CRC/C/PRY/CO/3 53. The Committee recommends that the State party: (a) Undertake a comprehensive study in order to understand the nature and extent of adolescent health problems and use this as a basis for the formulation of adolescent health policies and programmes, with particular attention to girl adolescents, with the full participation of adolescents; (b) Seek partnerships with relevant organizations to carry out awarenessraising campaigns on, for example, the health risks for both baby and mother in cases of teenage pregnancies and the importance of vaccination; (c) Design strategies to prevent teenage pregnancies, sexually transmitted infections and drug, tobacco and alcohol abuse, through attractive opportunities for use of free time; (d) Promote and ensure access to reproductive health services for all adolescents, including sex and reproductive health education in schools, community and health facility levels; (e) Take into account the Committee’s general comment No. 4 (2003) on adolescent health and development in the context of the Convention. Breastfeeding 54. While welcoming Act No. 1478 on Marketing of Breast-Milk Substitutes, the Committee is concerned at the low level of breastfeeding in the State party and at the lack of an effective implementation of that law. 55. The Committee recommends that the State increase its efforts to promote the importance of breastfeeding, by providing information to adolescents in particular. It also recommends the effective implementation of Act No. 1478. Standard of living 56. The Committee welcomes initiatives to combat poverty and improve the standard of living of children, such as the National Food and Nutritional Assistance Programme and the Programme on Prevention and Treatment of Malnutrition. However, it is concerned that poverty in urban areas has increased steadily in recent years, the National Food and Nutritional Assistance Programme faced many difficulties in 2008 and hardly any progress was made to improve and expand it. The Committee is also concerned at the high number of children who do not have access to drinking water and proper sanitation services. 57. The Committee recommends that the State party: (a) Increase its efforts to make a stronger commitment to the multiple causes of malnutrition, develop a nutrition surveillance system and evaluate the effectiveness of existing strategies; (b) Increase investment and reinforce coordination among public institutions, private companies and social organizations to guarantee the delivery of drinking water and proper sanitation services for the population, particularly for children of rural areas; (c) Increase its efforts to make all children, particularly children living in rural areas, able to benefit from the programmes that are being implemented. HIV/AIDS 58. The Committee notes with satisfaction that the State party has put the prevention of HIV infections high on its health agenda. It is, however, concerned that the preventive 13