A/HRC/21/22
as many of the criteria as possible are met, including data objectivity (as in measures of
skilled birth attendance).
72.
Monitoring should facilitate the strengthening of the health system, including of
the health information system. Emergency obstetric care is a core obligation under
international law, and is the core maternal health intervention that depends most on a
functioning, coordinated health system. Broader collection of information on the
availability and use of emergency obstetric care, which depends on health facility survey
data, can strengthen health information systems. 42 Health information systems should also
address biases in current demographic and health data, which may affect vulnerable and
marginalized groups, such as by excluding floating and migrant populations and women
who do not have live births.
73.
Monitoring should encompass non-State actors, including, but not limited to,
pharmaceutical, commodities and device manufacturers, insurance companies and
private service providers.
B.
Forms of review and oversight
74.
Human rights accountability requires multiple forms of review and oversight,
including:
(a)
Administrative accountability with regard to sexual and reproductive health
calls for internal rules and norms in health facilities and within the Ministry of health,
which set standards for conduct and make subordinates accountable to superiors, to be
monitored by a person or committee with no conflicts of interest;
(b)
Social accountability calls for civil society and public participation at all
levels of decision-making regarding sexual and reproductive health, and throughout the
project cycle. Community-based oversight of facility staff, finances and quality of care at
facilities, such as “community scorecards”, “community-based local administration” of
health facilities and accompaniment of women by family and community members can all
contribute to social accountability and should be implemented according to context;
(c)
Political accountability calls for both national and subnational Governments
to be able to justify to legislators the criteria used and decisions taken regarding sexual and
reproductive health. For legislative oversight to be meaningful, the Executive should
transparently share budget and planning documents, as well as results, and provide
adequate time and information for meaningful deliberation by parliamentarians and local
legislatures;
(d)
National legal accountability includes the duty of the State to guarantee
effective enjoyment of human rights, including the duty to provide effective legal remedies
to victims.43 Legal remedies can be judicial and non-judicial, such as by through a national
human rights institution;44
42
43
44
16
WHO, UNFPA, the United Nations Children’s Fund (UNICEF) and the Averting Maternal Death and
Disability Programme, Monitoring Emergency Obstetric Care (2009); see also WHO, World Health
Report 2005: Make Every Mother and Child Count (Geneva, 2005).
Committee on Economic, Social and Cultural Rights, general comment No. 3, para. 5.
See for example Kenya National Commission on Human Rights, “Realizing sexual and reproductive
health rights in Kenya: a myth or reality?”, 2012, available from
www.knchr.org/reproductivehealth.aspx.
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