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Dr. Sue Bennett, MB ChB FRCPC, University of Ottawa Dr. Shafik Dharamsi, MSc PhD, University of British Columbia


The Stark Facts • In developing nations, 1 out of 10 children dies before the age of 5 • In developed nations, 1 out of 143 dies before the age of 5 • Today nearly 11 million children under the age of 5 die in the world every year – well over 1,200 every hour most from easily preventable or treatable causes.


Children by the numbers There are 2.2 billion children under 18 years old in the world - almost one third of the world’s population Adolescents, age 10-19, represent 18 per cent of the total population 1 billion children are deprived of one or more services essential to survival and development 2 million children under age 15 worldwide are living with HIV/AIDS 215 million children are engaged in child labour 101 million children are not attending primary school 51 million children are unregistered at birth http://www.childinfo.org/index.html


MDG #4 - Reduce Child Mortality • Up to 90% of infant mortality could be prevented through breast feeding, oral rehydration therapy, malaria prevention, proper diet and access to antibiotics and vitamin supplements, but many women simply lack the knowledge necessary to make informed decisions.


More Stark Facts... In 1960 there were 3 billion people in the world; today there are 7 billion, and in 2050, the population will jump to 9 billion


What happens in low income countries in times of financial crisis? Social services are usually the first to be cut from national and local budgets Inflation raises the cost of food and housing Childhood nutrition is negatively impacted Forced migration jeopardizes children’s health and well-being Children can be pulled from school, especially if there is a cost implication for families Children can be sent to work where safety regulations for their protection may not exist


Short term implications for children and youth Living in poverty Poor nutrition Lack of complete education Child labour (exposure to injury, illness) Forced migration Higher risk of suffering and neglect due to lack of policy When government can’t provide, burden falls on women and girls


Long-term implications Once in poverty, hard to get out of it In 10 + years, an uneducated work force In 10 + years, an undernourished work force The poverty cycle continues, impacting future generations


“Good social policy = good economic policy� International Labour Organization, 2004


Child Rights = Human Rights!


Child Rights Training – the context Most rights training focuses on the content of the Convention on the Rights of the Child, not its implications for practice Most training is provided by/directed at NGOs, not professionals To date, little progress – few paediatricians, nurses, teachers, social workers, lawyers, judges, police etc. aware of CRC or its implications for their practice


Why the lack of progress? Lack of government funding or commitment

Resistance to the concept of children’s rights

Lack of resources for curriculum development

Lack of capacity and understanding of child rights

Overcrowded existing curricula


Why is it needed? Lack of awareness of rights among health professionals Inequality of access and outcomes for many children Inadequate focus on quality of children’s own experience Need for greater focus on social determinants of health Failure to acknowledge the contribution of children to their own healthcare


Implications of rights based education for professionals Governments primary duty bearers - need to be held to account

Professionals working with children have a key role to play in promoting respect for children’s rights

Rights based education needs to engage with attitudes and behaviour

A rights based approach to professional practice

Children’s rights require more than legislative change – need to promote a culture of respect of rights

Education needs to be rooted in the social, economic and cultural environment in which it is delivered


What can health professionals do? Infuse child rights into daily practice Ensure children receive the care they need to thrive

Monitor and evaluate programs and services Become a champion for the health and well-being of children and youth by advocating for their rights with families, social services and governments


A rights-based focus on health education Understanding the relationship between rights and needs Introduction to the CRC – knowing what rights children have and the corresponding responsibilities for adults Relationship between the child and the professional – respecting children’s rights at the individual level The provision of services – fulfilling children’s rights The role of professionals as advocates – protecting children’s rights and preventing continuing violations and neglect Monitoring and evaluation On-going advocacy


So…how to move the agenda

forward? A global initiative: Child Rights Education for Professionals (CRED-PRO)


Building support for moving forward Human rights bodies

• To lend legitimacy and emphasis to the need for progress

International agencies

• To provide programmatic support, advocacy, and consistency to the work

Professional bodies

• To review content and address entry points, buy in and sustainability

Academic institutions

• For expertise on curriculum development, certification and accreditation


Establishing CRED-PRO International initiative to serve as a catalyst towards translation of children’s rights into professional practice Aim is to integrate principles of children’s rights into professionals’ values and ethics Strategy is to mobilise the development and implementation of child rights training for professionals as a core tool for achieving change Brings together key partners – professional associations, academics, UN agencies, NGOs Supported by funding from Oak Foundation, Bernard van Leer Foundation


How CRED-PRO works‌ Develop core curricula on child rights for professionals

Revise curriculum, add case studies, consult with children, and run a TOT to build a cohort of champions

Explore potential interest at country level to engage in a programme to develop child rights education

Working group review the core curriculum from a regional/national perspective and develop process for modification

Identify a lead national partner and establish working group to develop, implement, and sustain the curriculum

Explore potential entry points, opportunities for sustained implementation

Follow up strategy for implementation

Monitor and evaluate the programme, and introduce systems for certification and accreditation


Partners Human rights bodies - Committee on the Rights of the Child, UNHCHR UN agencies – UNICEF, UNESCO, WHO/PAHO Professional bodies - AAP, RCPCH, ESSOP, EI, ISPA, FLACSO INGOs/NGOS – ISPCAN, Save the Children, World Vision, Children’s Institute SA, Children’s Rights Centre, Turkey, MS-TCDC, East Africa, IIN Latin America, Colsubsidio Colombia Universities – IICRD, Open University, Tulane University , Lund University, Trinity College Dublin, Royal Roads University


Key working principles Respect for the rights of every child A strengths-based approach Working through partners Sustainability and integration

Local ownership


Focus of curriculum Needs vs. rights

Convention on the Rights of the Child The individual The profession

The individual practitioner Systems Accountability Advocacy


Where does CRED-PRO work? Africa

Europe

Latin America

North America

Tanzania, Turkey Argentina, Canada, USA Ethiopia, Kenya, Chile, Uganda, Colombia, South Africa Paraguay, North America – USA and Canada Uruguay, (health, social work, education, school Guatemala, psychologists) Jamaica Curriculum focus Child Rights and Law for Health Professionals, Early Childhood Professionals

Pan-European initiative for school psychologists

Health, Child Social Work, Participation, Pediatrics, Child Protection School Psychology, Education


Key outcomes In Argentina, “Te Escucho” (“I hear you”), a programme to provide health care workers the knowledge and tools to enable them to influence their own work environment In Chile, a cross-national cooperative project to orient and prepare health managers to implement the national child protection policy In Colombia, training of undergraduate students and members of the CPS, participating in the Congresses of the CPS, and advocacy activities. In Uruguay, training undergraduate and postgraduate health professional students the development of instruments, adapted to the local context, to analyze clinical cases through the lens of child rights.


Key outcomes (cont.) In South Africa, development and accreditation of curriculum and Post Graduate Diploma in General and Community Paediatrics In Tanzania, an early years curriculum, ‘owned’ by the government and being rolled out to early years workers across the country, as well as incorporated in the core training for community development workers In Turkey, development, in partnership with Paediatric Society, of a locally adapted curriculum for doctors and nurses In USA, five year funding to develop a diploma in societal paediatrics and child rights, make the programme available online and produce an internationally relevant text book on child rights and health equity In Canada, Social Work and Health curricula under development


Lessons learned Importance of local ownership

Role of professions Need for broad alliances

Importance of consulting with children Different role of governments depending in context

Importance of sustainable implementation strategies Potential for wider advocacy arising from the process


The short term and long terms benefits of using a child rights approach in a shifting world economy Short term: Better health for children and youth Greater awareness by practitioner of how rights are protected (or not) in their country/region/community Ability to influence policy to protect children’s rights over the long term Ability to hear the voice of the child, to engage them in safeguarding their own health and well-being Long term: Healthy and well-educated children grow into adults who are better able to contribute to the economic well-being of society


Conclusion Child rights education needs to be integral to professional training, not just provided in one-off workshops Achieving effective child rights education is about a process, not just a product Moving the agenda forward is slow, needs investment of commitment and time Nevertheless, it can be a powerful mechanism which can make real change in children’s lives Raising professional awareness of and commitment to children’s rights is not an option – it is an imperative!!


Learn More

www.cred-pro.org


Global Health October 2012 Ottawa  

Wrote and designed PowerPoint.

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