《儿童少年卫生学 Child and adolescent health》课程教学资源（参考文献）UNICEF世界儿童报告（2012）THE STATE OF THE WORLD’S CHILDREN 2012（Children in an Urban World）

2 UNICEF/NYHQ2008-1027/Christine Nesbitt

CHAPTER 2 © UNICEF/NYHQ2008-1027/Christine Nesbitt

Children's rights in urban settings Children whose needs are greatest are also those who unregistered at birth-and about half the children in face the greatest violations of their rights.The most the urban areas of sub-Saharan Africa and South Asia deprived and vulnerable are most often excluded from are unregistered.This is a violation of Article 7 of the progress and most difficult to reach.They require Convention on the Rights of the Child.The invisibil- particular attention not only in order to secure their ity that derives from the lack of a birth certificate or an entitlements,but also as a matter of ensuring the official identity vastly increases children's vulnerability realization of everyone's rights. to exploitation of all kinds,from recruitment by armed groups to being forced into child marriage or hazard- Children living in urban poverty have the full range ous work.Without a birth certificate,a child in conflict of civil,political,social,cultural and economic rights with the law may also be treated and punished as an recognized by international human rights instruments. adult by the judicial system.Even those who avoid The most rapidly and widely ratified of these is the these perils may be unable to access vital services and Convention on the Rights of the Child.The rights of opportunities-including education. every child include survival;development to the fullest; protection from abuse,exploitation and discrimina- Obviously,registration alone is no guarantee of access tion;and full participation in family,cultural and social to services or protection from abuse.But the obliga- life.The Convention protects these rights by detailing tions set out by the Convention on the Rights of the commitments with respect to health care,education, Child can be easily disregarded when whole settle- and legal,civil and social protection. ments can be deemed non-existent and people can, in effect,be stripped of their citizenship for want All children's rights are not realized equally.Over of documentation. one third of children in urban areas worldwide go Children's rights in urban settings 13

Children’s rights in urban settings 13 Children whose needs are greatest are also those who face the greatest violations of their rights. The most deprived and vulnerable are most often excluded from progress and most difficult to reach. They require particular attention not only in order to secure their entitlements, but also as a matter of ensuring the realization of everyone’s rights. Children living in urban poverty have the full range of civil, political, social, cultural and economic rights recognized by international human rights instruments. The most rapidly and widely ratified of these is the Convention on the Rights of the Child. The rights of every child include survival; development to the fullest; protection from abuse, exploitation and discrimina￾tion; and full participation in family, cultural and social life. The Convention protects these rights by detailing commitments with respect to health care, education, and legal, civil and social protection. All children’s rights are not realized equally. Over one third of children in urban areas worldwide go unregistered at birth – and about half the children in the urban areas of sub-Saharan Africa and South Asia are unregistered. This is a violation of Article 7 of the Convention on the Rights of the Child. The invisibil￾ity that derives from the lack of a birth certificate or an official identity vastly increases children’s vulnerability to exploitation of all kinds, from recruitment by armed groups to being forced into child marriage or hazard￾ous work. Without a birth certificate, a child in conflict with the law may also be treated and punished as an adult by the judicial system.1 Even those who avoid these perils may be unable to access vital services and opportunities – including education. Obviously, registration alone is no guarantee of access to services or protection from abuse. But the obliga￾tions set out by the Convention on the Rights of the Child can be easily disregarded when whole settle￾ments can be deemed non-existent and people can, in effect, be stripped of their citizenship for want of documentation. Children’s rights in urban settings

An environment for fulfilling child rights Inadequate living conditions are among the most pervasive violations of children's rights.The lack of decent and secure housing and such infrastructure as water and sanitation systems makes it so much more difficult for children to survive and thrive.Yet,the attention devoted to improving living conditions has not matched the scope and severity of the problem. Evidence suggests that more children want for shelter and sanitation than are deprived of food,education and health care,and that the poor sanitation,lack of A mother holding a one-year-old infant obtains micronutrient powder ventilation,overcrowding and inadequate natural light from social workers in Dhaka,Bangladesh.Micronutrient deficiencies can lead to anaemia,birth defects and other disorders. common in the homes of the urban poor are responsi- ble for chronic ailments among their children.2 Many children and families living in the urban slums of low- world's slum dwellers by 2020.This is only a small income countries are far from realizing the rights to percentage of those who live in slums worldwide;the "adequate shelter for all"and "sustainable human target does not address the continuing growth in the settlements development in an urbanizing world" number of new slums and slum dwellers. enshrined in the Istanbul Declaration on Human Settlements,or Habitat Agenda,of 1996.3 This chapter looks at the situation of children in urban settings and considers in particular their rights Since children have the rights to survival,adequate to health;water,sanitation and hygiene;education health care and a standard of living that supports their and protection. full development,they need to benefit from environ- mental conditions that make the fulfilment of these Health rights possible.There is no effective right to play with- out a safe place to play,no enjoyment of health within Article 6 of the Convention on the Rights of the a contaminated environment.Support for this perspec- Child commits States parties to "ensure to the maxi- tive is provided by such treaties and declarations as mum extent possible the survival and development the International Covenant on Economic,Social and of the child."Article 24 refers to every child's right to Cultural Rights;the Convention on the Elimination the "enjoyment of the highest attainable standard of of All Forms of Discrimination against Women;the health and to facilities for the treatment of illness and Habitat Agenda;and Agenda 21,the action plan rehabilitation of health."The Convention urges States adopted at the 1992 United Nations Conference on parties to"ensure that no child is deprived of his or her Environment and Development.The Centre on right of access to such health care services." Housing Rights and Evictions,among others, documents the extensive body of rights related Child survival to housing and the disproportionate vulnerabil- ity of children to violations of these rights.In Nearly 8 million children died in 2010 before reach- recent years,practical programming aimed at ing the age of 5,largely due to pneumonia,diarrhoea fulfilling rights has been focused on the pursuit of and birth complications.Some studies show that the Millennium Development Goals (MDGs),all of children living in informal urban settlements are which have relevant implications for children in urban particularly vulnerable.+High urban child mortal- poverty.One of the targets of MDG 7-to ensure ity rates tend to be seen in places where significant environmental sustainability focuses specifically concentrations of extreme poverty combine with on improving the lives of at least 100 million of the inadequate services,as in slums. 14 THE STATE OF THE WORLD'S CHILDREN 2012

14 THE STATE OF THE WORLD’S CHILDREN 2012 An environment for fulfilling child rights Inadequate living conditions are among the most pervasive violations of children’s rights. The lack of decent and secure housing and such infrastructure as water and sanitation systems makes it so much more difficult for children to survive and thrive. Yet, the attention devoted to improving living conditions has not matched the scope and severity of the problem. Evidence suggests that more children want for shelter and sanitation than are deprived of food, education and health care, and that the poor sanitation, lack of ventilation, overcrowding and inadequate natural light common in the homes of the urban poor are responsi￾ble for chronic ailments among their children.2 Many children and families living in the urban slums of low￾income countries are far from realizing the rights to “adequate shelter for all” and “sustainable human settlements development in an urbanizing world” enshrined in the Istanbul Declaration on Human Settlements, or Habitat Agenda, of 1996.3 Since children have the rights to survival, adequate health care and a standard of living that supports their full development, they need to benefit from environ￾mental conditions that make the fulfilment of these rights possible. There is no effective right to play with￾out a safe place to play, no enjoyment of health within a contaminated environment. Support for this perspec￾tive is provided by such treaties and declarations as the International Covenant on Economic, Social and Cultural Rights; the Convention on the Elimination of All Forms of Discrimination against Women; the Habitat Agenda; and Agenda 21, the action plan adopted at the 1992 United Nations Conference on Environment and Development. The Centre on Housing Rights and Evictions, among others, documents the extensive body of rights related to housing and the disproportionate vulnerabil￾ity of children to violations of these rights. In recent years, practical programming aimed at fulfilling rights has been focused on the pursuit of the Millennium Development Goals (MDGs), all of which have relevant implications for children in urban poverty. One of the targets of MDG 7 – to ensure environmental sustainability – focuses specifically on improving the lives of at least 100 million of the world’s slum dwellers by 2020. This is only a small percentage of those who live in slums worldwide; the target does not address the continuing growth in the number of new slums and slum dwellers. This chapter looks at the situation of children in urban settings and considers in particular their rights to health; water, sanitation and hygiene; education and protection. Health Article 6 of the Convention on the Rights of the Child commits States parties to “ensure to the maxi￾mum extent possible the survival and development of the child.” Article 24 refers to every child’s right to the “enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health.” The Convention urges States parties to “ensure that no child is deprived of his or her right of access to such health care services.” Child survival Nearly 8 million children died in 2010 before reach￾ing the age of 5, largely due to pneumonia, diarrhoea and birth complications. Some studies show that children living in informal urban settlements are particularly vulnerable.4 High urban child mortal￾ity rates tend to be seen in places where significant concentrations of extreme poverty combine with inadequate services, as in slums. © UNICEF/NYHQ2009-0609/Shehzad Noorani A mother holding a one-year-old infant obtains micronutrient powder from social workers in Dhaka, Bangladesh. Micronutrient deficiencies can lead to anaemia, birth defects and other disorders

OUT OF SIGHT. 3AI13ds83 OUT OF REACH by Her Majesty Queen Rania Al Abdullah of Jordan, UNICEF Eminent Advocate Half the world's population now lives in cultural barriers,like gender and ethnic- search for regional peace,we must set cities.Throughout history,urban life,so ity,that deny children from the slums aside our anger and angst and give them concentrated with humanity,has been the chance to enrol in and complete the childhoods they deserve,childhoods a catalyst for trade,ideas and opportuni- primary school.Education is pushed out we expect for our own children,filled with ties,making cities engines of economic of reach because there are not enough happy memories and equal opportunities. growth.Today,living in a city is widely public schools or the costs are too high. regarded as the best way to find pros- Religious groups,non-governmental In a few Arab countries,the fates of perity and escape poverty.Yet hidden organizations and entrepreneurs try to fill disadvantaged urban children are being inside cities,wrapped in a cloak of statis- the gap but struggle without government rewritten.In Morocco,the government tics,are millions of children struggling to support or regulation.As the best chance programme 'Cities without Slums' survive.They are neither in rural areas nor to escape their parents'destinies eludes hopes to raise the standards of nearly in truly urban quarters.They live in squa- these children,the cycle of destitution 300,000 homes.By engaging banks lor,on land where a city has outpaced spins on. and housing developers,a'triple win' itself,expanding in population but not scenario is possible for poor people, in vital infrastructure or services.These In the Arab world the facts are clear: the government and the private sector. are children in slums and deprived neigh- More than one third of the urban Jordan,too,is making strides.Amman is bourhoods,children shouldering the many population lives in informal settlements one of the region's leading child-friendly burdens of living in that grey area between and slums.These environments are cities,with over 28,000 students partici- countryside and city,invisible to the hazardous to children;a lack of adequate pating in children's municipal councils to authorities,lost in a hazy world of statisti- sanitation and drinkable water poses a prioritize their needs,rights and interests. cal averages that conceal inequality. major threat to their well-being.In some The results have been impressive:parks, less developed Arab countries,over- libraries,community spaces,educational The contrast could not be more ironic. crowding in makeshift houses further support for children who dropped out of Cities,where children flourish with good aggravates the precarious health condi- school,campaigns against violence and schools and accessible health care,are tions of these vulnerable families. abuse,and information and communica- where they also suffer greatly,denied tion technology centres for the deaf. their basic human rights to an educa- For Palestinian children,city life can be tion and a life of opportunity.Side by a grim life.Too often,it represents guns Yet for Arab children-for al/children-to side,wealth juxtaposed against poverty, and checkpoints,fear and insecurity. thrive,nations have to work together.We nowhere else is the iniquity of inequity as Yet their greatest hope is their national have to share resources,adopt and adapt obvious as in a city. pride:a deep-seated belief in education, successful initiatives from around the which they know is essential for build- globe and encourage our private sectors Over the course of a decade,the state of ing a life and rebuilding their country.Yet, to engage with disadvantaged families so the world's urban children has worsened. since 1999,across Occupied Palestinian we can catch those falling through the The number of people living in slums Territory,the number of primary-school- cracks.In cities across the world,chil- has increased by over 60 million.These aged children who are out of school has dren out of reach are too often out of are mothers and fathers,grandmothers leapt from 4,000 to 110,000,a staggering sight.If we are to raise their hopes and and grandfathers,sons and daughters, 2,650 per cent increase.In Gaza,among their prospects,we have to dig deep into scratching out a life in shantytowns the the world's most densely populated areas, the data,unroot entrenched prejudices world over.With the direct disadvan- access to and quality of education have and give every child an equal chance at tages of urban poverty-disease,crime, deteriorated rapidly.For the sake of these life.Only in this way can we truly advance violence-come indirect ones,social and children's futures and of the all-important the state of al/the world's children. Children's rights in urban settings 15

Half the world’s population now lives in cities. Throughout history, urban life, so concentrated with humanity, has been a catalyst for trade, ideas and opportuni￾ties, making cities engines of economic growth. Today, living in a city is widely regarded as the best way to find pros￾perity and escape poverty. Yet hidden inside cities, wrapped in a cloak of statis￾tics, are millions of children struggling to survive. They are neither in rural areas nor in truly urban quarters. They live in squa￾lor, on land where a city has outpaced itself, expanding in population but not in vital infrastructure or services. These are children in slums and deprived neigh￾bourhoods, children shouldering the many burdens of living in that grey area between countryside and city, invisible to the authorities, lost in a hazy world of statisti￾cal averages that conceal inequality. The contrast could not be more ironic. Cities, where children flourish with good schools and accessible health care, are where they also suffer greatly, denied their basic human rights to an educa￾tion and a life of opportunity. Side by side, wealth juxtaposed against poverty, nowhere else is the iniquity of inequity as obvious as in a city. Over the course of a decade, the state of the world’s urban children has worsened. The number of people living in slums has increased by over 60 million. These are mothers and fathers, grandmothers and grandfathers, sons and daughters, scratching out a life in shantytowns the world over. With the direct disadvan￾tages of urban poverty – disease, crime, violence – come indirect ones, social and cultural barriers, like gender and ethnic￾ity, that deny children from the slums the chance to enrol in and complete primary school. Education is pushed out of reach because there are not enough public schools or the costs are too high. Religious groups, non-governmental organizations and entrepreneurs try to fill the gap but struggle without government support or regulation. As the best chance to escape their parents’ destinies eludes these children, the cycle of destitution spins on. In the Arab world the facts are clear: More than one third of the urban population lives in informal settlements and slums. These environments are hazardous to children; a lack of adequate sanitation and drinkable water poses a major threat to their well-being. In some less developed Arab countries, over￾crowding in makeshift houses further aggravates the precarious health condi￾tions of these vulnerable families. For Palestinian children, city life can be a grim life. Too often, it represents guns and checkpoints, fear and insecurity. Yet their greatest hope is their national pride: a deep-seated belief in education, which they know is essential for build￾ing a life and rebuilding their country. Yet, since 1999, across Occupied Palestinian Territory, the number of primary-school￾aged children who are out of school has leapt from 4,000 to 110,000, a staggering 2,650 per cent increase. In Gaza, among the world’s most densely populated areas, access to and quality of education have deteriorated rapidly. For the sake of these children’s futures and of the all-important search for regional peace, we must set aside our anger and angst and give them the childhoods they deserve, childhoods we expect for our own children, filled with happy memories and equal opportunities. In a few Arab countries, the fates of disadvantaged urban children are being rewritten. In Morocco, the government programme ‘Cities without Slums’ hopes to raise the standards of nearly 300,000 homes. By engaging banks and housing developers, a ‘triple win’ scenario is possible for poor people, the government and the private sector. Jordan, too, is making strides. Amman is one of the region’s leading child-friendly cities, with over 28,000 students partici￾pating in children’s municipal councils to prioritize their needs, rights and interests. The results have been impressive: parks, libraries, community spaces, educational support for children who dropped out of school, campaigns against violence and abuse, and information and communica￾tion technology centres for the deaf. Yet for Arab children – for all children – to thrive, nations have to work together. We have to share resources, adopt and adapt successful initiatives from around the globe and encourage our private sectors to engage with disadvantaged families so we can catch those falling through the cracks. In cities across the world, chil￾dren out of reach are too often out of sight. If we are to raise their hopes and their prospects, we have to dig deep into the data, unroot entrenched prejudices and give every child an equal chance at life. Only in this way can we truly advance the state of all the world’s children. PERSPECTIVE Out of sight, out of reach by Her Majesty Queen Rania Al Abdullah of Jordan, UNICEF Eminent Advocate Children’s rights in urban settings 15

The Convention on the Rights of the Child The Convention on the Rights of the Child,adopted in 1989, Furthermore,"a mentally or physically disabled child should was the first international treaty to state the full range of civil, enjoy a full and decent life,in conditions which ensure political,economic,social and cultural rights belonging to dignity,promote self-reliance and facilitate the child's active children.The realities confronting children can be assessed participation in the community"(Article 23).This extends to against the commitments to which it holds States parties. the right to special care,provided free of charge whenever possible,and effective access to education,training,health Legally binding on States parties,the Convention details care,rehabilitation services,recreation opportunities and universally recognized norms and standards concerning the preparation for employment. protection and promotion of the rights of children-everywhere and at all times.The Convention emphasizes the complementar- Participation ity and interdependence of children's human rights.Across its One of the core principles of the Convention is respect for 54 articles and 2 Optional Protocols,it establishes a new vision and consideration of the views of children.The document of the child-one that combines a right to protection through recognizes children's right to freely express their views in all the State,parents and relevant institutions with the recognition matters affecting them and insists that these views be given that the child is a holder of participatory rights and freedoms. due weight in accordance with the age and maturity of the All but three of the world's nations-Somalia,South Sudan and children voicing them(Article 12).It further proclaims chil- the United States of America-have ratified the document. dren's right to freedom of all forms of expression(Article 13). This broad adoption demonstrates a common political will to Children are entitled to freedom of thought,conscience and protect and ensure children's rights,as well as recognition religion(Article 14),to privacy and protection from unlawful that,in the Convention's words,"in all countries in the world, attack or interference(Article 16)and to freedom of association there are children living in exceptionally difficult conditions, and peaceful assembly(Article 15). and that such children need special consideration." Social protection The values of the Convention stem from the 1924 Geneva The Convention acknowledges the primary role of parents Declaration of the Rights of the Child,the 1948 Universal or legal guardians in the upbringing and development of Declaration of Human Rights and the 1959 Declaration of the the child(Article 18)but stresses the obligation of the State Rights of the Child.The Convention applies to every child, to support families through"appropriate assistance,""the defined as every person younger than 18 or the age of major- development of institutions,facilities and services for the ity,if this is lower(Article 1).The Convention also requires care of children"and"all appropriate measures to ensure that in all actions concerning children,"the best interests of that children of working parents have the right to benefit from the child shall be a primary consideration,"and that States child-care services and facilities for which they are eligible." parties "ensure the child such protection and care as is necessary for his or her well-being"(Article 3). Of particular relevance in the urban context is the recognition of"the right of every child to a standard of living adequate Every child has the right to be registered immediately after birth for the child's physical,mental,spiritual,moral and social and to have a name,the right to acquire a nationality and to development"(Article 27).The responsibility to secure these preserve her or his identity and,as far as possible,the right to conditions lies mainly with parents and quardians,but States know and be cared for by her or his parents(Articles 7 and 8). parties are obliged to assist and"in case of need provide material assistance and support programmes,particularly Non-discrimination with regard to nutrition,clothing and housing."Children have States parties also take on the responsibility to protect children the right to benefit from social security on the basis of their against discrimination.The Convention commits them to circumstances(Article 26). respecting and ensuring rights"to each child within their juris- diction without discrimination of any kind,irrespective of the Health and environment child's or his or her parent's or legal guardian's race,colour,sex, States parties are obliged to"ensure to the maximum extent language,religion,political or other opinion,national,ethnic or possible the survival and development of the child"(Article social origin,property,disability,birth or other status"(Article 2) 6).Each child is entitled to the "enjoyment of the highest Children belonging to ethnic,religious or linguistic minorities attainable standard of health and to facilities for the treat- and those of indigenous origin have the right to practise their ment of illness and rehabilitation of health"(Article 24).This own culture,religion and language in the community(Article 30). includes child care;antenatal,postnatal and preventive 16 THE STATE OF THE WORLD'S CHILDREN 2012

16 THE STATE OF THE WORLD’S CHILDREN 2012 The Convention on the Rights of the Child The Convention on the Rights of the Child, adopted in 1989, was the first international treaty to state the full range of civil, political, economic, social and cultural rights belonging to children. The realities confronting children can be assessed against the commitments to which it holds States parties. Legally binding on States parties, the Convention details universally recognized norms and standards concerning the protection and promotion of the rights of children – everywhere and at all times. The Convention emphasizes the complementar￾ity and interdependence of children’s human rights. Across its 54 articles and 2 Optional Protocols, it establishes a new vision of the child – one that combines a right to protection through the State, parents and relevant institutions with the recognition that the child is a holder of participatory rights and freedoms. All but three of the world’s nations – Somalia, South Sudan and the United States of America – have ratified the document. This broad adoption demonstrates a common political will to protect and ensure children’s rights, as well as recognition that, in the Convention’s words, “in all countries in the world, there are children living in exceptionally difficult conditions, and that such children need special consideration.” The values of the Convention stem from the 1924 Geneva Declaration of the Rights of the Child, the 1948 Universal Declaration of Human Rights and the 1959 Declaration of the Rights of the Child. The Convention applies to every child, defined as every person younger than 18 or the age of major￾ity, if this is lower (Article 1). The Convention also requires that in all actions concerning children, “the best interests of the child shall be a primary consideration,” and that States parties “ensure the child such protection and care as is necessary for his or her well-being” (Article 3). Every child has the right to be registered immediately after birth and to have a name, the right to acquire a nationality and to preserve her or his identity and, as far as possible, the right to know and be cared for by her or his parents (Articles 7 and 8). Non-discrimination States parties also take on the responsibility to protect children against discrimination. The Convention commits them to respecting and ensuring rights “to each child within their juris￾diction without discrimination of any kind, irrespective of the child’s or his or her parent’s or legal guardian’s race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status” (Article 2). Children belonging to ethnic, religious or linguistic minorities and those of indigenous origin have the right to practise their own culture, religion and language in the community (Article 30). Furthermore, “a mentally or physically disabled child should enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate the child’s active participation in the community” (Article 23). This extends to the right to special care, provided free of charge whenever possible, and effective access to education, training, health care, rehabilitation services, recreation opportunities and preparation for employment. Participation One of the core principles of the Convention is respect for and consideration of the views of children. The document recognizes children’s right to freely express their views in all matters affecting them and insists that these views be given due weight in accordance with the age and maturity of the children voicing them (Article 12). It further proclaims chil￾dren’s right to freedom of all forms of expression (Article 13). Children are entitled to freedom of thought, conscience and religion (Article 14), to privacy and protection from unlawful attack or interference (Article 16) and to freedom of association and peaceful assembly (Article 15). Social protection The Convention acknowledges the primary role of parents or legal guardians in the upbringing and development of the child (Article 18) but stresses the obligation of the State to support families through “appropriate assistance,” “the development of institutions, facilities and services for the care of children” and “all appropriate measures to ensure that children of working parents have the right to benefit from child-care services and facilities for which they are eligible.” Of particular relevance in the urban context is the recognition of “the right of every child to a standard of living adequate for the child’s physical, mental, spiritual, moral and social development” (Article 27). The responsibility to secure these conditions lies mainly with parents and guardians, but States parties are obliged to assist and “in case of need provide material assistance and support programmes, particularly with regard to nutrition, clothing and housing.” Children have the right to benefit from social security on the basis of their circumstances (Article 26). Health and environment States parties are obliged to “ensure to the maximum extent possible the survival and development of the child” (Article 6). Each child is entitled to the “enjoyment of the highest attainable standard of health and to facilities for the treat￾ment of illness and rehabilitation of health” (Article 24). This includes child care; antenatal, postnatal and preventive