A/HRC/39/25 International Code of Marketing of Breast-milk Substitutes could be named on an annual list. D. Ensuring maximum investment: budget monitoring and financial accountability 18. Bob Muchabaiwa of the United Nations Children’s Fund (UNICEF), Ethiopia pointed out that investment in children was a rights issue, given that it was the means through which core challenges to child rights were targeted. There was a positive correlation between increased health expenditure and reductions in mortality rates, where fiscal policies supported access to and the availability, affordability and quality of health care. In this respect, the use of disaggregated data and statistics in defining budgets was fundamental to ensure responsiveness to key age and gender considerations. Corruption was a challenge, as it led to the wasting of large amounts of resources allocated to health, while low levels of financing in emergencies resulted in higher rates of mortality and morbidity. Health budgets could be buttressed by tackling inefficient expenditure and by ensuring cost-effective management of procurement, together with fiscal transparency, budget monitoring and greater social accountability. Focus should be strengthened on the political economy dimension, the links between policy plans and budgets on the basis of children’s rights, a greater reliance on sustainable domestic resources, and investment in community health care. 19. Participants stated that an effective legal framework on health should be accompanied by corresponding financial plans. While policies were compliant in most countries, major shortfalls undermined implementation. Ensuring adequate resource allocations was a key factor in implementing laws and policies, and children should be able to give their opinion on these matters in appropriate forums. Trade-offs (though contentious) were sometimes made between the application of a purely economic model and of a rights-based model; Governments therefore had to find a balance between them. Private health care in poor countries undermined the overall quality of public health systems by serving as a refuge for those who could afford it. III. Improving quality of care through monitoring and accountability A. Child rights-based quality care 20. Andrew Clarke of Lancashire Care NHS Foundation Trust (United Kingdom of Great Britain and Northern Ireland) and Kidasha (United Kingdom and Nepal) discussed the development of tools and approaches to measure children’s rights in health settings and to improve the quality of care. He explained that human rights were often violated in health-care settings, and elaborated on the lessons learned from projects in Nepal based on standards contained in the Convention on the Rights of the Child, which made children’s rights part of daily health practices, including through support for health workers and by providing a framework to monitor and improve the quality of care. In Nepal and Chile, human rights were a greater concern in primary care than in most countries; in the Hospital Amigable (“Friendly Hospital”) programme in Santiago, child rights had been adopted as the mission strategy of the hospital. This case demonstrated that a human rights-based approach could guide health planners and support health workers, improving the experience of care and reducing suffering. Pragmatic tools that could be integrated into routine health practices were needed, and health workers should be enabled to design rights-based improvements to quality of care through training and facilitation. 21. Ana Isabel Guerreiro, an independent consultant, presented her perspective on improving quality of care in hospitals through human rights-based standards. She explained that the Convention on the Rights of the Child could be used as a functional framework to guide the development and delivery of human rights-based health care to children, and pointed that equality, participation and accountability were key principles in this respect. 7