A/HRC/45/19 of women’s and girls’ reproduction during the conflict in order to support the work of the truth commission. III. Challenges for the implementation of the technical guidance 29. The examples provided above present an encouraging picture regarding the implementation of the technical guidance and human rights-based approaches more broadly. Despite these positive experiences, there are many challenges that hinder further implementation of the guidance and human rights-based approaches. On the basis of the submissions received, the following challenges have been identified: discriminatory laws and practices, difficulties in obtaining quality data, lack of financial and human resources, including specialized health professionals, and lack of awareness and capacity for applying human rights-based approaches. 30. In many places, discriminatory laws and practices continue to hinder the realization of women’s and girls’ human rights, with a negative impact on their maternal, sexual and reproductive health. For instance, UNAIDS expressed concern that pregnant women living with HIV faced discrimination ranging from denial of health care to stigmatization and, in some cases, institutional violence, all of which were contributors to maternal morbidities and could create a chilling effect on seeking health care when needed. Women Enabled International stressed that women with disabilities could have particularly negative experiences during pregnancy and childbirth, which had a serious impact on their physical and mental health. 31. There are also challenges in accommodating the needs of specific groups. Australia highlighted the challenge of ensuring the availability of culturally appropriate antenatal and postnatal services for Aboriginal and Torres Strait Islanders. Nepal explained that while there were policies responsive to the needs of adolescent girls and women living in rural areas, there remained gaps in implementation and in the availability of resources. 32. Widespread discrimination against women and girls, which manifests in high rates of child, early and forced marriage, female genital mutilation and intimate partner violence, all contribute to poor maternal health outcomes, in addition to violating women’s and girls’ human rights. Legal barriers, such as third-party authorization requirements or highly restrictive abortion laws, also prevent women and girls from accessing the health care they need, and to which they are entitled. Successfully applying a human rights-based approach to maternal health policies and programmes requires simultaneous action to address entrenched discrimination and promote gender equality. These challenges require persistent, long-term engagement towards social change. 33. Obtaining quality data on sexual and reproductive health, including maternal health, remains challenging. Few countries reported an institutionalized and nationwide process for reporting and reviewing maternal deaths and morbidities. Data on maternal morbidities is especially hard to collect, as further explained later in the present report. Submissions included descriptions of challenges in ensuring consistent data standards with respect to maternal morbidities and the subsequent implementation of standards across all jurisdictions for nationally comparable reporting.15 34. A lack of financial and human resources was also highlighted as a major challenge to applying rights-based approaches. In many places, infrastructure constraints and geographical distance to health facilities continued to impede the full implementation of the technical guidance and human rights-based approaches more broadly.16 Submissions also pointed to shortages of specialized medical personnel and a concentration of available personnel in urban areas, translating into poor coverage for rural populations.17 Weak health 15 16 17 8 See submissions from Australia and Paraguay. See submissions from Azerbaijan, Georgia, Iraq, Italy, Latvia, Mexico and Nepal. See submissions from Azerbaijan and Nepal, and UNFPA.