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the human rights community. Section III focuses on the close link between the right
to health and the healthy development of children under 5 years of age by exploring
the meaning and determinants of healthy development, including new scientific
understanding of development during the early years. Section IV focuses on the
application of the right to health framework to the theme of the report.
6.
The right to health provides a valuable normative and legally binding
framework to support the health-related dimensions of early child development. It
places a legal obligation on States to guarantee the right to healthy deve lopment of
children; eliminate discrimination and inequalities that obstruct equitable healthy
development; ensure participation of stakeholders by including parents and young
children in relevant efforts; devote maximum available resources to the healthy
development of children; develop suitable laws and policies, including a
comprehensive national plan; and ensure accountability.
7.
Definitions of early childhood vary by country and region. The Committee on
the Rights of the Child establishes the limit of early childhood at 8 years of age.
This is a common categorization for early childhood used by, among others, the
World Health Organization (WHO). In the present report, the Special Rapporteur
focuses on children under 5 years of age. This age group is c ommonly further
divided into the neonatal period (0-28 days), infancy (the first year of life) and the
preschool years (1-5 years).
II. Progress in relation to child survival and the right to health
A.
Scale and causes of under-5 mortality and morbidity
8.
Some 17,000 children under 5 years of age continue to die every day, mainly
from preventable or treatable causes. In addition, 44 per cent of deaths of children
under 5 occur in babies aged 0-28 days. The neonatal deaths result mainly from
preterm birth complications (35 per cent), birth asphyxia and trauma (24 per cent)
and sepsis (15 per cent). 6 From 29 days until 5 years of age, the majority of deaths
are attributable to infectious diseases such as pneumonia (23 per cent), diarrhoeal
diseases (16 per cent), malaria (13 per cent) and HIV/AIDS (3 per cent). 7
9.
Low birth weight, lack of breastfeeding, undernutrition, overcrowded living
conditions, indoor air pollution, unsafe drinking water and food and poor hygiene
practices are the main immediate risk factors for pneumonia and diarrhoea.
However, while such diseases are proximate causes of death and are duly reflected
in statistics, poverty and inequalities are the root causes, or underlying social
determinants. Poverty increases young children’s exposure to risks such as poor
nutrition, violence, inadequate sanitation, lower levels of maternal education,
inadequate stimulation in the home, increased maternal stress and depression and, at
the same time, limits access to health and other services. 8 In 2013 the under-5
mortality rate in low-income countries was more than 12 times the average rate in
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7
8
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UNICEF and others, pp. 14-15.
WHO, Global Health Observatory Data Repository. Available from http://apps.who.int/gho/data/
node.main.CODWORLD?lang=en.
S. Walker and T. Wachs and others, “Child development: risk factors for adverse outcomes in
developing countries”, Lancet, vol. 369, No. 9556 (13 January 2007), pp. 145-157.
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