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for maternal mortality and morbidity is critical. Experts highlighted that safe spaces where
humanitarian actors can undertake critical reflection, examine their practice and be open
about what is not working is needed. In this context, dispelling the notion that human rights
are limited to a “blame and shame” approach is particularly relevant. In addition,
addressing accountability within the health system also requires attention to the risks that
health providers can face, such as reprisals from the family, if there is a perception of
medical malpractice. Despite these challenges, experts found that being self-reflective and
adaptable when things do not work and responsive to changing circumstances and demands
from affected populations are critical elements of accountability in their work.
85.
Good practices to uphold human rights accountability through social accountability
tools were also shared, for instance, community scorecards and other forms of community
monitoring, complaint mechanisms and feedback loops at the local level. These are also
critical to transparency and ensuring that humanitarian actors are accountable at the service
level. At the same time, how changes are made following such initiatives and who is
accountable for these changes is less clear. It is important to clarify this aspect and further
support similar social accountability initiatives – also highlighted in the technical guidance
– in emergencies. This would lead to more accountable services that reflect the views and
experiences of affected women and girls.
86.
When it comes to ensuring legal accountability, training for communities, in
particular women and girls, about their rights and how to claim them is also required. A
good practice identified in this context is mobile clinics for the provision of legal and
judicial services. Mapping of local justice actors and mechanisms and identifying possible
entry points for strengthened service provision and accountability were also highlighted.
Moreover, experts emphasized that legal accountability is not necessarily adversarial and
can also be a positive experience for all actors concerned. Public interest cases before
courts in certain contexts actually helped identify where problems lie and come to effective
rights-based solutions.
87.
Experts also noted the challenge of a lack of disaggregated data or sharing and
pooling of data on sexual and reproductive health and rights in emergencies, including on
what does and does not work. Collection of such data could also include information on
funding and could be used to build an evidence base for rights-based interventions in
emergencies that captures what works and the impact of successful actions to inform future
interventions.
88.
With vital and birth registration systems absent, one particular challenge in
emergencies concerns the lack of counting, registering and notification of maternal deaths
and morbidities and calculating the cost, in order for actors operating in a humanitarian
setting to learn and avoid the action or inaction in the future. The focus is not on who is
guilty, but on identifying the problem and possible remedial actions. For instance, experts
suggested further implementation of maternal death surveillance and response in
emergencies, which involves a continuous cycle of identification, notification and review of
maternal deaths followed by actions to improve quality of care and prevent future deaths.
89.
Although data gaps need to be filled, experts also argued that the real result and
impact are measured not only by quantitative work and through indicators but also through
qualitative work, including human rights analysis.
V. Conclusion
90.
The meeting provided for a rich and constructive discussion between a
diversity of actors operating in humanitarian settings. A human rights-based
approach to policies and programmes to address preventable maternal mortality and
morbidity in humanitarian settings gives an added value to humanitarian action that
should be further emphasized and better articulated.
91.
This means advocacy at the global level against silos, attacks, criminalization,
funding incoherence and restrictions and other obstacles and undue restrictions in
emergencies that impact the enjoyment of the sexual and reproductive health and
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