A/HRC/33/24 IV. Challenges in implementation 36. The numerous examples given above present an encouraging picture regarding the implementation of the technical guidance and human rights-based approaches more broadly. The guidance is being utilized by a wide diversity of stakeholders, often collaboratively, across various sectors and in a range of different contexts. The ownership at the country level by multiple stakeholders in certain contexts has, in particular, been a positive development. 37. Despite these positive experiences, there are many challenges that hinder further implementation of the guidance. A. Sustained engagement 38. It has been four years since the technical guidance was presented to the Council. Specific results have been seen in terms of influencing the understanding of human rights in the context of maternal health and sexual and reproductive health more broadly. That has had an impact on the content of policies, strategies and work plans in certain countries. 39. Local- and national-level implementation of the guidance requires concerted and dedicated political and financial efforts to identify relevant barriers, devise solutions and build the capacity of a variety of actors. That sort of sustained engagement over long periods of time is often difficult to achieve. Furthermore, stakeholders observed that, while there is momentum behind certain multi-stakeholder processes, in several contexts civil society organizations are expected to lead the process, but they are often restricted by the resources available and the extent to which their collaborative efforts can influence State actors to implement human rights-based approaches. B. Dissemination 40. Many stakeholders have expressed concern that there is little knowledge or ownership of the technical guidance among key decision-makers at the national level. Though dissemination has improved since 2012, lack of awareness of the guidance and the Council’s call for its implementation remains a significant challenge. 41. Although the Council process related to maternal mortality and morbidity is a comparatively positive example of the Council’s work being implemented at the national level, more effort is needed to link its important work, as well as that of regional human rights mechanisms, to national-level implementation efforts and vice versa. As the Council celebrates its tenth anniversary, it is an auspicious moment to consider modalities for reducing the gap between international-level and regional processes and national-level action. C. Multi-stakeholder engagement 42. The present report places particular emphasis on the importance of multi-stakeholder processes. Those processes require a considerable investment in terms of time, as well as human and financial resources. In some contexts, when faced with the complexity of meaningful participation, different actors may opt for shortcuts, which are deemed to achieve the same result. In a human rights-based approach, the process of deliberation among a wide variety of stakeholders, including health providers, and reaching marginalized women and adolescent girls is critical for building an environment of empowerment where rights may be claimed. 10