A/HRC/33/23 68. During the discussions concerning the technical guidance, allegations emerged concerning mistreatment of women during labour, including being slapped, yelled at, insulted and denied pain medicine. Such attitudes are unacceptable and contribute to women not returning to health facilities to seek attention at the time of birth or for their children. Quality must therefore be redefined in such a way that the dignity and worth of the patient is central.21 Factors that dehumanize health care must be removed, including understaffing and the deterioration of health facilities.22 Health workers must be supported to ensure that they have appropriate conditions of work to provide adequate care to patients in accordance with human rights principles. Training and capacity-building on human rights and child rights principles for health workers can have a positive impact in that regard. 69. There is now broad recognition that health care must be organized around people’s needs and expectations, including the small child. In the case of children, that requires implementing the right of the child to express their views and be consulted in all matters that affect him or her and that this be implemented from the earliest stages in ways appropriate to the child’s capacities, best interests and right to be protected from harmful experiences. As rights holders, even the youngest children are entitled to express their views. The ongoing work by WHO in that area, including efforts to develop and adopt a WHO global strategy on people-centred and integrated health services and the preparation of human rights-based global frameworks for quality of care for maternal and newborn health and child health, respectively, are testimony to this growing recognition. Those frameworks address both the provision of care and experience of care, and require systematic integration of human and child rights principles and standards in guiding how health care must be constructed, implemented, monitored and evaluated. Participation and accountability are key components of the frameworks. D. Inappropriate marketing of breast-milk substitutes 70. One of the key ways to reduce newborn, infant and under-5 mortality and morbidity is breastfeeding. According to research published in The Lancet in 2016, 23 increasing breastfeeding to near-universal levels could save the lives of more than 820,000 children under the age of 5 each year. In addition, boosting rates of exclusive breastfeeding for infants under 6 months of age would significantly reduce costs for treatment of childhood illnesses such as pneumonia, diarrhoea and asthma. 71. In spite of those advantages, globally nearly two out of three infants under 6 months are not exclusively breastfed — a rate that has not improved in two decades. Fewer than 1 in 5 infants are breastfed for 12 months in high-income countries and only two out of three children between 6 months and 2 years of age receive any breast milk in low- and middleincome countries.24 72. A significant barrier to improved breastfeeding rates in many countries remains the aggressive marketing of breast-milk substitutes. Global sales of breast-milk substitutes total US$ 44.8 billion, and are expected to rise to US$ 70.6 billion by 2019.25 Aggressive and inappropriate marketing of breast-milk substitutes and other food products that compete 21 22 23 24 25 GE.16-11320 Tarek Meguid, “(Re)Humanising Health Care-Placing Dignity and Agency of the Patient at the Center”, Nordic Journal of Human Rights, vol. 34, No. 1 (2016). Ibid. WHO, Marketing of Breast-milk Substitutes: National Implementation of the International Code — Status report 2016. Ibid. Ibid. 15