Children’s place in manifestos

FORMER prime minister Raja Pervez Ashraf declared 2013 the year of the rights of the child in Pakistan on Nov 20, 2012 while speaking at a function to commemorate Universal Children’s Day. Unfortunately, however, his government couldn’t take any tangible steps in the first two and half months of 2013 except the last-minute approval of the Prohibition of Corporal Punishment Bill 2013 by the National Assembly and the approval of the Criminal Law Amendment (Child Protection) Bill 2013 by the federal cabinet in its last meeting.

The current year is also the year of elections in Pakistan and in the coming days and weeks we’ll be hearing political parties share their programmes and manifestos with the masses. This article has attempted to review the manifestos of Pakistan’s major political parties, specifically with reference to the rights of children to health and protection.

The PPP in its manifesto of 2008 referred more to what the party has done during earlier periods in power. While referring to health, the party declared it a high priority and committed that “it will further consolidate the Lady Health Workers Programme”.

The PTI highlighted “the present dismal state of women and children in terms of their access to healthcare, nutrition, and education”. The party plans to revamp and upgrade the public healthcare system in Pakistan in line with its slogan “healthy people, healthy nation” by putting in place reforms such as doubling state spending on health, achieving 100 per cent immunisation of children against preventable diseases, policy emphasis on preventive healthcare etc.

The PML-Q while referring to health commits to investment in hospitals to provide better treatment to patients and special incentives for doctors to serve in rural areas.

The PML-N while highlighting the importance of health made commitments to modernise main teaching hospitals both in the federal capital and provincial headquarters and equip these with state of the art medical equipment and facilities. The PML-N also committed to increase overall expenditure on health to 2% of the GDP, achieve 100% vaccination of children and 50% reduction in maternal and infant mortality by 2018.

The MQM committed to increase public expenditure on health from 0.6 per cent to five per cent of the GDP during the next five years. Interestingly, in its 2008 manifesto, the MQM had committed to increase it from 0.6 per cent to four per cent of the GDP and while drafting their manifesto for 2013 they were aware that it’s still at 0.6 per cent. The MQM further committed to ensure full coverage of the Expanded Programme of Immunization (EPI) and to establish hospitals in every district and healthcare centres in every village of the country. In its manifesto the MQM also committed for effective legislation against social ailments like gender discrimination, sexual harassment, domestic violence, child abuse, rape, honour killings, child marriage, karo kari, vani, marriage to the Quran, bonded labour and child labour. The party also committed to repeal all discriminatory laws against women and religious minorities.

The ANP committed it would strive to provide health facilities to all citizens. The party aimed to allocate at least six per cent of the GDP to health. It emphasised child and mother care, provision of clean drinking water and preventive medicine. ANP is the only political party that has included section on child rights in its manifesto and has vowed to review, legislate and implement child labour laws to ensure that child labour under the age of 16 years is prohibited in all formal and informal sectors including domestic sector. The ANP is committed to implementation of the Juvenile Justice System and will establish exclusive juvenile courts and introduce exclusive prisons with immense rehabilitation possibilities for the children. The ANP has also committed to make efforts to prohibit all forms of violence against children such as corporal punishment, sexual abuse, rape, kidnapping and ensuring punishment as per law.

The ANP also made commitments about bringing changes in FATA however, no child rights specific recommendation was made to ensure children of FATA equal rights without any discrimination as per the UN Convention on the Rights of the Child and other international human rights instruments.

While reviewing the manifestos of political parties it was observed that the content of most of the manifestos has minor changes from the 2008 elections. It was also observed that most of the commitments made regarding the right to health are of a general nature and there has been little focus on large-scale health reforms linking this right with achieving our international commitments such as the Millennium Development Goals (MDGs), Convention on the Rights of the Child and International Covenant on Economic, Social and Cultural Rights etc.

Similarly, except the PTI little attention has been paid to the prevention aspect highlighting areas like child and maternal health, infant and under-five mortality, immunisation and budgetary allocation.

The ANP and MQM have made specific recommendations related to budgetary allocation for health. However, one fails to understand what steps they took to increase budgetary allocation for health during their time in power.

According to the findings of the Draft National Nutrition Survey 2011, malnutrition has become a key concern for the country. Approximately 400,000 children die in Pakistan every year before their fifth birthday and 35 per cent of these deaths are attributed to malnutrition. However, none of the political parties have shared any vision about how they will address this important issue. Similarly, no specific agenda has been shared about what steps they would take to put Pakistan or their respective provinces on the right direction towards achieving the MDGs.

Health workers and immunisation are of immense importance towards achieving the MDGs. However, these important areas are not that visible on the agendas of political parties except the PPP and PTI, and that too without clear objectives and strategies.

It has emerged from the review of the manifestos that except ANP child protection is of no interest to any political party, except some highlights in the manifesto of the MQM without any solid plan about addressing the issues.

 

I need not remind anyone that millions of children are working as child labourers in Pakistan, including as part of the child domestic labour force, particularly in the homes of elites including politicians, while the number of children living and or working on the streets is increasing. Child marriage is still common, corporal punishment is widespread, internal trafficking of children, the use of children as child soldiers and suicide bombers and a poor criminal justice system for children are also some of the issues faced by minors.

The political parties in Pakistan need to come up with firm commitments about child rights, particularly children’s right to health and protection. Focus should be on areas which can bring solid changes in key indicators like child and maternal mortality, vaccination ratio, nutrition indicators, health workers’ coverage, protection of children from abuse, exploitation and violence against children, and above all policy, legislation and budgetary allocation for children.

The writer is a child rights activist. Twitter: @amahmood72

Published in Daily Dawn on April 9, 2013 http://dawn.com/2013/04/09/more-of-the-same-6/

 

 

 

Time to invest in routine immunization

It was a unanimous agreement among participants of the annual review of the Expanded Programme of Immunization (EPI), Khyber Pakhtunkhwa (KP) Province, to invest in routine immunization and that investment in routine immunization will help not only put Pakistan on the right track for achieving the Millennium  Development Goal 4 but will also ensure eradication of polio on sustainable basis. The review was held in Islamabad on March 22-24, 2013.

Dr Janbaz Afridi, Deputy Director EPI, highlighted the issues faced by the programme in KP including complicated security situation, difficult terrain, burden of Afghan refugees since 1979 and Internally Displaced Persons (IDPs) since 5 years, absence of a uniform and sustained quality of  coverage in critical districts, reporting and data management problems, weak technical capacity at district level and late compliance from some of the districts, limited number of female EPI technicians and no legislation concerning immunization to ensure 100% coverage of the target population.

While discussing the way forward it was agreed that the World Immunization Week to be celebrated in the last week of April 2013 with the theme “Stop Measles Now” shall be used as an opportunity to strengthen routine immunization in the province. Furthermore, service structure of staff involved in routine immunization, training of EPI staff in vaccine management, data management, communication and M&E, involvement of paramedics in routine immunization, evaluation of Lady Health Workers involvement in routine immunization, involvement of private sector and CSOs in EPI and legislation to ensure 100% coverage of target population were some of the areas require to be focused for greater immunization coverage and strengthening of the routine immunization system in the province.

A brief introduction of the EVERY ONE campaign was presented with its purpose and strategic objectives with a focus on immunization. It was highlighted that not enough children in Pakistan receive childhood vaccinations and children in rural areas are 1.4 times less likely to be immunized than children in urban areas. Highlighting the importance of immunization among the masses it was shared that 20% of the people in Pakistan have no knowledge about immunization and 14% think it’s unnecessary. It was emphasized that parental attitudes & knowledge and the quality of communication and outreach strategies directly affects the parental knowledge & attitudes – many parents of unimmunised children lack information about routine immunisation programme.

The EVERY ONE Campaign demanded that the provincial government should allocate specific resources to scale up routine immunisation targeting uncovered areas and children from poorest wealth quintiles. For this purpose, a policy should be adopted to train and expand the scope of work of LHWs to administer routine immunisation. Similarly, for KP to progress towards achieving universal standard for number of vaccinators (one vaccinator per 5,000 people) it is imperative to introduce a policy and make budgetary allocation. Furthermore, donors’ commitment was requested for responding to the needs of the province for universal coverage of routine and new vaccines.

It was discussed during the review that specific existing initiatives can be used to strengthen routine immunisation such as investments in LHWs and vaccinators, specific initiatives to reach out to every union council of the district as currently 110 of 1040 union councils of the province have no fix EPI Centre for immunization. It was also an undisputed agreement that there is a need for widespread awareness among the communities and their empowerment to demand services and hold the EPI accountable.

Dr Roohullah representing the Director General of Health Services reassured provincial government’s commitment for strengthening the routine immunization system in the province. He further committed that all issues raised in the review will be seriously considered and addressed.

It was agreed that such reviews should be held regularly both at the provincial and district levels to be able to identify and remove weaknesses and strengthen the routine immunization system in the province including in the poor performing and hard to reach union councils and districts. Based on the findings of the review, the Deputy Director EPI and Provincial Coordinator of LHW Programme agreed to review the Terms of Reference of the LHWs and formally include responsibilities related to EPI as they are now permanent government servants. It was also agreed that joint advocacy efforts should be made by the civil society, donors and UN Agencies for legislation and increased budgetary allocation for immunization in the province. 

http://everyone.savethechildren.net/articles/time-invest-routine-immunization  

 

SUPERFOOD for Babies

There was a unanimous agreement among the participants and speakers of the launching ceremony of Save the Children’s Global Breastfeeding report, ‘SUPERFOOD FOR BABIES: How overcoming barriers to breastfeeding will save children’s lives’, that breastfeeding is the most effective and tested method to protect children from killer diseases as soon as they are born.  

“The lives of 95 babies could be saved every hour - 830,000 a year, if new mothers around the world breastfed immediately after giving birth”, said Dr. Qudsia Uzma, Director Health & Nutrition at Save the Children, while sharing the salient features of the report. She highlighted that if babies receive colostrum – the mother’s first milk – within an hour of birth, it will kick start the child’s immune system, making them three times more likely to survive. If the mother continues feeding for the next six months, then a child growing up in the developing world is up to 15 times less likely to die from killer diseases like pneumonia and diarrhea.

It was only four days ago that Pakistan witnessed the adoption of the local legislation by Sindh to address breastfeeding violations. Serendipity perhaps, but the timing of this development in terms of the revealing of the Report could not have been better.  

“It’s heartening to know that the Provincial Assembly in Sindh has adopted the Sindh Protection of Breastfeeding and Child Nutrition (Amendment) Act 2013. However, the real test is its implementation in letter and spirit”, noted Save the Children’s Deputy Country Director in Pakistan, Mr. Ghulam Qadri: “Despite the Protection of Breastfeeding and Child Nutrition Ordinance on statute books since 2002, its implementation has always remained a distant desire.”

The EVERY ONE Campaign in Pakistan also recently saw the induction of its second champion, Haroon Rashid.

 “I would like to take this opportunity to pledge that as a Campaign Ambassador for Save the Children’s EVERY ONE Campaign, I will do all that is possible in my capacity to take forward the cause of maternal, newborn and child health in Pakistan” the singer proclaimed at the launch,  where he was formally introduced as the Campaign Ambassador. “When I was approached to become an Ambassador, I didn’t hesitate to take the assignment up as this is a subject very close to my heart.”

“The teachings of Islam strongly endorse that mothers should breastfeed their children for two years and I congratulate Save the Children for taking up such an important subject related to infant mortality”, said Dr. Donya Aziz, Member National Assembly of Pakistan, who was also part of the panel. With her proclamation of taking up the matter of implementation of the Ordinance with the Minister for Capital Administration and Development Division (CADD), it was clear that Dr. Donya recognized the value of such an intervention to ensure that every infant is given the life-saving protection that breastfeeding can offer. Referring to the report’s recommendation about lack of adequate maternity legislation which makes breastfeeding and returning to work a challenge, Dr. Donya Aziz, promised that if provided with a bill about adequate maternity legislation, she will place it before the National Assembly of Pakistan and endeavour to help ensure that the law is adopted.

“Legislation alone is not going to change the situation as numerous bills already exist in Pakistan; it is the implementation of laws that demand attention”, said Dr. Sania Nistar, a prominent right to health advocate in Pakistan and founder of the organization Heartfile.

“Equity statistics at all levels shows fundamental distortions in Pakistan. The Breast Milk Substitute production industry has to be brought to the table. If they are part of the problem, they should also be part of the solution.”

Dr. Sania rounded up the entire event by underlining that breastfeeding can have an impact on the bottom line because it costs nothing, thereby having a large scale impact on the improvement of newborn and child health By concluding that Save the Children has touched the heart of the problem with the new report, we knew that a potential partnership with Heartfile could be in the making. 

Child rights agenda

Universal Children’s Day (UCD) was observed on November 20 with great show by the government and civil society across Pakistan. The Prime Minister declared 2013 as the year of child rights and made announcements about establishment of the National Commission on the Rights of Children and budgetary allocation for the Parliamentary Forum on Child Rights. These are good steps however; 2013 being declared as the year of child rights, I would like to put a few concrete recommendations for the current government to pursue in the last few months of its tenure and to be able to bring some positive changes in the arena of child rights in Pakistan.

On October 30, 2012 Pakistan’s Universal Periodic Review (UPR) was held at the Human Rights Council in Geneva. It’ll be great if the present government immediately accept all recommendation and particularly those related to child rights and chalk out a plan for the implementation of the UPR recommendations. Furthermore, Pakistan’s Periodic report being party to the UN Convention on the Rights of the Child was due in 2012 however, it could not be submitted timely, neither were the recommendations on the last periodic report implemented properly. The government should prepare and submit the periodic report to the UN Committee on the Rights of the Child and implement recommendations both by the Committee on the Rights of the Child and Human Rights Council including the recommendations related to legislation by passing all pending bills i.e. the Criminal Law Amendment (Child Protection) Bill 2009, the National Commission on the Rights of Children Bill 2009, the Charter of Child Rights Bill 2009, the Prohibition of Corporal Punishment Bill and the Child Marriages Restraint Amendment Bill.

To respond to the issue of child domestic labour the government should immediately ban child domestic labour by notifying it under the schedule of banned occupations of the Employment of Children Act 1991. Furthermore, the government should notify rules of the recently enacted the ICT Right to Free and Compulsory Education Act 2012 and make budgetary allocation of ensuring its implementation in the Federal Capital. Similarly, the President should notify the Federally Administered Areas Right to Free and Compulsory Education Regulation and all the four provinces should enact the Right to Free and Compulsory Education Bills on the pattern of national legislature.

The federal government and particularly the Parliamentary Forum for Child Right should help as well as push the provincial governments for investing in children and introducing laws in the remaining few months of the present Provincial Assemblies. It is regrettable that there was no child rights related legislation in some provinces in the tenure of current assemblies.

Khyber Pakhtunkhwa introduced the Khyber Pakhtunkhwa Child Protection and Welfare Act 2010 and the Khyber Pakhtunkhwa Borstal Institutions Act 2012 however; implementation of these laws and budgetary allocation for their proper implementation is still to be made. The Khyber Pakhtunkhwa Child Protection and Welfare Commission is doing an excellent job since its establishment following the enactment of the law in 2010 however; the provincial government should make sufficient budgetary allocation for the Commission to be able to establish Child Protection Units (currently CPUs have been established in 8 out of 25 districts) across all districts of the Province and work more effectively.

Punjab enacted the Punjab Employment of Children Amendment Act 2011, without any amendments in the federal Employment of Children Act 1991 though except changing the word Pakistan with Punjab and the word Federal with the word Provincial. The government of Punjab should ban Child Domestic Labour by notifying it under the schedule of banned occupations of the Employment of Children Amendment Act 2011. The Provincial Assembly should also enact the Punjab Prohibition of Corporal Punishment Bill. The government of Punjab should also establish an independent Provincial Commission on the Rights of Children through an Act of the Provincial Assembly to work for the promotion and protection of child rights in the province in light of our national and international obligations and make budgetary allocation for the implementation of all children related laws in the province.

Sindh introduced the Sindh Child Protection Authority Act 2011 however; implementation of the law and budgetary allocation is still awaited. The government of Sindh should immediately notify rules of the Sindh Child Protection Authority Act 2011; notify the Sindh Child Protection Authority and establish Child Protection Units at the local level in accordance with Section 16 of the law and this will not be possible without proper budgetary allocation for the implementation of the law.

Furthermore, Balochistan, Khyber Pakhtunkhwa, Punjab and Sindh should introduce the Right to Free and Compulsory Education Acts in light of Article 25 A of the Constitution whereby education has been made a fundamental right for every child of 5 to 16 years of age and make budgetary allocation for the effective implementation of this very important constitutional provision. Recently in a forum on Right to Education in Islamabad most of the provincial government representatives were presenting lack of financial resources particularly budget for building new school buildings as a major hurdle in the implementation of this constitutional provision. It is recommended that the provincial governments should think of various options including using the existing facilities i.e. school buildings, teachers efficiently to respond to the situation such as evening shifts. 

Unfortunately, Balochistan is the only province which has failed to introduce any child rights specific legislation since independence. It’s high time that the Provincial Assembly responds to its constitutional obligations and passes all pending bills related to child rights particularly the Balochistan Child Protection and Welfare Bill, the Balochistan Borstal Institutions Bill, the Balochistan Employment of Children Amendment Bill and the Balochistan Prohibition of Corporal Punishment Bill. The government of Balochistan should also make budgetary allocation for the implementation of these laws particularly in the areas of health, education and child protection.

The federal and provincial government with the support of the civil society, UN Agencies and donors should immediately begin planning for 2013; the year of child rights, and come up with plans and strategies for making 2013 truly a year of the rights the children of Pakistan. As recommended above, the federal and provincial legislature should pass all pending bills related to child rights and the respective governments should make budgetary allocations for the implementation of those laws. Furthermore, the federal government should ratify Optional Protocols to the UN Convention on the Rights of the Child on the Involvement of Children in Armed Conflict and on the Communications Procedure. Similarly, the civil society, the UN and donors Agencies can support the federal and provincial governments not only in the initial implementation of children related plans and projects but also in creating widespread awareness about child rights and extending technical assistance in having in place the right laws, policies and strategies.

The writer is a child rights activist and tweets @amahmood72

 

Publised in Daily Dawn on December 10, 2012 http://dawn.com/2012/12/10/child-rights-agenda/

Universal Children’s Day and the UPR recommendations

By Arshad Mahmood

Universal Children’s Day (UCD) is observed every year since 1956 following a UN General Assembly recommendation. On November 20, 1989 the UN adopted the Convention on the Rights of the Child (CRC) also know as Magna Carta of child rights. This UCD is special as recently Pakistan’s UPR was held at the Human Rights Council in Geneva where the state of child rights in the country was highlighted and a number of countries gave child rights related recommendations. Even if the government accept all child rights related recommendations from the UPR on the occasion of the UCD and take steps for the implementation of these recommendations, the from the state of child rights in the country could be improved considerably.

Pakistan’s review was held in the 14^th Session of the Universal Periodic Review (UPR) Working Group in Human Rights Council (HRC), Geneva, Switzerland on Tuesday October 30, 2012. Foreign Minister Hina Rabbani Khar lead Pakistan’s high level delegation that also included Mr. Mustafa Nawaz Khokar, Prime Minister’s Advisor on Human Rights, Mr. Paul Bhatti, Advisor to Prime Minister on National Harmony, Mr. Riaz Fatyana, Chairman National Assembly Standing Committee on Human Rights, Mr. Araish Kumar MNA to name a few.

Ms. Khar informed the HRC that the recommendations that were accepted by Pakistan in 2008 were widely circulated and that the report shared was prepared through a broader consultative process. She said that there is a robust civil society, independent judiciary, free and active media in Pakistan which is playing a key role in the protection of human rights. She further stated that the reporting period was challenging for Pakistan.

Highlighting some positive developments with regard to human rights in Pakistan, the foreign minister informed the HRC that the UPR has been a catalyst for Pakistan to bring positive changes in legislation, policy and practice. She also informed the HRC that consistent with its long standing commitment to promote and protect human rights, Pakistan ratified the International Covenant on Civil and Political Rights (ICCPR) and Convention Against Torture (CAT) in June 2010. In August 2011, Pakistan ratified the Convention on the Rights of Persons with Disabilities and the Optional Protocol to the Convention of the Rights of the Child on the Sale of Children, Child Prostitution and Child Pornography. She mentioned a number of legislative and administrative steps taken by the government in the past four years.

The Foreign Minister’s statement was followed by recommendations by the States. States recommendations mainly focused on five key areas including minorities’ rights, ratification of the UN Human Rights instruments, women and children’s rights, education particularly with a focus on girls’ education and appreciation for the establishment of the National Commission on Human Rights (NCHR).

Some the key recommendations included strengthening and resource allocation for the National Commission on Human Rights (Algeria, Egypt, South Africa, Spain, Qatar, USA), ratification of Convention against Involuntary and Enforced Disappearances and the Optional Protocol to UN Convention on the Rights of the Child on the Involvement of Children in Armed Conflict (Spain, Uruguay, Argentina, Mexico), Extension of standing invitation to HRC’s Special Procedures Mandate Holders (Australia, Belgium, Costa Rica, Hungary, Iraq, Latvia, Norway), a number of countries shared their concerns related to the situation of minorities and the blasphemy laws (Austria, Belgium, France, Spain, Thailand, UK).  

There were a number of child rights related recommendations including Universal free primary education to all children (Thailand); Develop a comprehensive strategy to prevent sexual exploitation of children and their cruel treatment and increase criminal liability for these crimes (Belarus); Continue to develop and enhance programmes to provide education and support to children who have been recovered from militants or extremists, and to help them reintegrate into society (Singapore); Ratify the Optional Protocols to CRC, on involvement of children in armed conflict (Iraq); Ratify the third OP to CRC on a communication procedure (Slovakia); Expedite the adoption of the Charter of Child Rights Bill (Bhutan); Enact efficient legislation to prohibit and prevent the employment of children as domestic workers (Slovakia); Ensure adequate resources in implementing MDGs with priority focus on vulnerable groups such as women and children (Viet Nam); Develop a clear implementation and monitoring plan for the Bonded Labour System (Abolition) Act, 1992, the Bonded Labour System (Abolition) Rules, 1995 and the National Policy and Plan of Action for the Abolition of Bonded Labour, 2001 (Ireland).

Similarly, there were a number of recommendations related to human rights education and training for judicial and law enforcement officials (Uganda, Democratic People’s Republic of Korea, Malaysia). Canada and Austria recommended to take steps to implement laws and policies with a view to eliminating early and forced marriage in particular with a view to ending rape, sexual exploitation and forced conversions of scheduled caste girls. Uruguay recommended adopting all possible measures to prevent and explicitly prohibit in its legal order the recruitment of children and their participation in armed actions and terrorist activities. France recommended prohibiting child labour of minors under the age of 14 while Islamic Republic or Iran recommended developing the Child Protection Management Information System (CPMIS) and advancement in child immunization.

It’s time for the government Pakistan to respond to the recommendations positively and not only accept all children specific recommendations but also immediately take measures to implement the recommendations that will ultimately result in the implementation of the UN Convention on the Rights of the Child. The National Assembly of Pakistan should pass all the pending bills related to child rights including the Charter of Child Rights Bill, the Criminal Laws Amendment (Child Protection) Bill, the National Commission on the Rights of Children Bill, the Child Marriages Restraint Amendment Bill and the Prohibition of Corporal Punishment Bill. Besides, passing the pending bills the federal and provincial governments should increase budgetary allocations in health, education and children specific scheme, programs and projects.

The federal government should help as well as push the provincial governments for investing in children and introducing laws in the remaining few months of all assemblies. It is regrettable that there was no child rights related legislation in some provinces in the tenure of current assemblies. Khyber Pakhtunkhwa and Sindh introduced laws however; implementation of these laws and budgetary allocation is still awaited particularly in the case of Sindh. Balochistan is the only province which has failed to introduce any child rights specific legislation since independence. It’s high time that the provincial assembly pass all pending bills related to child rights particularly the Balochistan Child Protection and Welfare Bill and the Balochistan Right to Free and Compulsory Education Bill.

The writer is a child rights activist and tweets @amahmood72

Creating a frontline

Two important world reports were released in the past month, with direct links to newborn and maternal survival. The first, release by the World Health Organisation on May 3rd, ranked Pakistan fourth in the world for preterm births, at 748,100 per year. The report, Born too Soon, argued that shortages in qualified health workers and inadequate capacity for the care of premature babies are a major reason for the lack of progress in reducing neonatal deaths. It went on to explain how investment in health workers can considerably reduce maternal and child mortality ratio.The lack of health workers directly impacts the quality of life for mothers. This was reflected in the second report, released by Save the Children on May 8th, where Pakistan was ranked 78 out of 80 countries under the less developed countries category on the annual Mothers’ Index. The State of the World’s Mothers, released for the thirteenth year, ranked 165 countries for being the worst and best places to be a mother. It echoed the views of Born too Soon – that health workers are the key to success. Frontline health workers have a vital role to play in promoting good nutrition in the first 1,000 days in impoverished communities in the developing world where malnutrition is too common, doctors and hospitals are often unavailable, too far away, or too expensive.Indeed, we need more frontline health workers who are skilled and confident in newborn care. We need health clinics equipped with life-saving commodities. We need community health workers and midwives to screen children for malnutrition, treat diarrhoea, promote breastfeeding, distribute vitamins and other micronutrients, and counsel mothers on good nutrition, hygiene and sanitation. The “lifesaving six” interventions highlighted in the State of the World’s Mothers report can be delivered in many remote and impoverished places through well-trained and well-equipped community health workers. In a number of countries – including Cambodia, Malawi and Nepal – these health workers have contributed to broad-scale success in fighting malnutrition and saving lives.Save the Children says nearly 1.3 million children’s lives could be saved each year if six interventions are fully implemented at scale in the 12 countries, including 100,000 in Pakistan, most heavily burdened by child malnutrition and under-5 mortality. With the help of frontline health workers, all six of these interventions can be delivered fairly rapidly using health systems that are already in place.What is lacking is the political will – the will to invest in inexpensive yet proven solutions that are essential to the women and children who need them most. Three of the six solutions – iron, vitamin A and zinc – are typically packaged as capsules costing pennies per dose, or about $1 to $2 per person per year. The other three solutions – breastfeeding, complementary feeding and good hygiene – are behavioural change solutions, which can be implemented through outreach, education and community support.In Pakistan, about 100,000 Lady Health Workers (LHWs) and 4,000 Community Midwives (CMWs) exist at community level. While the government’s LHW Program is present in all districts, in reality only 60% to 65% of the whole population is covered, with many of the poorest and hardest to reach without any access at all. The Prime Minister announced an increase in the number of LHWs to 120,000 and CMWs to 16,000, although about 12,000 more CMWs need to be deployed in order to meet the World Health Organisation (WHO) criteria.The Government of Pakistan should live up to its commitment to increase the number of LHWs and extends its commitment to increase the number of CMWs. These increases would help close the gap in health promotion and provision of services. Both the federal and provincial governments and donors should work together to fill this frontline health workers gap by recruiting, training and supporting new and existing health workers, and deploying them where they are needed most.The provincial governments and donors are now playing a larger role in the post 18th constitutional amendment scenario as the LHW program has devolved to provinces. The appointment and training of CMWs have become provincial subjects as well and should now be prioritized by the provincial leaders.The provincial governments now need their own frontline health workers policies and strategies in light of their respective Millennium Development Goal (MDG) targets. This needs to be done with great urgency, given high maternal mortality ratios like that of Balochistan, at 785 per 100,000 live births. All provincial governments and the Federally Administered Tribal Areas (FATA) secretariat will need to come up with policies and strategies about increasing frontline LHWs and CMWs quickly in order to put provinces and FATA on the right track towards achieving MDGs 4 and 5. Donor agencies are also required to align their support in the post 18th constitutional amendment scenario and extend technical assistance to provinces to respond to the demands in an effective manner.The writer is an advocacy manager for Save the Children and tweets at @amahmood72.

Published by The News on Sunday on June 17, 2012 http://jang.com.pk/thenews/jun2012-weekly/nos-17-06-2012/dia.htm#4

Published as a blog on Save the Children Asia's website http://save-the-children-asia.mynewsdesk.com/blog_post/view/in-pakistan-health-workers-are-crucial-in-delivering-life-saving-support-to-newborns-and-mothers-13075

Published as a blog on Every One Campaign's website http://everyone.org/saving-newborns-in-pakistan/

Pakistan’s human rights scrutiny

The Universal Periodic Review (UPR) Working Group’s 14^th session is scheduled to take place from October 22 to November 5, 2012 in Human Rights Council, Geneva, Switzerland. Pakistan’s review is scheduled from 09:00 to 12:30 hours on Tuesday October 30, 2012 while the report on Pakistan will be adopted on Friday November 02, 2012. The UPR is a United Nations review mechanism of the overall human rights situation of all UN Member States, by all UN Member States. This includes child rights issues.

The review is based on three reports: 1) the State’s national report, 2) a compilation of UN information on the State prepared by the Office of the High Commissioner (OHCHR) and 3) a summary of other relevant stakeholders’ information, including NGOs’, prepared by the OHCHR. From Pakistan a number of stakeholders’ reports have been submitted by different civil society organizations focusing on different areas such as human rights, women’s rights, minorities’ situation, labour rights, right to information and child rights. I’ll briefly discuss the concerns and recommendations raised by the Child Rights Movement (CRM), a coalition of 108 national and international organizations working for child rights in Pakistan in its report.

The CRM report highlights the fact that there is no an independent body at the federal level with a statutory status for reporting, coordination and monitoring for the implementation of the United Nations Convention on the Rights of the Child (UNCRC) and its Optional Protocols and have recommended that the Government of Pakistan should establish an independent National Commission on the Rights of Children (NCRC) by passing the long pending NCRC bill.

While highlighting the issue of malnutrition, the civil society report states that malnutrition is contributing to 35 percent of all under-5 deaths in Pakistan. According to UNICEF, 32 percent of infants have low birth-weight (recorded in 2006 and 2010). In 2010, the infant mortality rate was 70/1000 and under-5 mortality rate was 87/1000. As a result, Pakistan is at risk of failing to reach its MDGs targets on maternal and child health. Pakistan should take all legislative, administrative and other appropriate measures to develop and implement comprehensive food security and malnutrition prevention and response programmes recommended the CRM.

The report further states that Pakistan has ratified three conventions related to children: UNCRC and ILO’s Conventions 138 (the Minimum Age Convention) and 182 (Convention on the Worst Forms of Child Labour) however, little progress has been made in amending existing or introducing new legislation to comply with the provisions of these conventions. The report also highlights cases of severe torture and abuse of child domestic workers. The civil society report recommends that Pakistan should introduce new laws and where required amend existing laws to implement the provisions of these conventions and to ban child domestic labour under the Employment of Children Act (ECA) 1991.

The report also highlights child protection issues like corporal punishment and child marriages and recommended to immediately enact the long awaited Prohibition of Corporal Punishment and the Child Marriages Restraint (Amendment) Bills to prohibit corporal punishment in all its forms and raise the minimum marriageable age for girls from 16 to 18 years, along with strict penalties for violations.

The CRM report highlighted stark statistics related to the number of child sexual abuse cases (1,839 in 2008, 2,012 in 2009, 2,595 in 2010): On average, six children are sexually assaulted every day, but reported cases are only a fraction of all cases due to social taboo. CRM recommends that Pakistan should ensure that professionals working on the front line with children, such as teachers, medical professionals, school counselors, and police personnel, are sensitized and trained to appropriately respond to child sexual abuse, including prevention, detection and management.

There are an estimated 1.2 million children living and or working on the streets in major cities of Pakistan. Following the floods in 2010 and 2011, and ongoing conflict in the tribal areas, there has been a surge of street children. The federal and provincial governments in Pakistan should support mechanisms for rehabilitation and reunification of children living and or working on the streets recommended the CRM.

The civil society report further states that the Juvenile Justice System Ordinance (JJSO), 2000, is little recognized or known among law enforcement agencies, and officials are generally not sensitized or qualified to deal with children’s issues. Furthermore, the law does not override, but is in addition to, several laws such as  the Army Act, Frontier Crimes Regulation, Action (in Aid Civil Power) Regulation, Anti-terrorism Act, Control of Narcotics Substance Act, Punjab Prohibition of Kite Flying Ordinance and the Railways Act to name a few. Under these laws, harsh punishments including death sentence and life imprisonment can be imposed upon children. The Government of Pakistan should take measures to ensure that the JJSO overrides other laws in cases involving children and take solid steps for the implementation of the JJSO including the establishment of exclusive juvenile courts, appointment of probation officers and budgetary allocation.

Similarly, the minimum age for criminal responsibility that currently stands at 7 years under Section 82 of the Pakistan Penal Code (PPC) should be increased immediately to an internationally accepted level i.e. 12 years. A Child Protection Criminal Laws (Amendment) Bill has been pending since 2009 in which the minimum age of criminal responsibility was proposed to increase from 7 to 10 years under Section 82  and from 12 to 14 years under Section 83 of the PPPC.

National birth registration average is at a dismal 29.5 percent as Pakistan has not taken sufficient measures to remove structural obstacles to birth registration and harmonize birth registration systems across the country. The CRM recommended that Pakistan should take legal and administrative measures to remove obstacles to birth registration (particularly for marginalized segments of society, e.g. single parents children, children out of wedlock, street children and orphans) and harmonize laws related to birth registration across the country by 2015.

While highlighting the state of education in the country, the report stated that about 7 million children are not attending primary school in Pakistan; approximately 60 percent of these are girls. Accordingly, more than 50 million Pakistanis above 10 years of age are illiterate. Through a positive constitutional amendment Article 25A was inserted in the Constitution of Pakistan in 2010, where education has been made a fundamental right of every child from 5 to 16 years of age however; neither the federal nor provincial governments have introduced laws to implement the Article. Both the federal and provincial legislature should enact laws Pakistan that should comply with Article 25-A (the Right to Education).

Pakistan ratified the Optional Protocol to the UNCRC on Sale of Children, Child Prostitution and Child Pornography in October 2011; however, the Child Protection (Criminal Law) Amendment Bill 2009, which would provide for preventive and protective measures against sale of children, child prostitution and child pornography is still pending to be placed before the National Assembly of Pakistan for enactment. Pakistan should translate ratification of the Optional Protocol on Sale of Children, Child Prostitution and Child Pornography into national laws.

Pakistan has introduced the Action in Aid for Civil Power Regulations (AACPRs) for the Federally Administrated Tribal Areas and Provincially Administrated Tribal Areas. These regulations allow for the confinement of an individual for 120 days without the authority of the magistrate. Furthermore, the Regulations state that for 120 days, there will be no legal representation or trial, and a single statement by an official from the Law Enforcement Agencies is sufficient to prove a suspect guilty of an offence and set a death sentence, which cannot be challenged at any other legal forum. Pakistan should immediately abolish the AACPRs and proper administrative and judicial procedures should be applied in accordance with the Constitution of Pakistan in FATA and PATA.

The issues raised and recommendations made in the civil society report clearly highlight the state of affairs in the country as for as child rights are concerned. Pakistan’s periodic report being party to the Convention on the Rights of the Child is also due later this year. Therefore, its high time for the both the federal and provincial legislature to respond to the state of child rights in the country and immediately enact all pending bills related to child rights. Similarly, budgetary allocation should also be made to ensure that the laws are not limited to law books only and a visible change is witnessed in the child rights situation in the country.

The writer is a member of the Child Rights Movement and tweets @amahmood72

 

Published in The News on Sunday http://jang.com.pk/thenews/Oct2012-weekly/nos-27-10-2012/pol1.htm#6 and http://www.trust.org/alertnet/blogs/asia-views/pakistans-human-rights-scrutiny