A/HRC/18/27 49. Action Aid and Marie Stopes implement a human rights-based approach programme focusing on rural women, by empowering them about sexual and reproductive rights; training traditional birth attendants as community health workers and supporting mobile outreach clinics; using the media to increase awareness of the Government’s free healthcare scheme; and establishing women’s forums in local communities to be active in monitoring access to health services and cases of violence against women. 50. In the remote west of the United Republic of Tanzania, Pathfinder International and the Women’s Refugee Commission have worked to reduce maternal deaths caused by postpartum haemorrhaging in internally displaced and refugee populations. They have developed an innovative model that guides stakeholders at the national, facility and community levels in addressing the underlying causes. This model combines community engagement with clinical interventions and Government advocacy. Pathfinder International is also pioneering new life-saving technologies, such as a non-pneumatic anti-shock garment that allows women to be stabilized and transported long distances, thus extending essential services to women in poor, rural underserved areas. B. Asia 51. In Bangladesh, the status of women and maternal mortality and morbidity were addressed at the national policy level as human rights and prioritized in 1990;47 since then, the role of husbands, family and community are recognized as being essential to improve maternal health and, as a result, strategies to improve community engagement were developed.48 The Community Support Systems initiative mobilizes and empowers by educating women and their families. They have identified several ways to decrease delays in getting to services that provide emergency obstetric care. Antenatal check-ups, deliveries by skilled birth attendants and referral for complications have increased. 52. In Tamil Nadu in southern India, there has been significant progress towards Millennium Development Goal 5 owing to improved literacy, reduced incidence of early marriage, early pregnancy and frequent pregnancies, and greater public awareness of family planning and good nutrition. These advances were also due to social reform and political commitment to improve maternal and newborn health and to establish women-centred health policies.49 53. The reductions in maternal mortality were achieved through a three-pronged strategy: (a) prevention and termination of unwanted pregnancies; (b) accessible highquality antenatal care and institutional childbirth, with routine essential obstetric care and emergency obstetric first aid at the primary level; and (c) accessible high-quality emergency obstetric care at the first referral level.50 54. Quality of services was addressed through initiatives to create a more welcoming environment, including tours of the facility; a birth companionship programme to encourage women to have support during labour and childbirth; and Valaikappus ceremonies held in primary health centres to integrate tradition and culture into service provision. Community leaders and village officials were brought together to participate in the planning and implementation of health programmes. Finally, street theatre has been 47 UNICEF submission. Ibid. 49 WHO, Safer Pregnancy in Tamil Nadu: from vision to reality, New Delhi, WHO Regional Office for South-East Asia, 2009; Office of the Registrar General, India. Special bulletin on maternal mortality in India 2004-06: sample registration system. 50 WHO submission. 48 14