 4
- We also hope that the government will soon nominate a National Breastfeeding Coordinator. - In as much as we are able to - given the difficulties we have encountered following the crisis in our country - LACMAT-IBFAN s future plans are to develop activities that will enable Argentina to meet the aims of the CRC. Our own perspective as a NGO working on the issue is that the current government is trying to improve the real situation of child s rights in our country. We find that it would be important that at the next review of Argentina, the CRC Committee closely examine how the WHO Global Strategy has been implemented, since the health and development of our children of today and tomorrow, depend to a large degree on its positive results and success. 5