The Rights of Children for Optimal Development and Nurturing Care Julie Uchitel, BS,A Errol Alden, MD, FAAP,B Zulfiqar A
Total Page：16
File Type：pdf, Size：1020Kb
The Rights of Children for Optimal Development and Nurturing Care Julie Uchitel, BS,a Errol Alden, MD, FAAP,b Zulfiqar A. Bhutta, PhD, MBBS, FRCPCH, FAAP,c,d Jeffrey Goldhagen, MD, MPH,e Aditee Pradhan Narayan, MD, MPH,f Shanti Raman, PhD, FRACP,g,h Nick Spencer, MPhil,i Donald Wertlieb, PhD,j Jane Wettach, JD,k Sue Woolfenden, MBBS, PhD, MPH,l Mohamad A. Mikati, MDa,m Millions of children are subjected to abuse, neglect, and displacement, and abstract millions more are at risk for not achieving their developmental potential. Although there is a global movement to change this, driven by children’s rights, progress is slow and impeded by political considerations. The United aDivision of Pediatric Neurology and fDepartment of Pediatrics, Duke University Health System, Durham, North Nations Convention on the Rights of the Child, a global comprehensive Carolina; bInternational Pediatric Association and commitment to children’s rights ratified by all countries in the world except Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland; cDivision of the United States (because of concerns about impingement on sovereignty Women and Child Health, Aga Khan University, Karachi, and parental authority), has a special General Comment on “Implementing Pakistan; dCentre for Global Child Health, The Hospital for ” Sick Children, Toronto, Canada; eDivision of Community and Child Rights in Early Childhood. More recently, the World Health Societal Pediatrics, Department of Pediatrics, College of Organization and United Nations Children’s Fund have launched the Medicine, University of Florida, Jacksonville, Florida; g Nurturing Care Framework for Early Childhood Development (ECD), which International Pediatrics Association Standing Committee, International Society of Social Pediatrics and Child Health, calls for public policies that promote nurturing care interventions and Geneva, Switzerland; mEarly Childhood Development addresses 5 interrelated components that are necessary for optimal ECD. This Standing Advisory Group, International Pediatrics Association, St Louis, Missouri; hDivision of Community move is also complemented by the Human Capital Project of the World Bank, Pediatric, South Western Sydney Local Health District, providing a focus on the need for investments in child health and nutrition Sydney, New South Wales, Australia; iDivision of Mental fi ’ Health and Wellbeing, Warwick Medical School, University of and their long-term bene ts. In this article, we outline children s rights under Warwick, Coventry, United Kingdom; jEliot-Pearson international law, the underlying scientific evidence supporting attention to Department of Child Study and Human Development, School ’ of Arts and Sciences, Tufts University, Medford, ECD, and the philosophy of nurturing care that ensures that children s rights Massachusetts; kDuke Children’s Law Clinic, School of Law, are respected, protected, and fulfilled. We also provide pediatricians Duke University, Durham, North Carolina; and lDiscipline of anywhere with the policy and rights-based frameworks that are essential for Paediatrics, School of Medicine, University of New South Wales, Sydney, New South Wales, Australia them to care for and advocate for children and families to ensure optimal developmental, health, and socioemotional outcomes. These Ms Uchitel served as the major role in drafting the manuscript for intellectual content, creating the recommendations do not necessarily reflect American Academy of Pediatrics figures for the manuscript, revising the manuscript policy. for intellectual content, and preparing the manuscript for submission; Drs Alden, Bhutta, Goldhagen, Narayan, and Raman, Mr Spencer, Dr Wertlieb, Mrs Wettach, and Dr Woolfenden drafted components of the manuscript for intellectual It is imperative that all children receive Rights of the Child (CRC), an content and revised the entire manuscript for the necessary care and support to allow international commitment to ensuring intellectual content; Dr Mikati planned the outline of them to reach their full potential. children’s rights, was adopted in 1989 the article, guided the drafting of the article, and However, an estimated 250 million by the United Nations (UN) General contributed heavily to revision of the manuscript for , intellectual content and preparing the manuscript children 5 years of age, in low-, Assembly and entered into force in for submission; and all authors approved the final middle-, as well as high-income 1990.3 The CRC has been ratified by manuscript as submitted and agree to be countries, are at risk for not achieving 196 countries, making it the most accountable for all aspects of the work. their potential because of risk factors of widely ratified UN human rights treaty DOI: https://doi.org/10.1542/peds.2019-0487 1 extreme poverty and stunting, and to date.4 Subsequently, the Millennium Accepted for publication Sep 19, 2019 nearly 17 million children have been Development Goals, adopted by world forcibly displaced because of violence leaders in 2000 (to be reached by To cite: Uchitel J, Alden E, Bhutta ZA, et al. The and conflict as of the end of 2017.2 2015), concentrated on child survival.5 Rights of Children for Optimal Development and But there is a global movement to These goals have now been replaced by Nurturing Care. Pediatrics. 2019;144(6): e20190487 change this. The Convention on the the Sustainable Development Goals Downloaded from www.aappublications.org/news by guest on September 26, 2021 PEDIATRICS Volume 144, number 6, December 2019:e20190487 SPECIAL ARTICLE (SDGs). The SDGs, as outlined in the and protection.10 In response to CHILD RIGHTS AND THE CRC: US UN 2030 Agenda for Sustainable increasing calls for a legally binding CONTEXT ’ Development, are a collection of 17 children s rights treaty, in 1989, the Although the United States has signed global goals related to global poverty, UN General Assembly adopted the the CRC, indicating its support for the 11 inequality, peace, and justice as well CRC (Table 1). The CRC enshrines embodied principles, the US Congress as human and child rights protection, promotion, and has not ratified it, meaning that its 6,7 fi standards. More recently, the World participation rights and af rms protections, unless already ’ Health Organization (WHO) and children s right to health, to be guaranteed by existing US laws, are ’ United Nations Children s Fund protected from abuse, and to freedom legally unenforceable in the United 11 (UNICEF) have launched the of expression, among other rights. States. Opponents of ratification have fi Nurturing Care Framework (NCF) in The CRC has been rati ed by 196 concerns about infringements on an effort to support early childhood countries, making it the most widely national sovereignty and parental fi development (ECD) and transform rati ed UN human rights treaty to authority.13 Many believe that 8 4 child rights principles into practice. date. After recognizing the critical ratification would conflict with the US role that early childhood plays in the In this article, we outline children’s system of federalism, which leaves human life course, the Committee on rights under international law, the most issues relating to the rights and the Rights of the Child prepared an underlying scientific evidence protections of children to individual authoritative interpretation of the 14 supporting attention to ECD, and the state governments. Others observe CRC’s articles and their relevance to philosophy of nurturing care that that laws throughout the United early childhood: “General Comment ensures that children’s rights are States are consistent with the (GC) No. 7 (2005) Implementing respected, protected, and fulfilled. It objectives of the CRC, thereby making Child Rights in Early Childhood.”12 fi is important to note that child rights rati cation unnecessary. The GC 7 defines early childhood as extend into adolescence as the period below the age of 8 years to The United States has no comparable exemplified by the 2030 Agenda for include all children from birth universal statement declaring the Sustainable Development, through the preschool years to rights of children nor are there particularly with respect to transition to school. universal rights to survival, early adolescent mental health, early and forced marriage, and access to sexual and reproductive health care TABLE 1 Summary of the Articles of the CRC services.9 However, for this article, CRC Purpose the focus will be on early childhood, Article fi de ned by the CRC as birth to – , 3 1 2 All children 18 years of age have these rights 8 years. 3–5 All adults should do what is best for children. The government has a responsibility to ensure that these rights are protected, and a child’s family has the responsibility to help In this article, we also provide new a child exercise these rights. fi information with respect to speci c 6–8 The right to life, a name, and an identity recommendations for pediatricians 9–10, 18 The right to live with their parents and to be raised by their parents and pediatric societies to promote 11, 19, 39 The rights to be protected from kidnapping, to be protected from being hurt in body or and implement nurturing care and mind, and to help in case of injury, maltreatment, or neglect 12–15, 30 The rights to give their opinion, to choose their own religion and beliefs, to choose their child rights–based practices, both in own peers, and to practice their own culture, language, and religion the United States and globally.