CRC/C/NIC/CO/4 Health and health services 62. The Committee welcomes and acknowledges the progress made in reducing child, infant and maternal mortality rates, but notes that they remain high. The Committee is concerned at the limited access to health-care services, especially in the Caribbean Coast autonomous regions (RAAN and RAAS) and rural areas of the Pacific. It is further concerned at recent decreases to health allocations from public resources and international donors, mainly due to the economic crisis. 63. The Committee recommends that the State party increase its efforts to sustain and increase achievements in infant, child and maternal mortality by ensuring access to high-quality, culturally-sensitive health care for all children and women, including in rural and indigenous areas, targeting especially the prenatal and neonatal period. It further recommends that the State party: (a) Promote exclusive breastfeeding and enforcement of the Breastfeeding Marketing Code, and develop a feeding strategy for small children; (b) Implement the comprehensive care programmes for Prevailing Childhood Illnesses (AIEPI) and Maternal Illnesses (AIEPM), as well as the Women and Child-Friendly Units Initiative (IUAMN); (c) Strengthen the Family and Community Health Model, and support public and private service providers in implementing the maternal houses network; and (d) Sustain and increase budgetary allocations to primary health care, and facilitate appropriate increases in international cooperation. Adolescent health 64. The Committee is deeply concerned that despite the reduction in maternal mortality, the percentage of adolescent maternal deaths in relation to total maternal deaths has increased, especially in rural municipalities. It is further concerned that the Penal Code has criminalized abortion, even when the mother’s life is at risk and when the pregnancy is the result of rape or incest, and in this regard it shares the concerns expressed previously by the Committee against Torture (CAT/C/NIC/CO/1, paragraph 16, 2009), the Human Rights Committee (CCPR/C/NIC/CO/3, paragraph 13, 2008), the Committee on Economic, Social and Cultural Rights (E/C.12/NIC/CO/4, paragraph 26, 2008) and the Committee on the Elimination of Discrimination against Women (CEDAW/C/NIC/CO/6, paragraph 17, 2007). The Committee is also concerned that health and community services do not pay sufficient attention to the overall physical and mental well-being of adolescents and their sense of belonging to their families and communities, as well as issues related to sexual and reproductive health and substance abuse. 65. The Committee recommends that the State party: (a) Ensure that adolescents have access to safe, legal and confidential sexual and reproductive health services, including information, counseling and termination of pregnancy, and that contraception is widely available; (b) Strengthen adolescent-friendly health and community services with a view to preventing teenage pregnancies and substance abuse, supported by information and education in schools and the media; and (c) Give strong priority to the development of a strategy to promote healthy lifestyles for adolescents, including leisure and sports activities, and re-activate the National Commission for the Fight against Drugs to provide inter-institutional and inter-sectoral support to prevention and care. 13