Author: Jette Nietzard

El Salvador has a huge problem with violence ensuing from street gangs but also from family members. In addition, women are commonly seen as personal property and sexual objects by a patriarchal society. This also affects girls who take on household chores and sexual services and are often abused at a very young age. In the Concluding Observations, certain points are elaborated on, while others are only touched on briefly.

The Committee urges the State party to strengthen its efforts to eliminate discrimination against girls, particularly regarding their access to education and to sexual and reproductive health services, and in relation to sexual violence, civil unions and teenage pregnancy. Furthermore, it is deeply concerned about the vulnerability of girls, aged from 12 years onwards, known as “brides”, to being targeted by street gangs for sexual purposes.

While welcoming the measures taken by the State party regarding the health and education of and data collection on children with disabilities, the Committee recommends to continue to invest in measures to ensure that children with disabilities have access to health care, including early detection and intervention programmes, and inclusive education. In addition to that, the Committee recommends to develop awareness-raising programmes, with the participation of children with disabilities, aimed at health and educational professionals, the public and families, to combat the stigmatization of and prejudice against children with disabilities, and to promote a positive image of those children.

El Salvador should strengthen the measures taken to continue decreasing health costs, including the cost of medicines, and increase the availability of vaccines without compromising quality. In the departments of Chalatenango, Santa Ana, La Libertad and Usulután, the rate of preventable deaths of new-borns and children under 5 years of age is significantly higher.

The Committee recommends that the State party develop comprehensive awareness-raising programmes on the harmful effects of civil unions involving girls on their physical and mental health and well-being. These actions should target girls and boys, families, health and education professionals and judges.
Also, the Committee is concerned about inadequacy of mental health services for pregnant teenagers and teenage mothers, with suicide being the most common cause of death among teenage mothers.

The Committee notes the consistently high number of children involved in child labour, despite efforts towards its reduction, and recommends that the State party strengthen its measures to combat the economic exploitation of children, especially in rural areas, and in particular girls working in domestic service and boys working in agriculture and commerce.

El Salvador should take the measures necessary to establish a specialized juvenile criminal justice system in accordance with the law, encompassing non-custodial measures such as diversion, mediation and counselling. Also, education and vocational training in juvenile detention facilities need to be improved.

The Committee is deeply concerned about the very high number of killings, with 4,094 recorded between 2010 and 2017, mostly affecting boys, and by the insufficient information provided by the State party on the investigations and prosecutions conducted. To reduce the number, the Committee urges the State Party to urgently step up its efforts to eliminate the availability of arms, including small arms.

Also, the Committee urges El Salvador to promote and protect the right of children to freedom of association and peaceful assembly and to ensure that, in the current climate of violence, law enforcement officials and other professionals are trained adequately to respect those rights.

France has made large public investments in children. However, the concluding observations show that the implementation of children's rights varies between France and the Overseas Territories, and many children are not aware of their rights. It is noteworthy that children with autism are mentioned in an additional section in the concluding observations. Of concern is the lack of official statistics and the presence of reports that an estimated two children die each day, possibly as a result of domestic violence.

Contraceptives are available free of charge and confidentially to children over 15 years old. The Committee recommends France to strengthen its efforts to challenge gender stereotypes and to increase awareness of female genital mutilation in the State party.

The Committee is concerned by cases of ill-treatment of children with disabilities in institutions and the insufficient independent monitoring of such institutions. The Committee is further concerned that the “packing” technique (wrapping the child in cold, wet sheets), which amounts to ill-treatment, has not been legally prohibited and is reportedly still practiced on some children with autistic spectrum disorders. Besides prohibiting the “packing“ method, the Committee recommends to create accessible and child-friendly reporting systems and services, including confidential channels for denouncing cases of ill-treatment and protection from reprisals.

Children are not automatically allowed to be accompanied by parents when hospitalized overnight. An overall worse health service persists in the oversea departments, including high levels of infant mortality, early pregnancies and preventable infectious diseases. Therefore, the Committee recommends to increase efforts to reduce existing disparities in access to health-care services for children and mothers in the overseas departments and to make basic healthcare accessible for everyone, including children without valid residence permit.

The Committee is concerned about the increased rates in tobacco and alcohol use and experimentation with cannabis throughout the middle school years.

The rate of mental health and psychosocial disorders is high among children and increases with age, affecting mainly children over 15 years. The Committee recommends to increase the training of medical personnel on issues relating to child psychiatry, and guarantee that children receive treatment by qualified professionals and in establishments designated for children.

The Committee recommends to establish a clear regulatory framework for industries operating under the jurisdiction and control of the State party to ensure that their activities do not negatively affect human rights or endanger environmental and other standards, especially those relating to children’s rights. France should also ensure that companies effectively implement international standards, including on human rights, the environment and health, that due diligence processes are required, and that effective means exist for monitoring implementation and appropriately sanctioning and providing remedies whenever violations occur.

The Committee is concerned about cases in which subsidiaries of French companies have directly contributed to the violation of children’s rights, including activities conducted by rubber companies in Cambodia. Therefore, it recommends to establish a clear regulatory framework for industries operating under the jurisdiction and control of the State party to ensure that their activities do not negatively affect human rights or endanger environmental and other standards, especially those relating to children’s rights.

The Committee recommends to end the detention of children in wards within adult detention facilities and to establish specialized juvenile court facilities and procedures with adequate human, technical and financial resources and properly trained and available ad hoc administrators.

In France, 20 per cent of children live in poverty and there are large numbers of homeless children. The Committee is also concerned about the insufficient registration of children belonging to populations in the overseas departments and territories, which impedes them from exercising their rights.

Legislation continues to restrict the rights to freedom of expression, association and peaceful assembly for children under 16 years of age.
The Committee is seriously concerned about allegations of sexual abuse committed against children by French soldiers in the Central African Republic and notes that the preliminary investigations are still ongoing.

In Spain, there are differences between the autonomous regions, for example in health and education.
While investment in social protection measures remains below the European average, national indicators of social exclusion, poverty and inequality have risen. It should also be noted that Spain is still suffering from the consequences of the 2008 financial crisis. Spain does well in the area of health, where the committee found almost no room for improvement. However, a major problem has been found in the area of migration and the situation of refugees, especially in the exclaves, where the basic rights of children are not respected.

Gender stereotypes are persistent in the education system, including in school curricula and textbooks.

The Committee urges the State party to fully implement a human rights-based approach to disability that ensures equal access to good-quality inclusive education in mainstream schools for children with disabilities. Spain should ensure that children with disabilities have access to health care, including early detection and intervention programmes.

The Committee recommends that the State party increase the number of paediatricians and ensure that general practitioners providing health services to children acquire additional specialized skills and expertise relating to and receive further training on child and adolescent care.

Psychologists are available in all public schools. The Committee recommends to reduce excessively long response times for access to mental health services for children and increase the availability of services. It also recommends to address the increased diagnosis of ADHD and other behavioural specificities, and the use of drug treatments for the children diagnosed.

The Committee recommends that the State party carry out an assessment of the impact of air pollution from coal-fired power plants on children’s health and on the climate as a basis for designing a well-resourced strategy to remedy the situation, and strictly regulate maximum air-pollutant emissions, including those by produced private businesses.

The Committee recommends to establish and implement regulations to ensure that the business sector, including in the context of public procurement, fulfils the rights of the child.

The Committee recommends to expedite the court proceedings in sexual abuse cases involving child victims, in order to reduce the period of time for which they must wait before testifying. They also recommend to increase the number of specialized judges for children and ensure the availability of specialized juvenile court facilities and child-friendly procedures.

The Committee is seriously concerned that the level of investment in children by the State party has not been high enough to offset the negative impact of the severe economic and social crisis that began in 2008 and that has led to increased poverty and social inequality.

The Committee recommends that the State party ensure that children born through international surrogacy have access to information about their origins.

In Serbia, children are not seen as right holders and as a group with special needs. All articles of the Convention regarding participation are implemented insufficiently. Furthermore, the discrimination against Roma is prevalent, and public funding is insufficient in all relevant sectors.

The Committee recommends that the State party establish a system to track all cases involving child marriage among ethnic groups, particularly Roma girls; provide child victims with shelter, as well as appropriate rehabilitation and counselling services, and develop awareness-raising campaigns highlighting the harmful consequences of child marriage.
In regards of reproductive health, the Committee recommends to ensure unimpeded access to sexual and reproductive health services, and to address the incidence of drug use by children and adolescents.

The Committee is concerned about the inhuman or degrading treatment experienced by children living in institutional care homes and about reports indicating that children with disabilities, particularly those with intellectual impairments, are more likely to be victims of physical and sexual violence. Children with disabilities also continue to be significantly overrepresented in residential care. The Committee recommends to reform the system of social assistance for children with disabilities and their families in order to improve its coherence and coordination and avoid unnecessary institutionalization. It further recommends to give priority to measures to facilitate the full inclusion of children with disabilities.

Serbia’s infant mortality rate remains above the European Union average. The Committee is also concerned about the high rate of infant and under-5 mortality among Roma children due to limited access to neonatal services. Regional disparities and equity gaps, combined with financial constraints and inadequate health insurance coverage continue to hinder access to basic health-care services.
The Committee recommends to ensure the availability of and equitable access to quality primary and specialized health care for all children in the country and expand support in Roma communities for newly appointed health mediators.

A shortage of qualified child psychiatrists and community-based mental health services is determined.

The Committee recommends that the State party collect disaggregated data identifying the types of risk faced by children related to the occurrence of a variety of disasters.

The Committee urges Serbia to ensure the provision of qualified and free legal aid to children in conflict with the law and to establish specialized juvenile court facilities and procedures with adequate human, technical and financial resources.

The Committee remains concerned that in its budgeting process the State party does not stipulate budget allocations for children in the relevant sectors.
Inadequate housing continues to be a problem, particularly for Roma families who are often subjected to forced evictions, which leaves children without access to basic services, including clean and safe drinking water and sanitation, therefore rendering them vulnerable to serious health problems. Therefore, the Committee recommends to strengthen the support provided to children living below the poverty line, and ensure that social protection measures cover the real costs of decent living for the children, including expenses relevant to their rights to health, a nutritious diet, education, adequate housing and water and sanitation.

In Austria, the criteria for removing and placing children in alternative care settings are not harmonized, and unnecessary surgical interventions are performed on intersex children. The committee also clearly states that the Austrian climate protection regulations are not sufficient to guarantee the child's right to the highest attainable standard of health.

The Committee recommends to Austria to continue to take preventive and protection measures to address female genital mutilation, including the provision of social, psychological, medical and rehabilitative services and training of relevant professionals and awareness-raising programmes. It also recommends to abolish the law that bans young girls from wearing headscarves in primary schools, classing them as ideological or religious clothing, because it may lead to girls’ exclusion from mainstream education.

Data is missing for children with disabilities in alternative care and there is no comprehensive plan for the deinstitutionalization of children with disabilities. Schools, playgrounds and other public spaces are not accessible and children with disabilities are rather seen as an object than as right holders. Comprehensive measures for inclusive education are not implemented. The Committee recommends to ensure that children with disabilities have effective access to public services and spaces and improve the physical accessibility of all public and private buildings, spaces and means of transport in all Länder.

The committee recommends to the state party to strengthen measures to address obesity in children and actions to promote a healthy lifestyle, including physical activity. Also, they recommend to ensure the availability of qualified and specialized health staff in all Länder, particularly paediatricians in rural areas.

The Committee is concerned about the prevalence of psychological health conditions, such as those related to anxiety, depression, self-injury and attention deficit and eating disorders. To improve the situation, the Committee recommends to continue to increase the availability and accessibility of child and adolescent mental health services and programmes.

Children’s rights to the enjoyment of the highest attainable standard of health and an adequate standard of living is not compatible with Austria's insufficient climate mitigation politics.

Instead of 0.7 per cent of gross national income Austria only uses 0.29 per cent for official development assistance.

The Committee is concerned that the number of children in detention has increased. To improve the situation, the Committee recommends that Austria starts working towards a time limit of 30 days for children in pretrial detention and ensure that the circumstances under which such a time limit can exceptionally be extended is clearly defined in law.

Children born out of wedlock to Austrian parents do not receive Austrian citizenship retroactive.

Argentina's report is very extensive and covers many points. Unfortunately, there are also several paragraphs on different forms of violence. Argentina still has a lot to do in terms of violence to better protect its children. Poverty in Argentina is very high and many children suffer from it.

The Committee is noting with concern the barriers that adolescents continue to face in their access to sexual and reproductive health-care services and education, the high incidence of teenage pregnancy and the elevated risks of maternal mortality among adolescent mothers, and the insufficient access to modern methods of contraception and family planning. To improve the situation, the Committee recommends to ensure that sexual and reproductive health education is part of the mandatory school curriculum, and that it is developed with the involvement of adolescent girls and boys, with special attention paid to preventing early pregnancy and sexually transmitted infections. It also recommends to ensure access to safe abortion and post-abortion care services for adolescent girls, ensuring that their views are always heard and given due consideration as part of the decision-making process.

Argentina should ensure equal access to good-quality inclusive education in mainstream schools for children with disabilities, and prioritize inclusive education over the placement of children in specialized institutions and classes. Additionally, Argentina should intensify efforts to put an end to discrimination against children with disabilities, and ensure that they are covered by health insurance schemes and receive the services and benefits, such as pensions and housing, to which they are entitled.

While noting the overall decrease in child mortality, the Committee is seriously concerned that the rate of infant mortality remains high in some provinces owing to a lack of adequate health care, including prenatal care for uninsured pregnant women, poverty and inadequate nutrition. The Committee is also concerned about the increased number of cases of suicide and self-inflicted injuries, particularly among children in detention.

The Committee recommends to establish mental health services and programmes for children, ensuring outpatient services for psychosocial care and rehabilitation in rural and urban areas, with a particular focus on suicide prevention.

The Committee is concerned about the well-documented harmful effects of open-pit mining activities and the use of agrochemicals for the environment and the health of children living in areas where mining and soya bean production are carried out. It recommends that the State party strengthen implementation of legislative and other measures to protect the physical and mental health of children, particularly indigenous children, from environmental harm caused by third parties, and ensure that the impact of mining and agrochemicals on underlying determinants of health, such as food, safe drinking water and sanitation, is minimized and that the entities responsible are held accountable and victims afforded effective remedies.

The Committee recommends that the State party intensify its efforts to eliminate child labour in practice by establishing multisectoral programmes at the local and regional levels to combat child labour.

The Committee is particularly concerned of overcrowding, poor nutrition, inadequate bedding and sanitation facilities, combined with lack of education and training opportunities, which can amount to torture or cruel, inhuman or degrading treatment of children. To improve the situation, Argentina must urgently address detention facilities across all provinces, and ensure that they are compliant with international standards and that independent monitoring is in place and ensure the provision of free, qualified and independent legal aid to children in conflict with the law at an early stage of the procedure and throughout the legal proceedings.

There are also reports of violence perpetrated by federal and provincial security forces in police custody, often in cases involving children and adolescents in socially marginalized situations, and the disproportionate use of force against children and adolescents by the security forces, including in schools, together with the justification of such measures.

The Committee is concerned that the financial crisis has had a negative impact on the social protection systems in the State party, resulting in insufficient coverage and delays in the processing of benefit allowances for children and their families, particularly at the provincial level.
In terms of birth registration, the Committee recommends that the State party strengthen measures to promote universal and timely birth registration, free of charge, and to increase resources to civil registries and improve coordination with health services. It also recommends that measures be intensified to ensure access to registry offices or mobile units, particularly for those living in remote and rural areas, and indigenous communities.

Concluding observations on the fifth and sixth periodic reports released on 1 October 2018. More information about education in Argentina: https://www.argentina.gob.ar/educacion/gestioneducativa/educacioninicial and
https://www.argentina.gob.ar/educacion/gestioneducativa/educacionsecundaria

Child poverty is widespread and access to drinking water and sanitation for children is limited. The data collected on the situation of children is not sufficiently disaggregated and consolidated. In the area of health, in particular, Peru still has a long way to go to implement the child's right to the highest attainable standard of health.

The Committee recommends to design and implement a comprehensive strategy, including awareness-raising programmes and educational campaigns, to eliminate patriarchal attitudes and gender stereotypes that discriminate against girls and explicitly prohibit discrimination based on sexual orientation and gender identity.

More than 90 per cent of children with disabilities do not possess a disability certificate and approximately 54 per cent of children with disabilities do not know how to read or write. The Committee is also concerned that legislative and policy measures are not implemented effectively in practice.
To improve the situation for disabled children, the Committee recommends that the State party strengthen its efforts to implement an inclusive education system for all children at all levels and ensure that children with disabilities throughout the State party have effective and free access to health and rehabilitation services, including early detection and intervention programmes.

The Committee welcomes the significant progress made by the State party in reducing child mortality and chronic malnutrition, but is concerned at disparities in progress between urban and rural areas and regarding indigenous children and children living in poverty. Despite the improvements, the Committee recommends that the State party continue to strengthen its efforts to address child mortality and malnutrition, focusing primarily on children living in poverty, children living in rural and remote areas and indigenous children. Therefore, Peru should ensure equal access to quality health services for all children, including children living in rural and remote areas, and effectively implement its strategies aimed at reducing maternal mortality throughout the country, including by strengthening the quality of prenatal care and the responsive capacity of health services.

Concerning adolescent health, the Committee recommends to the State party to address the high number of adolescent pregnancies by strengthening access to age-appropriate education on sexual and reproductive health and rights for girls and boys in all areas of the State party, including out-of-school children, and decriminalize abortion in all circumstances. Also, Peru should address the incidence of drug use by children and adolescents by, inter alia, providing children and adolescents with accurate and objective information, as well as life skills education on preventing substance abuse, including with respect to tobacco and alcohol, and develop accessible and youth-friendly drug dependence treatment and harm reduction services.

The State Party should ensure quality access to mental health services with a view to eliminating the prevalence of suicide and depression among adolescents.

The Committee expresses concern at the impact of mining and hydroelectric projects on the living conditions of children and their families in the regions concerned, such as the La Oroya, Cerro de Pasco and Cajamarca areas, and with respect to the health hazards and environmental degradation, in particular the contamination of drinking water, arising from such projects. It is also concerned that environmental impact assessments are not always carried out prior to granting licences to companies. The Committee recommends to ensure effective implementation by companies, especially those involved in mining and hydroelectric projects, of international and national environment and health standards, and effective monitoring of the implementation of those standards.

While noting the measures taken by the State party to address child labour, including awareness-raising and training activities, the Committee is seriously concerned that the minimum age for admission to employment remains at 14 and the prevalence of child labour remains extensive, in particular in rural areas, with a high percentage of children involved in the worst forms of child labour as well as in illicit activities, in particular illegal coca cultivation and drug trafficking. All measures by the State party remained insufficient and there are no comprehensive studies about the dimension of child labour. Therefore, the Committee urges the State party to increase the minimum age for admission to employment to 15, and for hazardous and abusive work to the age of 18. Peru should also take sufficient measures to investigate and improve the situation.

The Committee urges the State Party to promote diversion and alternative measures to detention, increase the number of specialized juvenile courts and ensure the provision of qualified and independent legal aid to children in conflict with the law at an early stage of the procedure and throughout the legal proceedings.

The Committee is concerned that some children continue to face difficulties in gaining access to birth registration and identity documents.

The Committee is also concerned at reports that only about 50 per cent of children infected with HIV receive antiretroviral treatment. It is also concerned at the increasing rate of infections among indigenous children and the limited provision of appropriate health-care services for HIV-infected pregnant women.

Although corporal punishment is prohibited, violence against children remains a serious problem in Uruguay. Furthermore, the Committee notes with concern the information on the lack or poor condition of playgrounds, parks and other public spaces available for recreational, cultural and sports activities for children. It is of further concern that 20 % of children continue to live in poverty, despite the fact that Uruguay has invested many resources to improve the situation of children.

While welcoming the measures adopted to address the high rates of teenage pregnancy and to provide support to teenage mothers, the Committee remains concerned about the insufficient accessibility of sexual and reproductive health services and education. The Committee is also concerned about information that pregnant teenagers who have decided to terminate their pregnancies do not receive adequate support and counselling.

The Committee is concerned that the State party has not adopted a comprehensive policy on the inclusive education and participation in society of children with disabilities. The Committee regrets that discrimination against children with disabilities remains widespread in the State party. To improve the situation, the Committee specifically recommends to set up comprehensive measures to develop inclusive education, and ensure that inclusive education is given priority over the placement of children in specialized institutions and classes. Also, Uruguay should adopt a human rights-based policy that addresses the barriers that hinder the full and effective participation in society of children with disabilities on an equal basis with other children.

The Committee is concerned about the large number of children suffering from nutritional disorders, such as chronic malnutrition, anaemia and obesity. Therefore, the Committee recommends that the State party strengthen its efforts to ensure access to high-quality health services by all children, particularly children living in the most disadvantaged and remote areas of the country, and encourages the State party to develop policies and programmes to address chronic malnutrition and anaemia.

Concerning adolescent health, the Committee is concerned that, while tobacco, alcohol and drug consumption are widespread among adolescents, programmes and services for those affected by substance abuse remain limited. The Committee recommends that the State party address the prevalence of substance abuse, including tobacco and alcohol abuse, provide children and adolescents with objective information in this respect, and develop accessible and youth-friendly drug dependence treatment and harm reduction services.

The State party has improved access to antiretroviral treatment and has adopted a national strategy for the prevention of HIV/AIDS vertical transmission. The committee is concerned, however, about the lack of a comprehensive HIV/AIDS prevention strategy addressed towards children and adolescents.

The Committee notes the lack of information on the current situation with regard to the use of methylphenidate for children with attention deficit hyperactivity disorder (ADHD) or attention deficit disorder (ADD). Therefore, the Committee recommends that the State party undertake a study to evaluate the situation of children diagnosed with ADHD or ADD, and the prescription of psychostimulants, such as methylphenidate.

The Committee is concerned about children being economically exploited, particularly in street vending, garbage collection and recycling, the construction sector, domestic work, and in the agriculture and forestry sectors. The Committee is also concerned at the large number of children involved in hazardous work in agriculture and fishing, using dangerous tools, carrying heavy loads, applying harmful pesticides, herding livestock and working long hours. To end exploitative and hazardous forms of child labour, Uruguay should strengthen its efforts to provide reliable information on the number of children who carry out economic activities and take measures to prevent children under the minimum age from working in all sectors.

The Committee is seriously concerned about allegations of ill-treatment and torture in police stations of adolescents suspected of having committed crimes and of children in street situations as well as reports of excessive use of force and collective punishments in detention facilities, children and adolescents being locked up in their cells for up to 22 hours per day and about the administration of anti-anxiety medication to juvenile detainees as a means of restraint. In addition to that, there is information about overcrowding and extremely poor conditions in detention centres for children and adolescents. To improve the situation, the Committee urges Uruguay to establish an independent complaints mechanism accessible to all children deprived of their liberty and ensure that conditions of detention in penitentiaries comply with the minimum international sanitary and hygienic standards.

The Committee notes with concern the lack of systematic training on the Convention among all professional groups working with and for children. In particular, the Committee is deeply concerned about the lack of training on the content of the Convention among judges, which on several occasions has led to interpretations of the State party’s legislation that are in contradiction with the Convention and its Optional Protocols.
The Committee is also concerned about the inadequacy of prison facilities for children living in prisons with their mothers and about the non-application of article 8 of Act 17.897 on probation, which allows for women who would otherwise be in detention to be placed under house arrest during the last trimester of pregnancy and the first three months of breastfeeding.

Concluding observations on the third to fifth periodic reports released on 5 March 2015. More information about education in Uruguay: https://www.oecd-ilibrary.org/

In Suriname, inclusion of people with disabilities and of minorities and marginalized groups is not working well enough. They go to school less, often have poorer health care and are discriminated against. Among other things, the report also deals with the effects of climate change on children in Suriname.

The Committee is seriously concerned about the high rate of child sexual abuse and exploitation in the State party, including incest, especially against girls. It urges Suriname to undertake legal and policy reform to increase the availability of sexual and reproductive health information and services, including confidential and youth-friendly health services throughout the country, and ensure the availability of contraceptive services to adolescents, without the need for parental consent, and free health care for pregnant adolescents up to the age of 18 years, through the national health insurance system.

The Committee urges the State party to adopt a human rights-based approach to disability and to devise a comprehensive strategy for the inclusion of children with disabilities. In addition to that, the Committee urges to take all the measures necessary to ensure that children with disabilities are fully integrated into all areas of social life, including schools, sports and leisure activities, and that facilities and other public areas are accessible for children with disabilities.

The Committee recommends that the State party continue to strengthen efforts to ensure adequate provision of prenatal and postnatal care and address the high rates of mortality of infants and children aged 5 years and younger, and the still high maternal mortality rates. They should also develop policies and programmes to strengthen the capacity of families and the community to provide care and support for children living with HIV/AIDS, and continue activities aimed at reducing stigma and discrimination relating to HIV/AIDS.

Concerning adolescent health, the Committee urges the State party to continue to take measures to address alcohol, drug and tobacco use among adolescents, including through awareness-raising programmes and campaigns, strengthen the regulation of alcohol and tobacco sales and the enforcement of such laws among vendors who sell such products to children, and expand programmes on alcohol and drug prevention, intervention and rehabilitation for adolescents.

The Committee recommends that the State party strengthen both the quality and availability of mental health services and programmes for children and, in particular, take measures to increase the number of specialists on children’s mental health and ensure adequate psychosocial care and rehabilitation facilities and outpatient services specifically for children. Suriname also needs to take urgent action to strengthen efforts to prevent suicide among children and adolescents, including by increasing available psychological counselling services and social workers in schools and communities.

The Committee recommends that the State party develop strategies, including awareness-raising, to reduce the vulnerabilities and risks for children owing to climate change, in particular children in situations of poverty, including Amerindian and Maroon communities. The Committee also recommends that the State party mainstream child-specific and child-sensitive risk and vulnerability reduction strategies into its national plan on climate change and disaster preparedness and emergency management and strengthen its social safety nets and social protection framework so as to more effectively mitigate the multiple social, economic and environmental impacts of climate change.

The Committee is seriously concerned about the persistence of child labour in the State party, in the agricultural, fishing, timber and mining sectors and domestic work, and in particular about boys from Maroon communities in the interior areas who are disproportionately represented in the worst forms of child labour.

The Committee recommends to adopt a holistic and preventative approach to addressing the problem of children in conflict with the law and the underlying social factors, with a view to supporting children at risk at an early stage, including by expanding intervention programmes, vocational training and other outreach activities. Also, in cases where detention is unavoidable, the Committee recommends that the State party take measures to provide adequate facilities for children in conflict with the law, and ensure that children are not detained together with adults, that boys and girls are held separately, that children are never held in solitary confinement, and that detention conditions are compliant with international standards, including with regard to access to education and health services, with particular focus on the Santa Boma prison.

The Committee recommends that the State party carry out awareness-raising programmes and campaigns on the importance of registering the birth of all children, including children born to migrant workers in both regular and irregular situations.

Further, the Committee is concerned about the lack of shelters for child victims and information on investigations in cases of sexual abuse, including the outcomes of such trials and redress and compensation offered to victims. Therefore, the Committee urges Suriname to establish mechanisms, procedures and guidelines to ensure mandatory reporting of child sexual abuse and exploitation, ensure that acts of sexual abuse and exploitation are effectively investigated and that perpetrators are brought to justice, with focus on the interior areas of the State party.

The report on the Dominican Republic is long, particularly due to the length of the chapter on violence. The country's problems with sex tourism and many pregnancies, especially among minors, are striking as well. In addition, there is poor supply of clean drinking water, which causes the death of many mothers and babies and leads to the spread of cholera. Furthermore, discrimination of Haitians is prevalent.

The Committee is concerned about persistent discrimination against and gender stereotyping of women and girls, often perpetuated in the media and in campaigns for promoting tourism, which contribute to the high prevalence of gender-based violence, particularly against girls of Haitian origin.

To improve the situation, the Committee recommends to the State party to strengthen its efforts to prevent violence, in particular feminicide, against mothers and caregivers, investigate all cases, prosecute the alleged perpetrators, punish the convicted and adequately compensate and rehabilitate the victims.
Also, the State party should review the legislation to set a minimum age for sexual consent in accordance with international standards and ensure that the definition of crimes relating to sexual exploitation and abuse complies with the Convention and its Optional Protocol on the sale of children, child prostitution and child pornography, and that sanctions are commensurate with the gravity of the offences.

The Committee urges the State party to adopt a human rights-based approach to disability, set up a comprehensive strategy for the inclusion of children with disabilities and ensure that inclusive education is given priority over education in specialized institutions and guarantee social-protection programmes, including subsidies for families with children with disabilities living in poverty, and free access to treatment and rehabilitation programmes.

The Committee is concerned about the high rate of maternal mortality, 80% of which was preventable, and persistent chronic child malnutrition. Another problem is the poor water quality leading to maternal and neonatal deaths and the increased risk of cholera becoming an epidemic.

To ensure the right of the child to the enjoyment of the highest attainable standard of health, the Committee recommends to continue implementing measures to eliminate the incidence of cholera and take all necessary measures to ensure that adequate safe water and sanitation are available, especially in hospitals.

Concerning adolescent health, the Committee is concerned about its low level of implementation as a result of insufficient resources and coordination and the influence of religious leaders and recommends to ensure the effective implementation of the National Sexual Education Programme for girls and boys, giving special attention to preventing early pregnancy and sexually transmitted infections.

The Committee recommends to the Dominican Republic to monitor the implementation of the agreement with the tourist industry on the prevention of child sex tourism and strengthen international cooperation for prevention and prosecution in relation to child sex tourism.

Furthermore, the Committee urges the State party to review its legislation in order to prohibit the employment of children under 15 years of age and ensure that all hazardous forms of labour, including domestic work, are prohibited for children under 18 years of age. Also, the State party should increase the coverage and quality of education and provide vocational training programmes to ensure that all children are enrolled and are protected from the harmful effects of child labour.

The Committee is concerned about the large number of children sentenced to prison and subjected to prolonged pretrial detention. It is further concerned about the inefficient functioning of the juvenile justice system, the insufficient juvenile courts and lack of adequate procedures, the lack of alternative measures to detention and reports of children being detained together with adults.

To improve the situation, the Committee urges the Dominican Republic to establish sufficient juvenile courts, adopt relevant procedures, allocate adequate resources to the juvenile justice system and provide qualified and independent legal aid to children accused of a criminal offence at an early stage of the procedure and throughout the legal proceedings.

The Committee is concerned that in 2012 one fifth of children under 5 years of age, mostly from families living in poverty, had no birth certificate.

Concluding observations on the third to fifth periodic reports released on 6 March 2015. More information about education in Dominican Republic: https://www.oecd-ilibrary.org