A/70/213
recognition of the detrimental effects of institutional care on the health and
development of all young children and for the adoption of a common understanding
that institutional care should not be accepted for children under 5 years of age.
74. The Special Rapporteur is also concerned about families and parents at risk
and in vulnerable situations who are exposed to multiple forms of stress because of
poverty, social exclusion and discrimination, including families who migrate, are
internally displaced persons or refugees or belong to marginalized r acial or ethnic
groups and parents who use drugs or have mental health problems. The solution is
not to blame parents and take their children away from them. It is first the
responsibility of States to address discrimination and provide adequate support
services so that risks are eliminated and the basic rights and needs of children are
protected within the family environment.
75. For instance, mental health issues or drug use are not in themselves indicators
of bad parenting, but rather a signal of a potential situation of risk. Parents with
mental health challenges or with drug dependency issues who have young children
should have access to appropriate services, such as psychosocial interventions or
harm reduction services that encourage the development o f healthy and nurturing
relationships of parents with their children. Barriers to realizing the right to health
of families at risk include the criminalization of parents who use drugs as well as
policies that pursue the revocation of custodial rights of t hose with mental health
issues. Criminalization and penalization drive families at risk, including parents
who are drug dependent or have mental health problems, away from health and
social services for fear of arrest and loss of their children.
C.
Equality and non-discrimination
76. Inequalities and discrimination obstruct equitable healthy development and
educational attainment among young children from marginalized groups, including
persons living in poverty, minority and indigenous groups, the girl child, persons
with disabilities, persons in underserved areas such as rural populations, refugees,
internally displaced children and children living in areas affected by conflict.
Inequalities and discrimination ultimately contribute to health and othe r inequalities
later in life and to the intergenerational transmission of disadvantage. 50
77. The twin fundamental human rights principles of equality and
non-discrimination mean that States have legally binding human rights obligations
to immediately address the healthy development of young children from
marginalized groups so they can enjoy the right to health on the basis of equality.
This obligation corresponds to the three pillars of the process of progressively
achieving universal health coverage — expand priority services, include more
people and reduce out-of-pocket payments — and must be addressed when
providing services for young children and their families from disadvantaged
groups. 51 The collection and analysis of disaggregated data are necessary to reveal
which groups are disproportionately affected. 52 Outreach and other programmes are
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50
51
52
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WHO and Commission on the Social Determinants of Health.
WHO, Making Fair Choices on the Path to Universal Health Coverage: Final Report of the
WHO Consultative Group on Equity and Universal Health Coverage (Geneva, 2014).
Committee on the Rights of the Child, general comment No. 7 (2005), para. 36.
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