III. CONCLUDING OBSERVATIONS, CONTINUED

ICCPR

•	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...

•	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.

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

(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.

ICESCR

•	Jamaica, ICESCR, E/2002/22 (2001) 130 at para. 953.

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).

•	Trinidad and Tobago, ICESCR, E/2003/22 (2002) 45 at para 295.

295. The Committee while noting the sustained efforts made to address HIV/AIDS problems, urges the State party to step up its measures to combat HIV/AIDS and, in particular, to enhance the provision of education on sexual and reproductive health.

•	Poland, ICESCR, E/2003/22 (2002) 54 at paras. 369 and 391.

369. The Committee...expresses concern that education in sexual and reproductive health is not adequately covered in the national school curricula.

...

391. The Committee...recommends that...sexual and reproductive health education be included in the national school curricula.

•	Republic of Moldova, ICESCR, E/2004/22 (2003) 49 at paras. 316 and 338.

316. The Committee is concerned about the rising incidence of HIV/AIDS and sexually transmitted diseases in the State party. In this regard, it is also concerned that sex education classes held in urban areas are almost non-existent in rural areas.

...

338. The Committee recommends that the State party intensify its efforts to combat the spread of HIV/AIDS and other sexually transmitted diseases, including through public information campaigns and by ensuring that sex education is also introduced to schools in rural areas.

•	Guatemala, ICESCR, E/2004/22 (2003) 59 at paras. 418, 435 and 436.

418. The Committee is alarmed about the increasing level of drug addiction in the State party, especially among young people.

...

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.

436. The Committee urges the State party to undertake effective measures to combat drug addiction, such as awareness-raising campaigns and educational activities.

•	Russian Federation, ICESCR, E/2004/22 (2003) 64 at paras. 476 and 504.

476. The Committee notes with concern the sharp increase in the HIV-infection rate during the last three years, the increasing incidence of HIV contracted through heterosexual contacts, and the increasing number of children born of HIV-positive mothers.

...

504. The Committee, in line with its general comment No. 14 (2000) on the right to the highest attainable standard of health (art. 12 of the Covenant), calls upon the State party to take urgent measures to stop the spread of HIV/AIDS. The State party should ensure that all persons know about the disease and how to protect themselves, including through sex education in schools, and that methods of protection are available at affordable prices. Moreover, awareness-raising campaigns should aim at preventing discrimination against HIV-positive people.

•	Democratic People's Republic of Korea, ICESCR, E/2004/22 (2003) 71 at para. 554.

554. The Committee recommends that the State party adopt a comprehensive HIV/AIDS prevention strategy, including awareness-raising campaigns and a blood safety programme. The Committee invites the State party to continue and enhance its collaboration with United Nations programmes and specialized agencies, such as WHO, UNDP and UNAIDS...

•	Greece, ICESCR, E/2005/22 (2004) 23 at paras. 145 and 167.

145. The Committee notes with concern that the State party has one of the highest tobacco and alcohol consumption rates in Europe, in particular, among minors.

...

167. The Committee recommends that the State party strictly enforce the prohibition of smoking in public areas and of the sale of strong alcoholic beverages to minors, adopt effective measures against "subtle" forms of tobacco and alcohol advertisement, in addition to existing restrictions, and intensify its efforts in the field of anti-smoking education and information campaigns.

•	Malta, ICESCR, E/2005/22 (2004) 45 at paras. 353 and 371.

353. The Committee is concerned at the lack of sexual and reproductive health-care services in the State party.

...

371. The Committee recommends that the State party strengthen education programmes on sexual and reprductive health and support sexual and reproductive health services.

•	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. The Committee is particularly concerned that the incidence of sexually transmitted diseases and HIV/AIDS is on the increase.

...

521. The Committee recommends that the State party conduct a study on the incidence of sexually transmitted diseases and HIV/AIDS in Azerbaijan and develop a comprehensive sexual and reproductive health programme, including a public awareness-raising campaign about safe contraceptive methods...

•	Chile, ICESCR, E/2005/22 (2004) 67 at paras. 553 and 580.

553. The Committee is concerned that, despite the progress made in controlling the spread of HIV/AIDS infections in the State party, HIV/AIDS is still on the increase. It also notes with concern the high rates of sexually transmitted infections among young women.

...

580. The Committee recommends that the State party strengthen measures to promote education programmes on sexual and reproductive health and to raise awareness about and access to safe contraception methods. It also recommends that the State party intensify its efforts, including through public information campaigns, to control the spread of sexually transmitted infections.

•	China, ICESCR, E/2006/22 (2005) 25 at paras. 162 and 189.

162. The Committee is concerned about the insufficient preventive care programmes that have resulted in the spread of infectious diseases, including sexually transmitted diseases and HIV/AIDS.

...

189. ...The Committee encourages the State party to take urgent measures to stop the spread of HIV/AIDS and other sexually transmitted diseases, including by means of sex education in schools and awareness-raising campaigns to eliminate discrimination against HIV-positive persons.

•	China (Hong Kong Special Administrative Region), ICESCR, E/2006/22 (2005) 34 at paras. 217 and 229.

217. The Committee remains concerned about the public's low level of awareness in the Hong Kong Special Administrative Region of sexual and reproductive health issues. The Committee also regrets that no comprehensive sexual and reproductive health programme exists in the Hong Kong Special Administrative Region and that sexual and reproductive health education is not part of the school curriculum.

...

229. The Committee recommends that the Hong Kong Special Administrative Region develop a comprehensive sexual and reproductive health programme, including a public awareness-raising campaign on safe contraceptive methods. The Committee also calls upon the Hong Kong Special Administrative Region to introduce sexual and reproductive health education in the school curriculum.

CEDAW

•	Estonia, CEDAW, A/57/38 part I (2002) 13 at para. 112.

112. ...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. 158.

158. The Committee urges the State party to ensure that all its minimum age of marriage laws and other programmes to prevent early marriage are in line with the obligations of the Convention. The Committee also recommends that Trinidad and Tobago introduce appropriate policies and programmes for sex education and family planning education.

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

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...

•	Russian Federation, CEDAW, A/57/38 part I (2002) 40 at paras. 397, 398 and 400.

397. Noting the measures taken by the State party to combat the effect of HIV/AIDS on pregnant women, the Committee is concerned that the State party regards HIV/AIDS as primarily resulting from the conduct of individuals in the context of drug abuse and alcoholism.

398. The Committee urges the State party to address the gender aspects of HIV/AIDS, including the power differential between women and men, which often prevents women from insisting on safe and responsible sex practices. It encourages the State party to strengthen its efforts to raise awareness and educate women and girls on ways to protect themselves from HIV/AIDS. The Committee urges the State party to ensure the equal rights and the access of women and girls to detection, health care and social services.

...

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. 58, 61 and 62.

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...

...

61. The Committee notes with concern that rates of HIV/AIDS infection have increased and that the majority of those who are HIV positive are young people between the ages of 15 and 29, with girls tending to become infected at a younger age than boys.

62. The Committee... encourages the State party to strengthen its efforts to raise awareness and educate women and girls on ways of self-protection...

See also:

•	Barbados, CEDAW, A/57/38 part III (2002) 177 at paras. 247, 248 and 250.

•	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.

•	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 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:

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

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

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

•	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...

148. ...The Committee...urges the State party to reinforce programmes of sexual and reproductive health education for both girls and boys...

•	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 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.

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

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. The Committee further notes with concern the increase in HIV/AIDS, mostly among adolescent girls.

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. It further urges the State party to promote sex education for adolescents with particular attention to the prevention and elimination of HIV/AIDS.

See also:

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

•	El Salvador, CEDAW, A/58/38 part I (2003) 41 at paras. 259 and 260.

259. The Committee observes with concern the lack of necessary sex education programmes and their dissemination and the resulting impact on the high rate of teenage pregnancy, in particular in rural areas, and on the increase in the spread of sexually transmitted diseases and HIV/AIDS...

260. The Committee recommends to the State party that it adopt measures to guarantee and expand access to health-care services, paying special attention to the implementation of programmes and policies for disseminating and raising awareness of sex education, particularly among adolescents, including information on contraceptives and their availability in society as a whole, taking into account that family planning is the responsibility of the couple and placing special emphasis on preventing and combating sexually transmitted diseases and HIV/AIDS.

•	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. 126 and 127.

126. ...The Committee is...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. The Committee is further concerned that, notwithstanding progress in relation to the control of HIV/AIDS, the number of infected women, particularly young women, had increased.

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. The Committee also recommends that sex education be widely promoted, particularly targeting adolescents, with special attention to the prevention and further control of HIV/AIDS.

•	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).

•	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...

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

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 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. 212 and 213.

212. The Committee is concerned at the status of women's health, particularly rural women. 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. It is further concerned at the lack of research on women's health and data disaggregated by sex.

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. The Committee requests the State party to conduct research on women's health...

•	Ethiopia, CEDAW, A/59/38 part I (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.

•	Belarus, CEDAW, A/59/38 part I (2004) 55 at paras. 355 and 356.

355. The Committee is concerned about the general decline in the status of women's health, as well as the decline in women's access to health services. The Committee is also concerned at the continuing use of abortion as a primary method of birth control, teenage pregnancy, the deterioration of the health of pregnant women and the spread of sexually transmitted diseases, including HIV/AIDS...

356. The Committee recommends the full implementation of a holistic, life cycle approach to women's health, including access to affordable health care, the financial and organizational strengthening of family planning programmes and the provision of wide access to contraceptives for all women and men, in accordance with its general recommendation 24 on women and health. It 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...

•	Latvia, CEDAW, A/59/38 part II (2004) 103 at paras. 71 and 72.

71. The Committee is concerned at the spread of HIV/AIDS, the increase in the infection rates of women and the absence of a strategic national plan to address the issue of HIV/AIDS and how it affects women.

72. The Committee urges the State party to take comprehensive measures to combat the spread of HIV/AIDS, to take strong preventive measures and to ensure that women and girls infected with HIV/AIDS are not discriminated against and are given appropriate assistance. The Committee also recommends that sex education, particularly targeting adolescents, be made widely available, with special attention to the prevention and further control of HIV/AIDS.

•	Angola, CEDAW, A/59/38 part II (2004) 118 at paras. 162 and 163.

162. ...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. The Committee is also concerned about trends in HIV/AIDS infection rates of women.

163. ...[T]he 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 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. It also calls on the State party to ensure the effective implementation of its HIV/AIDS law and policies.

•	Dominican Republic, CEDAW, A/59/38 part II (2004) 141 at para. 309.

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...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 para. 381.

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...

•	Samoa, CEDAW, A/60/38 part I (2005) 9 at paras. 56 and 57.

56. The Committee...is...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. The Committee is also concerned about the insufficient information provided about the HIV/AIDS infection rates of women.

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. ...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.

•	Benin, CEDAW, A/60/38 part II (2005) 116 at paras. 157 and 158.

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. 205 and 206.

205. The Committee expresses concern about the high rates of malnutrition, malaria and HIV/AIDS affecting women and girls in the country. 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 recommends the implementation of comprehensive policies and programmes to prevent and combat malnutrition, malaria and HIV/AIDS. 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.

•	Guyana, CEDAW, A/60/38 part II (2005) 136 at paras. 305 and 306.

305. While welcoming the adoption of the National Strategic Plan for HIV/AIDS 2002-
2006, the Committee notes with concern the high and growing prevalence of HIV/AIDS among women, especially younger women, who are particularly vulnerable because of unequal power relations and limited socio-economic opportunities...

306. The Committee urges the State party to strengthen attention to the gender dimensions in its efforts to combat the HIV/AIDS pandemic. It calls on the State party to increase its emphasis on men's responsibilities in preventing the spread of the disease, including through awareness-raising and prevention campaigns, and the implementation of education programmes on sexual and reproductive health and rights directed at both women and men, including the provision of condoms...

•	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...

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...

CRC

•	Oman, CRC, CRC/C/111 (2001) 36 at paras. 185-188.

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

(a) Malnutrition affects about 25 per cent of children under 5;

(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

(d) Ten per cent of school-age children suffer from mild to moderate iodine deficiency disorders.

186. The Committee recommends that the State party:

...

(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.

187. The Committee is concerned that insufficient information is available in relation to adolescent health, such as access to reproductive health services and mental health counselling services.

188. The Committee recommends that the State party:

(a) 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;

(b) Strengthen efforts in the area of adolescent health education within the educational system; and

(c) Seek assistance from, among others, UNICEF and WHO.

•	Portugal, CRC, CRC/C/111 (2001) 48 at paras. 242-245.

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;

...

244. Noting the launching of the State party's Health Education Programme to address, inter alia, HIV/AIDS, the Committee remains concerned at the incidence of HIV transmission, including mother-to-child transmission, and at the high incidence of AIDS (10.4 cases per 100,000) in the State party.

245. The Committee recommends that the State party:

(a) Continue to strengthen its HIV/AIDS prevention programmes, including safe sex education programmes;

...

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

646. The Committee is concerned that adolescents face numerous risks, including from life on the street, sexual exploitation, mistreatment, alcohol, tobacco and drug abuse and delinquency, and that there are no statistics available to indicate the number of adolescents exposed to these dangers. The Committee is concerned, in addition, 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:

...

(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.

•	Greece, CRC, CRC/C/114 (2002) 25 at paras. 152 and 153.

152. The Committee is concerned that:

(a) The existing plans for sex education in schools have not been fully implemented;

...

153. The Committee recommends that the State party:

(a) Ensure the provision of relevant health information to adolescents, including through the existing plans for sex education in schools, including a safe birth control practices;

...

•	Mozambique, CRC, CRC/C/114 (2002) 65 at paras. 319 and 320.

319. While noting the establishment of a central office for the prevention and control of drug abuse, the Committee is concerned that:

(a) Substance abuse, including inhaling glue and the consumption of narcotic drugs, is practised by children, particularly street children, in the State party, particularly in the south of the country;

...

320. The Committee recommends that the State party:

...

(b) Include in school curricula education programmes and information on drug abuse and its prevention;

...

•	Malawi, CRC, CRC/C/114 (2002) 104 at paras. 424 and 425.

424. The Committee remains concerned that insufficient attention has been given to adolescent health issues, including developmental, mental and reproductive health concerns, and substance abuse.

425. The Committee recommends that the State party:

...

(b) Strengthen sex education and reproductive and mental health counselling services and make them sensitive and accessible to adolescents.

•	Bahrain, CRC, CRC/C/114 (2002) 122 at paras. 489 and 490.

489. The Committee welcomes information that adolescent health education has been proposed for inclusion in the curricula. Nevertheless, it is concerned at insufficient information is available in relation to adolescent health, such as access to reproductive health services, and mental health counselling services.

490. The Committee recommends that the State party:

(a) Formulate adolescent health policies and programmes, including education, with the full participation of adolescents;

(b) Ensure that adolescents have access to child-sensitive and confidential counselling services; strengthen efforts in the area of adolescent health education within the educational system; and

(c) Seek assistance from, among others, UNICEF and WHO.

•	Andorra, CRC, CRC/C/114 (2002) 134 at paras. 541 and 542.

541. The Committee expresses its concern about the health problems faced by adolescents within the State party, including drug abuse, and the fact that they make little use of the health services available to them. In particular, it takes note of the number of cases of anxiety and depression affecting children and of the fact that psychological treatments for children are not covered by the national security system.

542. The Committee recommends that the State party:

(a) Continue with and expand the services provided by Consulta Jove;

(b) Continue and strengthen its activities to prevent HIV/AIDS and sexually transmitted diseases, drug and other substances abuse and unwanted pregnancies, and strengthen the programme of health education in schools;

...

•	Saint Vincent and the Grenadines, CRC, CRC/C/118 (2002) 101 at paras. 450-452.

450. The Committee recommends that the State party:

...

(h) Strengthen the education provided to young parents in the care and early attention they should give to their sick children and in the prevention of abuse and neglect;

...

451. The Committee is concerned that:

(a) Adolescents face health risks, including from sexual exploitation, maltreatment, drug and alcohol abuse, and HIV/AIDS;

(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.

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

505. The Committee notes with concern the number of children and adolescents addicted to drugs, in particular synthetic drugs, alcohol and smoking, and the fact that consumption of alcohol and tobacco is socially accepted and not perceived as a risk. It further expresses its concern at the increase in the number of teenage pregnancies.

506. The Committee recommends that the State party:

(a) Enforce existing programmes, such as the National Drug Plan for 2002-2008 and those at Autonomous Community level, with a focus on preventive action and awareness raising on the danger of synthetic drugs, alcohol and tobacco;

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

...

•	The Netherlands (Antilles), CRC, CRC/C/118 (2002) 129 at paras. 571 and 572.

571. While the Committee welcomes the introduction of "Healthy Lifestyles" and "Reproductive Health" into the education curriculum, the Committee remains concerned at the high rates of early pregnancy and the lack of information, counselling and preventive programmes on reproductive health. It also notes the rise in the number of children and youth using drugs, and the growing number of cases of HIV/AIDS among the youth.

572. The Committee recommends that the Netherlands Antilles:

(a) Implement the programme on reproductive health proposed in 1996 following the national workshop on reproductive health;

...

(c) Ensure that adolescents (both girls and boys) have access to and are provided with education on reproductive health and other adolescent health issues, as well as with child-
sensitive and confidential counselling services, and strengthen efforts in the area of adolescent health education within the educational system.

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

72. The Committee recommends that the State party:

...

(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. 135 and 136.

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);

...

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

205. The Committee is concerned that:

(a) Adolescents face health risks, including from sexual exploitation, maltreatment, smoking, drug and alcohol abuse, and HIV/AIDS and sexually transmitted diseases;

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

...

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;

...

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

350. ...The Committee expresses concern about the lack of access, without parental consent, to medical counselling and advice...

...

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;

...

•	Republic of Moldova, CRC, CRC/C/121 (2002) 89 at paras. 406 and 407.

406. The Committee, while welcoming the national programme to combat HIV/AIDS with the support of international organizations, notes with deep concern the increasing rates of sexually transmitted diseases (STDs) and HIV/AIDS among adolescents and the large number of teenage pregnancies and abortions. It further notes that the health services provided are not tailored to the needs of adolescents, thus reducing their willingness to avail themselves of primary health services.

407. The Committee recommends that the State party:

...

(b) Further strengthen the programme of health education in schools;

...

(d) Undertake 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;

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

•	Burkina Faso, CRC, CRC/C/121 (2002) 103 at paras. 467 and 468.

467. The Committee notes the establishment of children's centres, but remains concerned that insufficient attention has been given to adolescent health issues, including developmental, mental and reproductive health concerns, and substance abuse. The Committee is also concerned at the particular situation of girls, given, for instance, the very high percentage of early marriages, which can have a negative impact on their health.

468. The Committee recommends that the State party:

...

(b) Strengthen sexual and reproductive health education, mental health and adolescent-
sensitive counselling services and make them accessible to adolescents.

•	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:

(a) Improve the effectiveness of health promotion and health education programme, in particular by promoting healthy lifestyles among children and young people;

(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;

(b) Smoking amongst adolescents is excessive;

(c) The abuse of alcohol, drugs and illicit substances is increasing among teenagers.

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.

•	Estonia, CRC, CRC/C/124 (2003) 9 at paras. 62, 63, 68 and 69.

62. The Committee notes the existence of the State-sponsored ongoing prevention programme on alcoholism and substance abuse, 1997-2002, and welcomes information in the written replies concerning the development of new programmes to address the problems affecting the reproductive health of youths, including sexually transmitted diseases and HIV/AIDS. However, the Committee is concerned at the prevailing mental health problems, the high suicide rate, the large number of abortions and incidence of sexually transmitted diseases, the increasing number of HIV infections among injecting drug users and the high number of accidents, and reiterates the concerns expressed by the Committee on Economic, Social and Cultural Rights (E/C.12/1/Add.85, paras. 27-30) where these relate to children.

63. The Committee recommends that the State party:

(a) Strengthen and ensure that its programmes for adolescent health are effectively implemented, including through the provision of adequate resources;

(b) Ensure that future measures are formulated with the full participation of adolescents;

(c) Ensure that adolescents have access to child-sensitive and confidential counselling services, including mental health counselling;

(d) Strengthen efforts in the area of adolescent health education within schools.

...

68. The Committee notes the information related to the ongoing "Alcoholism and substance abuse prevention programme, 1997-2007"; however, it remains concerned that children are not effectively protected from the illicit use of narcotic drugs and psychotropic substances and at the increasing use of drugs and the rise in the number of injecting drug users.

69. The Committee encourages the State party to continue its efforts to provide children with accurate and objective information about substance use and to take all appropriate measures, including drug education in schools. The Committee urges the State party to evaluate the ongoing prevention programme with a view to reconsidering modalities of implementation to maximize its effectiveness. Furthermore, the State party is urged to enhance rehabilitation services for children who are victims of substance abuse.

•	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:

(a) Take all necessary measures to strengthen its mental health and counselling services, ensuring that they are accessible and sensitive to adolescents, and undertake studies on the causes and backgrounds of psychological disorders among adolescents;

(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.

•	Viet Nam, CRC, CRC/C/124 (2003) 67 at paras. 292 and 293.

292. The Committee is concerned at the high number of children who are injured, disabled or killed by accidents, such as traffic accidents, or by natural disasters.

293. While noting the State party's efforts, in particular the National Programme of Action for Accident Control (2000), the Committee recommends that the State party conduct a study on the scope and causes of accidental deaths and strengthen its efforts to reduce accident-
related deaths through, inter alia, awareness-raising campaigns and education programmes aimed at parents, children and the public at large.

•	Czech Republic, CRC, CRC/C/124 (2003) 78 at paras. 371 and 372.

371. The Committee reiterates the concerns expressed by the Committee on Economic Social and Cultural Rights (E/C.12/1/Add.76, paras. 21 and 41) at tobacco smoking, drug abuse and alcohol consumption, as well as at the decreasing but still high number of teenage pregnancies and abortions.

372. The Committee recommends that the State party undertake further measures, including through 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 substance abuse, 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.

•	Cyprus, CRC, CRC/C/132 (2003) 21 at paras. 135 and 136.

135. The Committee welcomes the information contained in the State party's report on health education in schools, in particular information on the harmful effects of alcohol and nicotine. However, the Committee is concerned at the high rate of children consuming alcohol, tobacco, drugs and other harmful substances.

136. The Committee encourages the State party to actively pursue its health education initiatives in schools and recommends that it undertake 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 substance abuse, 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.

•	Sri Lanka, CRC, CRC/C/132 (2003) 48 at paras. 267 and 268.

267. The Committee notes the establishment of Presidential Task Forces to deal with the problems of suicide and alcohol, drug and tobacco use by adolescents, and the subsequent improvement in the rate of youth suicide. Nevertheless, the Committee is concerned that these issues remain a problem for adolescents and that an organized system of reproductive health counselling and services for youth, as well as education on HIV/AIDS and STDs, does not yet exist.

268. The Committee recommends that the State party continue to strengthen its efforts to address youth suicide, drug abuse, alcoholism and tobacco use and develop a comprehensive policy on adolescent health which, inter alia, supports the implementation of the recommendations of the Presidential Task Forces, promotes collaboration between State agencies and NGOs [non-governmental organizations] in order to establish a system of formal and informal education on HIV/AIDS and STDs, and ensures access to reproductive health counselling and services for all adolescents. The State party should make use of the International Guidelines on HIV/AIDS and Human Rights (E/CN.4/1997/37) and the Committee's general comment No. 3 on HIV/AIDS and the rights of the child, in order to promote and protect the rights of children infected with and affected by HIV/AIDS.

•	Libyan Arab Jamahiriya, CRC, CRC/C/132 (2003) 74 at paras. 382 and 383.

382. The Committee notes the establishment of the National Committee for AIDS Prevention in 1987 and other measures to address the problem of HIV/AIDS, but is concerned at the relatively high number of children afflicted by HIV/AIDS in Benghazi. The Committee is also concerned at the insufficient information available in relation to adolescent health, particularly in relation to mental health issues.

383. The Committee recommends that the State party:

(a) Continue and strengthen its activities to prevent HIV/AIDS;

...

(c) Ensure that adolescents have access to, and are provided with, education on adolescent health issues, in particular regarding mental health, in a sensitive manner;

(d) Take appropriate measures to reduce substance dependency amongst young people;

(e) Strengthen efforts in the area of adolescent health education within the school system;

(f) Seek assistance from, among others, UNICEF and WHO.

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

436. The Committee is concerned that:

(a) Adolescents face particular physical and mental health risks, including from sexual abuse, violence, drug and alcohol abuse and STIs;

(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:

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

(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.

•	Indonesia, CRC, CRC/C/137 (2004) 8 at paras. 78 and 79.

78. The Committee notes the establishment in 1999 of the Commission on Reproductive Health, to deal, inter alia, with the problems of adolescent health, HIV/AIDS prevention and family planning. The Committee is nevertheless concerned that these issues remain a problem for adolescents and that no organized system of reproductive health counselling and services, nor education on HIV/AIDS and sexually transmitted infections (STIs) for youth exists. The Committee is further concerned at the high number of tobacco smokers among adolescents.

79. The Committee recommends that the State party:

...

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

...

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

(f) Provide adolescents with accurate and objective information on the harmful consequences of tobacco use and protect them from hurtful misinformation by imposing comprehensive restrictions on tobacco advertising.

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

222. ...[T]he Committee notes with concern that infant and maternal mortality rates remain high and that an increasing number of children and mothers suffer from malnutrition as a result of rising food prices and poverty...

223. The Committee urges the State party to:

...

(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;

(e) Take measures to educate the public on healthy eating habits, providing the necessary dietary supplements to reduce the incidence of iron deficiency anaemia among mothers and children;

...

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. Furthermore, while the incidence of HIV remains low in the State party, the Committee is concerned about the lack of knowledge about HIV/AIDS among young people. 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, the approval of the National Strategy to Combat HIV/AIDS in 2002, and the establishment of an Inter-Ministerial Council for HIV/AIDS Prevention.

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. 293 and 294.

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; and that the number of children either of whose parents is a drug addict is estimated at 3 million.

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. 364 and 365.

364. The Committee is concerned at the lack of sufficient mental health services for adolescents in the State party, and the prevalence of drug and alcohol abuse. It is also concerned that teenage pregnancies and sexually transmitted infections are on the rise in the Netherlands...

365. The Committee recommends that the State party:

...

(b) Take all necessary measures to prevent drug and alcohol abuse, including education campaigns, and ensure that there are sufficient rehabilitation services specifically for children and adolescents;

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

...

•	India, CRC, CRC/C/137 (2004) 75 at paras. 438 and 439.

438. The Committee is concerned at the very high percentage of early and forced marriages of girls, which can have a negative impact on their health, education and social development.

439. The Committee recommends that the State party:

...

(c) Strengthen sexual and reproductive health education, mental health and adolescent-
sensitive counselling services and make them accessible to adolescents.

•	Papua New Guinea, CRC, CRC/C/137 (2004) 94 at paras. 512 and 513.

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.

•	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:

...

(b) Alcohol, tobacco and drug abuse is affecting an increasing number of young people and that the existing legislation does not provide effective protection for children;

(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;

...

(e) Provide adolescents with accurate and objective information on the harmful consequences of alcohol, drug and tobacco use, and develop and implement a legislation adequately protecting them from harmful misinformation, including through comprehensive restrictions on alcohol and tobacco advertising;

...

•	France, CRC, CRC/C/140 (2004) 124 at paras. 623 and 624.

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 high rate of suicides, representing the second cause of death for this age group, 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. 151 and 152.

151. While welcoming the establishment of the National AIDS Council, chaired by the president, the National AIDS Coordinating Council, the National Policy on HIV/AIDS, the Prevention of Mother to Child Transmission Programme and the programme for AIDS orphans, the Committee shares the serious concern of the State party at the still exceedingly high prevalence rate of HIV/AIDS, especially among women in their child-bearing years compounded, in part, by inappropriate traditional practices, stigmatization and lack of knowledge on prevention methods.

152. In the light of general comment No. 3 on HIV/AIDS and the rights of children (CRC/GC/2003/3), the Committee urges the State party to strengthen its efforts in combating the spread and effects of HIV/AIDS by, inter alia, training professionals, conducting education campaigns on prevention, improving the prevention of mother to child transmission programme, by providing free and universal antiretroviral medication and improving protection and support for AIDS orphans.

•	Croatia, CRC, CRC/C/143 (2004) 36 at paras. 194 and 195.

194. The Committee notes with concern the relatively high number of deaths and injuries among children due to traffic and domestic accidents despite the various measures taken by the State party to address this problem.

195. The Committee recommends that the State party continue and strengthen as much as possible its efforts to prevent traffic and domestic accidents, inter alia by systematic enforcement of existing regulations and by ongoing awareness-raising via educational campaigns.

•	Angola, CRC, CRC/C/143 (2004) 78 at paras. 421 and 422.

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. 503-506.

503. ...The Committee...shares the concern of the State party at the rising incidence of obesity.

504. The Committee recommends that the State party:

...

(c) Engage in efforts to educate children and their parents about healthy diets and lifestyles.

505. The Committee is concerned that insufficient attention has been given by the State party to adolescent health issues, including developmental, mental and reproductive health concerns. The Committee further notes with concern that the adolescent outreach project focusing on fertility and sexuality funded by the United Nations Population Fund (UNFPA) has not been sustained. The Committee is also concerned that reproductive health education is not part of the official curriculum of primary and secondary education.

506. The Committee recommends that the State party:

(a) Undertake a comprehensive study to assess the nature and extent of adolescent health problems and, with the full participation of adolescents, use this as a basis to formulate adolescent health policies and programmes with a particular focus on the prevention of sexually transmitted diseases (STDs), especially through reproductive health education and child-sensitive counselling services, and taking into account the Committee's general comment No. 4 (2003) on adolescent health and development in this regard;

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

(c) Take measures to incorporate reproductive health education in the school curriculum, particularly at the secondary level, in order to fully inform adolescents about their reproductive health rights and the prevention of STDs, including HIV/AIDS, and early pregnancies;

...

(e) Continue to work with international agencies with expertise in health issues relating to adolescents, inter alia UNFPA, UNICEF and WHO.

•	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, and about the prevalence of tobacco and drug use, and of alcohol abuse.

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. It also recommends that the State party continue its efforts to prevent and combat the use of tobacco and drugs, and the abuse of alcohol.

•	Albania, CRC, CRC/C/146 (2005) 19 at paras. 129-132.

129. The Committee welcomes the information provided by the State party on legislative and other measures aimed at contributing to the protection of mothers, infants and school-age children, such as the joint programme of the Ministry of Health and UNICEF, or the establishment of an Inter-Ministerial Commission for HIV/AIDS in 2000. However, the Committee is concerned at the information on the poor quality of health services in general, particularly in some regions, and more specifically at the high number of children suffering from malnutrition, iodine deficiency and other preventable illnesses...

130. The Committee recommends that the State party:

...

(b) Address the issues of malnutrition and iodine deficiency through, inter alia, education and promotion of healthy feeding practices.

131. The Committee welcomes the legislative and other measures taken by the State party to reduce the use of tobacco, in particular among children under 16 years of age... It...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:

(a) Increase its efforts to promote adolescent health policies, introduce legislation and strengthen programmes of health education in schools;

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

...

(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;

...

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

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. 642 and 643.

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. 727 and 728.

727. ...The Committee is concerned about the situation of refugee and internally displaced children living in refugee camps...The Committee is...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, 93 and 94.

82. The Committee expresses its concern at the increasing rate of HIV/AIDS and other sexually transmitted diseases among adolescents. It further 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;

...

93. While the Committee is encouraged that the State party has taken measures to ensure the school environment remains drug-free for children, it remains concerned that measures for monitoring drug abuse among children as well as their involvement in drug trafficking outside of schools have not been fully developed in the report.

94. The Committee recommends that the State party strengthen its measures to combat drug abuse by children, including through public education awareness-raising campaigns and ensure that children who abuse drugs have proper access to effective structures and procedures for treatment, counselling, recovery and social reintegration.

•	Philippines, CRC, CRC/C/150 (2005) 24 at paras. 163-166.

163. The Committee is concerned, despite the legislative and other measures taken by the State party, about environmental problems, such as air and water pollution and environmental degradation which have serious consequences for children's health and development...

164. The Committee recommends that the State party:

...

(b) Increase children's knowledge of environmental health issues by introducing environmental health education programmes in schools;

...

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:

...

(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;

...

(e) Provide adolescents with information on the harmful consequences of alcohol, drug and tobacco use;

...

•	Bosnia and Herzegovina, CRC, CRC/C/150 (2005) 49 at paras. 254 and 255.

254. The Committee is concerned that high-risk behaviour among young people - (i.e. injecting drug use and risky sexual behaviour) - may expose the State party to serious HIV/AIDS problems in the future. The Committee also notes that this issue was recognized by the Government only in 2002 - with the creation of the National Advisory Board for the prevention of HIV/AIDS and the development of a "Strategy for Preventing and Combating HIV/AIDS in Bosnia and Herzegovina" - whereas it is still not perceived as a threat by most of the population.

255. The Committee recommends that the State party:

...

(b) Launch campaigns and programmes to raise awareness about HIV/AIDS among adolescents, particularly among those belonging to vulnerable groups as well as the population at large, so as to reduce discrimination against children infected and affected by HIV/AIDS;

...

•	Nepal, CRC, CRC/C/150 (2005) 66 at paras. 341, 343, 364 and 365.

341. The Committee welcomes the establishment of a working group to implement the Integrated Management of Childhood Illness strategy in 1997 and commends the State party's efforts in improving the immunization coverage for children under 5, including the recent completion of the comprehensive measles vaccination campaign. The Committee nevertheless shares the concerns of the State party that the health and social services are under tremendous resource constraints and that the overall quality and availability of health care available to children in the State party is seriously inadequate, in particular among poor families and in rural areas. In particular, the Committee is concerned about:

...

(e) Low awareness about health, hygiene and sanitation, particularly in rural areas and prevalence of traditional practices which could be harmful to the health of children, such as that of consulting witch doctors instead of modern medical facilities and withholding water from children suffering from diarrhoea.

...

343. The Committee recommends that the State party:

...

(e) Engage in awareness-raising efforts to provide the general public, in particular, families, children and health-care providers, including traditional health practitioners, with appropriate knowledge of basic first aid and health care;

...

364. The Committee expresses concern at the widespread prevalence of alcohol consumption by children, as well as the growing incidence of substance abuse by children, including the use of cannabis, heroin, opiates and intravenous drug use. The Committee is also concerned about the harmful effects of alcohol and substance consumption by parents on the physical, emotional and psychological development and well-being of children in the State party...

365. The Committee recommends that the State party take initiatives to combat drug and alcohol abuse by children, including through public education awareness campaigns and ensure that children who abuse alcohol and/or use drugs and other harmful substances have access to effective structures and procedures for treatment, counselling, recovery and reintegration. The Committee further recommends that parents are educated, through, inter alia, awareness-raising campaigns, on the harmful effects of parents' use of alcohol and controlled substances on the development and well-being of children...

•	Ecuador, CRC, CRC/C/150 (2005) 91 at paras. 439-442.

439. The Committee reiterates the concern raised in its previous concluding observations (CRC/C/15/Add.93) with regard to the damaging effect of oil extraction and the spraying of illegal crops under Plan Colombia on the environment and on the health of children.

440. The Committee recommends that the State party effectively address the problem of pollution and environmental degradation, including by seeking bilateral agreements and international cooperation. It also recommends that the State party strengthen its environmental health education programme.

441. The Committee remains concerned at the increasing number of teenage pregnancies and the number of very young mothers. The Committee is also concerned that adolescents face particular physical health and mental health risks, including violence, drug use and alcohol abuse and sexually transmitted infections (STIs).

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;

(c) Undertake effective measures to prevent sexually transmitted diseases and to combat drug use and alcohol abuse by children, including through public education awareness-raising campaigns and ensure that children who abuse alcohol and/or use drugs have access to effective structures and procedures for treatment, counselling, recovery and reintegration;

...

•	Mongolia, CRC, CRC/C/150 (2005) 113 at paras. 560 and 561.

560. The Committee takes note of the State party's efforts to promote adolescent health and health education in schools by implementing the National Reproductive Programme on Student and Adolescent Health and a campaign on the "health-promoting school". However, the Committee is concerned at the limited number of school health services, including the lack of regular physical examinations and statistical data on the status of schoolchildren's health. In addition, the Committee is concerned that insufficient attention has been given to adolescent health in the context of non-communicable diseases related to lifestyle factors, such as tobacco smoking, alcohol consumption and drug abuse.

561. The Committee recommends that the State party pay close attention to adolescent health, taking into account general comment No. 4 (2003) on adolescent health and development in the context of the Convention on the Rights of the Child, and strengthen its efforts to promote adolescent health, including sexual and reproductive health education in schools, and to introduce school health services, including youth-sensitive and confidential counselling and care. The Committee recommends that the State party ensure that adolescents not attending school are provided with the same education, information and services for health. In order to decrease tobacco smoking, alcohol consumption and drug abuse among adolescents, the Committee recommends that the State party initiates campaigns, particularly designed for adolescents, on health-behavioural choices.

•	Nicaragua, CRC, CRC/C/150 (2005) 132 at paras. 642 and 643.

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.