A/HRC/45/19
21.
Bulgaria reported that women and girls from the Roma community living in remote
areas faced a relatively higher risk of suffering from maternal morbidities due to low
socioeconomic status, early pregnancy, which was linked to early marriage, and lower
levels of education. In that regard, among other initiatives, the State had set up mobile units
in remote areas in order to ensure equal access to maternal health care for women and girls
from the Roma community.
22.
In Uganda, UNFPA had promoted a priority focus on young people’s human rights.
For instance, by providing teenage mothers with life-skills training and support for reenrolment at school. It had also worked with WHO to provide adolescent sexual and
reproductive health counselling, with a view to preventing unintended pregnancies in
Namibia.
D.
Monitoring, review, oversight and remedies
23.
The technical guidance emphasizes that accountability is central to every stage of a
human rights-based approach. Monitoring, review, oversight and remedies are critical
components of this understanding of accountability.
24.
Monitoring mechanisms are needed to track, analyse and publish disaggregated data
and information on maternal health outcomes, including maternal morbidity and maternal
mortality.13 In two countries, UNFPA had focused on supporting accountability by rolling
out the technical guidance with the respective national human rights institutions and
ministries of health, monitoring violations of sexual and reproductive health and rights, and
supporting the systematic process of conducting maternal and perinatal death reviews.14
25.
To facilitate monitoring, data-collection efforts must be prioritized. For instance,
Georgia noted its routine clinical audit of cases of stillbirth and of maternal and neonatal
deaths. The comprehensive audit process enabled the identification of gaps and deficiencies
in the delivery of care and in the wider health system, which then supported corrective
policy and practice measures at the local and national levels. In Yemen, Marie Stopes
International had created a mobile application that functioned through text message to
enable the collection of crucial data needed to monitor and evaluate services.
26.
Human rights fact-finding is another modality for the collection of data on maternal,
sexual and reproductive health. For example, in Nigeria, the Center for Reproductive Rights
had documented the situation of sexual and reproductive health and rights in the context of
conflict. The findings revealed a severe lack of availability and prioritization of sexual and
reproductive health services for internally displaced persons, including lack of proper care
for pregnant women and a lack of medical attention for nursing mothers. The analysis
informed advocacy with the authorities in order to improve health services for women and
girls.
27.
Inputs received pointed to the role of the courts, as a form of oversight and potential
avenue for remedies, in assessing whether existing practice is in line with human rights
obligations. In Guatemala, Mayan midwives and indigenous organizations, with support
from OHCHR, filed a case before the Constitutional Court calling for the ministry
responsible for health to comply with the law in relation to intercultural maternal health.
Although Guatemala has a legal framework for the protection of the rights of indigenous
women, this was not reflected in the implementation of intercultural public policies related
to the work of midwives. In 2019, the Constitutional Court handed down its judgement and
called on the State to respect traditions, customs and practices in line with a cultural
perspective and without discrimination.
28.
Transitional justice mechanisms are also important for ensuring accountability. The
Center for Reproductive Rights explained how it was working in Colombia to document
human rights violations such as forced abortion, forced sterilization and cases of the control
13
14
See submissions from Australia, Bulgaria, Georgia, Italy, Latvia, Mexico, Nepal and New Zealand.
Input provided by UNFPA.
7
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