CRC/C/KIR/CO/1 page 9 the steps taken to develop sanitation and public health education programmes as well as to establish solid waste disposal facilities. However, the Committee is concerned that access to these sewage disposal facilities and to clean water is restricted. The Committee is also concerned at reports of high rates of infant and child mortality, acute respiratory infection and diarrhoea, and severe malnutrition among children. 47. The Committee recommends that the State party continue to strengthen its efforts to improve the health situation of all children with particular attention paid to the establishment of effective and accessible primary health care services. Adolescent health 48. The Committee is concerned at reports of an increasing number of children who abuse drugs and consume alcohol and tobacco. The Committee is also concerned about the increasing rates of attempted suicides among young people, sexually transmitted infections (STIs), teenage pregnancies and the absence of programmes related to mental health and reproductive health. 49. The Committee recommends that the State party pay close attention to adolescent health, taking into account the Committee’s general comment No. 4 (2003) on adolescent health and development in the context of the Convention on the Rights of the Child. In particular, the Committee recommends that the State party: (a) Formulate a rights-based plan of action for the protection of all children, and particularly adolescents, from the dangers of drugs and harmful substances, and involve children in its formulation and implementation; (b) Provide children with accurate and objective information about the harmful consequences of substance abuse; (c) Ensure that children using drugs and harmful substances are treated as victims and not as criminals and develop recovery and social reintegration services for child victims of substance abuse; (d) Strengthen reproductive health education for adolescents, especially in schools, with a view to reducing STIs and the incidence of teenage pregnancies, and provide teenage pregnant girls with the necessary assistance and access to health care and education; and (e) Continue and strengthen technical cooperation from the World Health Organization (WHO) and UNICEF. Environmental health 50. The Committee is concerned about traditional practices that have resulted in the multipurpose use of the ocean by a large proportion of the population in Kiribati. In the absence of any practical preventive measures, the Committee is concerned about the ecological dangers of these practices. 51. The Committee recommends that the State party continues to undertake efforts to install an effective system for sewage disposal and conduct a sensitization campaign to