1. HPH CA Extending the remit to include maternal health

2. Promoting Child Rights in Health Care HPH-CA Taskforce produced the Self-Evaluation Model and Tool. This has been adopted by WHO Europe and applied in some 40 hospitals across Kyrgyzstan, Tajikistan and Moldova, in its work to improve the hospital care for children. WHO Europe has now initiated a process to prepare a similar set of tools on assessing and improving the respect of children's right in Primary Health Care (PHC). A number of HPH CA members are contributing to this programme.

3. Looking wider Since its establishment HPH CA has had a focus on child rights in healthcare, in particular the implementation of the UN Convention on the Rights of the Child and the European Association for Children in Hospital (EACH) Charter. However to promote the health of the child we must also concern ourselves with the health of the mother. Maternal and child health are inextricably linked, a relationship which is recognised in Article 24 of the UNCRC. By promoting maternal rights and good maternal health we not only promote the health and wellbeing of the mother we also set firm foundations for the health and wellbeing of the child.

4. UNCRC Article 24 1. States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services. 2. States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures: (d) To ensure appropriate pre-natal and post-natal health care for mothers; (e) To ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding, hygiene and environmental sanitation and the prevention of accidents; (f) To develop preventive health care, guidance for parents and family planning education and services.

5. HPH CA and the Life Course - Early Years - Scottish Government (2011) A Pathway of Care for Vulnerable Families (0-3)

6. Foundations for Health “Giving every child the best start in life is crucial to reducing health inequalities across the life course. The foundations for virtually every aspect of human development – physical, intellectual and emotional – are laid in early childhood. What happens during these early years (starting in the womb) has lifelong effects on many aspects of health and wellbeing – from obesity, heart disease and mental health, to educational achievement and economic status. To have an impact on health inequalities we need to address the social gradient in children’s access to positive early experiences. Later interventions, although important, are considerably less effective where good early foundations are lacking.” Marmot M (2010) Fair Society, Healthy Lives

7. Early intervention Heckman J J (2008) The Case for Investing in Disadvantaged Young Children

8. Maternal mental health A mother’s mental health can affect her baby even before he or she is born. Studies have shown that a range of mental illnesses including depression, anxiety, PTSD and schizophrenia all increase the risk of both early delivery and low birth weight. Whilst many babies who are born early and have low birth weight will go on to be healthy and develop normally, these things increase the risk of infant mortality, suboptimal growth, illnesses, neuro- developmental problems and long-term cognitive outcomes. Hogg, S (2013) Prevention in mind: All Babies Count: spotlight on perinatal mental health. London: NSPCC

9. Maternal mental health “Researchers have found ‘positive resistance’ from midwives to asking…. questions because they are afraid that they could uncover issues which would be difficult to resolve, and would create additional work when they are already very stretched” Hogg, S (2013) Prevention in mind: All Babies Count: spotlight on perinatal mental health. London: NSPCC

10. Limited support for maternal mental health? “Every mother, every time. Universal mental health screening for every pregnant and postpartum woman” Suicide is a leading cause of death for women during the first year after childbirth. 1 in 7 women will experience a mood or anxiety disorder during pregnancy or postpartum, yet nearly 50% remain untreated. In pregnancy, maternal mental illness negatively effects fetal development,and leads to adverse birth outcomes such as low birth weight and premature delivery. Perinatal mood and anxiety disorders (PMADs) can impair infant and early childhood cognitive and emotional development. Despite overwhelming empirical evidence, there is no universal mandate for care providers to screen pregnant and postpartum women for depression, anxiety, or family history of mental illness–a well established risk factor. Screen every mother, every time to prevent and treat perinatal mental illness. To register and sign to petition (takes less than 5 minutes): https://petitions.whitehouse.gov/petition/every-mother-every-time-universal-mental-health- screening-every-pregnant-and-postpartum-woman/rG1jLyYj This petition failed to be delivered due to insufficient signatures

11. On the other hand this petition … Deport Justin Bieber and revoke his green card. We the people of the United States feel that we are being wrongly represented in the world of pop culture. We would like to see the dangerous, reckless, destructive, and drug abusing, Justin Bieber deported and his green card revoked. He is not only threatening the safety of our people but he is also a terrible influence on our nations youth. We the people would like to remove Justin Bieber from our society. Received: 273,728 signatures

12. Breastfeeding

15. HPH-CA action The taskforce will undertake action to address the issues raised in this presentation

16. LinkedIn sub-site To aid communication and information sharing HPH-CA has set up a sub-site of Health Promoting Hospitals & Health Services – Global LinkedIn website Find us at: www.linkedin.com/groups/HPHMaternal-Child-Health-6567958/about