with children, and to do this separately with their parents, in order to learn about their health challenges, developmental needs and
expectations as a contribution to the design of effective interventions and health programmes.
F.Evolving capacities and the lifecourse of the child
Childhood is a period of continuous growth from birth to infancy, through the preschool age to adolescence. Each phase is significant
as important developmental changes occur in terms of physical, psychological, emotional and social development, expectations and
norms. The stages of the child’s development are cumulative and each stage has an impact on subsequent phases, influencing the
children’s health, potential, risks and opportunities. Understanding the life course is essential in order to appreciate how health
problems in childhood affect public health in general.
The Committee recognizes that children’s evolving capacities have a bearing on their independent decision-making on their health
issues. It also notes that there are often serious discrepancies regarding such autonomous decision-making, with children who are
particularly vulnerable to discrimination often less able to exercise this autonomy. It is therefore essential that supportive policies are in
place and that children, parents and health workers have adequate rights-based guidance on consent, assent and confidentiality.
To respond and understand children’s evolving capacities and the different health priorities along the life cycle, data and information
that are collected and analysed should be disaggregated by age, sex, disability, socioeconomic status and sociocultural aspects and
geographic location, in accordance with international standards. This makes it possible to plan, develop, implement and monitor
appropriate policies and interventions that take into consideration the changing capacities and needs of children over time, and that
help to provide relevant health services for all children.
III.Normative content of article 24
A.Article 24, paragraph 1
“States parties recognize the right of the child to the enjoyment of the highest attainable standard
of health”
The notion of “the highest attainable standard of health” takes into account both the child’s biological, social, cultural and economic
preconditions and the State’s available resources, supplemented by resources made available by other sources, including nongovernmental organizations, the international community and the private sector.
Children’s right to health contains a set of freedoms and entitlements. The freedoms, which are of increasing importance in
accordance with growing capacity and maturity, include the right to control one’s health and body, including sexual and reproductive
freedom to make responsible choices. The entitlements include access to a range of facilities, goods, services and conditions that
provide equality of opportunity for every child to enjoy the highest attainable standard of health.
“and to facilities for the treatment of illness and rehabilitation of health”
Children are entitled to quality health services, including prevention, promotion, treatment, rehabilitation and palliative care services.
At the primary level, these services must be available in sufficient quantity and quality, functional, within the physical and financial
reach of all sections of the child population, and acceptable to all. The health-care system should not only provide health-care support
but also report the information to relevant authorities for cases of rights violations and injustice. Secondary and tertiary level care
should also be made available, to the extent possible, with functional referral systems linking communities and families at all levels of
the health system.
Comprehensive primary health-care programmes should be delivered alongside proven community-based efforts, including preventive
care, treatment of specific diseases and nutritional interventions. Interventions at the community level should include the provision of
information, services and commodities as well as prevention of illness and injury through, e.g., investment in safe public spaces, road
safety and education on injury, accident and violence prevention.
States should ensure an appropriately trained workforce of sufficient size to support health services for all children. Adequate
regulation, supervision, remuneration and conditions of service are also required, including for community health workers. Capacity
development activities should ensure that service providers work in a child-sensitive manner and do not deny children any services to
which they are entitled by law. Accountability mechanisms should be incorporated to ensure that quality assurance standards are
maintained.
“States parties shall strive to ensure that no child is deprived of his or her right of access to such
health care services”
Article 24, paragraph 1, imposes a strong duty of action by States parties to ensure that health andother relevant services are
available and accessible to all children, with special attention to under-served areas and populations. It requires a comprehensive
primary health-care system, an adequate legal framework and sustained attention to the underlying determinants of children’s health.
Barriers to children’s access to health services, including financial, institutional and cultural barriers, should be identified and
eliminated. Universal free birth registration is a prerequisite andsocial protection interventions, including social security such as child
grants or subsidies, cash transfers and paid parental leave, should be implemented and seen as complementary investments.
Health-seeking behaviour is shaped by the environment in which it takes place, including, inter alia, the availability of services, levels
of health knowledge, life skills and values. States should seek to ensure an enabling environment to encourage appropriate health-