A/HRC/45/19
through an interdisciplinary project developed by a group of lawyers, health professionals,
researchers and activists, focused on a human rights-based approach to access safe and
legal abortion, which was one of the leading causes of maternal mortality and morbidity in
the country. The work, which was still ongoing, had been combined with case-specific legal
advice, to enable health professionals to understand better where abortion services were
permitted under the current legislation, and also influenced the way health professionals
engaged in public discourse concerning the legislative proposal to liberalize the abortion
law in Argentina.
17.
Marie Stopes International explained how it engaged with health workers on human
rights principles through a values-clarification exercise in order to identify potential
underlying biases, and put the client at the heart of its programming. With respect to
ensuring quality services, Marie Stopes International reported on training conducted in
Yemen for government health officers to support the organization in the area of quality
assurance for sexual and reproductive health services. That had enabled the organization to
maintain high quality standards while also helping to strengthen the health system.
18.
Several submissions also highlighted efforts to ensure the affordability of services.
For instance, Marie Stopes International had used a voucher programme in Yemen to
enable women to access maternal health and contraceptive services. UNFPA explained that
in India, there were different safety-net programmes to ensure that the poorest women had
access to antenatal and neonatal care. In Burundi, UNFPA had increased the availability of
emergency obstetric and newborn care services by providing equipment and training at
health facilities.
1.
Programmes in humanitarian settings
19.
Recognizing that the majority of maternal deaths occur in crisis settings, there has
also been dedicated attention to ensuring human rights in these contexts. The Human Rights
Council has prioritized this issue, requesting that the United Nations High Commissioner
for Human Rights organize a meeting to discuss the issue.10 As a result of the expert group
meeting, efforts are under way to build understanding and capacity to apply human rightsbased approaches in these contexts, taking account of their specificities. This includes
clarifying what human rights require and dispelling misunderstandings, as well as
considering the complicated circumstances that crisis scenarios present that have an impact
on the identification of duty bearers, the availability of health services and the existence of
accountability mechanisms (see A/HRC/42/24). There has been more of a focus on rightsbased approaches to sexual and reproductive health in guidance and policy documents in
humanitarian spaces, including The Sphere Handbook: Humanitarian Charter and
Minimum Standards in Humanitarian Response, 11 the Inter-Agency Field Manual on
Reproductive Health in Humanitarian Settings, including the Minimum Initial Service
Package for sexual and reproductive health,12 and Economic and Social Council resolution
2019/14, adopted in the context of the humanitarian affairs segment at its 2019 session, in
which the Council urged States to ensure reliable and safe access to the services that were
important in protecting women and girls from preventable mortality and morbidity that
occurred in humanitarian emergencies.
2.
Addressing discrimination, and programming for marginalized groups
20.
Some stakeholders highlighted health interventions specifically designed to address
discrimination and focused on marginalized women and girls who were at high risk of
maternal mortality and morbidity. For instance, New Zealand indicated that Maori, Pacific
and Asian women were overrepresented in the maternal morbidity statistics compared with
non-Maori, non-Pacific and non-Asian women. Both Australia and New Zealand had
developed health plans with the aim of addressing inequalities resulting from structural
discrimination in the health-care system.
10
11
12
6
Council resolution 39/10.
See https://spherestandards.org/handbook-2018/.
See https://iawgfieldmanual.com/.
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