A/HRC/44/48/Add.1 psychosocial disabilities, to marry, found a family, exercise parental responsibilities and adopt children on an equal footing with others (CRPD/C/ECU/CO/2-3, para. 42). The Special Rapporteur recommends that the restrictions on the legal capacity of persons with disabilities be eliminated, so as to ensure that persons with intellectual disabilities can give their prior consent to a medical procedure such as sterilization. 64. According to information received, services for children with autism and children with psychosocial or intellectual disabilities remain insufficient, while civil society organizations attempt to fill the lack of mental health community services for children and adolescents. The Special Rapporteur recommends the development of a rights-based national child and adolescent mental health programme in line with modern public health principles. The objective must be to promote networks of community-based services so that families, children and adolescents with mental health needs may have access to preventive and therapeutic services. Those services should reach parents who belong to the disadvantaged population groups and those who have children with intellectual or psychosocial disabilities or other mental health conditions. F. People on the move 65. Since the adoption of the humanitarian visa in July 2019, which requires applicants to have a passport, the number of migrants and refugees crossing the borders of the country through regular channels has decreased significantly. Such a requirement disproportionately affects migrants in vulnerable situations who find themselves in an irregular situation when they enter Ecuador and are thus afraid to demand their constitutional right to medical assistance. For that reason, the requirement of a visa may have a serious effect on the health of the overall population. The Special Rapporteur supports the recommendations of the Committee on Economic, Social and Cultural Rights and recommends that the State party adopt a simplified procedure to facilitate the regularization of migrants and relax the passport requirement for persons in vulnerable situations, especially unaccompanied minors (E/C.12/ECU/CO/4, para. 28). 66. During the visit, the Special Rapporteur had the opportunity to visit a centre on the border with Colombia where migrants and refugees are provided with services. He also heard about moving stories from migrants crossing Ecuador. According to the information provided, of the total number of women who entered the country, 8.7 per cent were pregnant. 31 There is also an increased risk of sexual exploitation and sexual violence. According to data provided by the Ministry of Public Health in May 2019, there has been a 45 per cent increase in the number of migrants who request a health booklet in order to access medical control as a sex worker. 67. Although the Constitution guarantees access to health services, irrespective of legal status, in practice it is apparently difficult for people on the move. The Special Rapporteur received allegations of discriminatory attitudes regarding migrants and refugees, contributing to an environment of fear and intolerance. Such an environment must be prevented at all costs because it damages the quality of human relationships, brings mistrust, disrespect and intolerance into societal life and affects the health both of people on the move and of host communities. The Special Rapporteur strongly believes that rights-based responses to health and migration can be a transformative opportunity to rebuild and strengthen a health and social system that supports and restores dignity, inclusion and rights for everyone in the country (see A/73/216). He recommends that the necessary measures are taken to ensure that people on the move are provided with access to appropriate healthcare services, without discrimination, through the incorporation of their needs into the national health-care system. 31 Office of the United Nations High Commissioner for Refugees and Ministry of Economic and Social Inclusion, protection monitoring report, Ecuador overview (May 2019). 15

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