A/HRC/21/22 (b) “Maximum available resources” under international law include resources from international assistance and cooperation;36 however, increased resources from external sources should not replace governmental funding of sexual and reproductive health programming unless publicly justified and based on an impact assessment; (c) If the overall budget of the State decreases, resources for sexual and reproductive health programmes should not be decreased unless the Government demonstrates that it has taken all reasonable measures to avoid such reductions; (d) As reducing budgets for programmes directed at low-income and marginalized women may constitute retrogression under international law, Governments bear a special burden in demonstrating the need for such cuts. 48. Both national and subnational governments should establish participatory processes, such as public hearings, during budget formulation. Citizens, civil society organizations, academics and health service providers should be able to contribute meaningfully to budgeting discussions, including by identifying needs, and be aware of decision-making criteria. 49. Budgets earmarked for sexual and reproductive health should not be reassigned, diverted or underspent during the fiscal year. In decentralized health systems, budgets should be allocated and funds distributed to the regions and districts in a timely and equitable manner. 50. In order to implement budgets effectively and ensure that they are properly spent, annual work plans that clearly allocate responsibilities at all levels of government should be used. 51. The human rights principles of transparency and accountability call for both allocated and spent budgets on sexual and reproductive health to be disaggregated by functional and programmatic classifications and on the basis of regional reporting. Sexual and reproductive health spending should be clearly identifiable in the overall budget and available in a format readily accessible to the general public. 52. Budgets should include provisions for ensuring effective accountability, including monitoring, access to justice for the poor, and both judicial and non-judicial accountability mechanisms to facilitate timely redress. IV. Ensuring implementation in practice 53. Despite elaborate national planning and policies, a failure to respect, protect and fulfil women’s rights to maternal health is often observed or becomes evident in implementation. Identifying an obstruction to effective implementation requires periodic, bottom-up, local diagnostic exercises to ascertain and provide feedback on what is happening to whom and where; why it is happening (what factors are preventing women, or certain women, from safely experiencing pregnancy and childbirth and enjoying their sexual and reproductive health rights more broadly?); who or what institution is responsible for such factors, and for addressing the problem; and how action should be taken (what do different duty-bearers need to do to address each factor?). 54. Human rights accountability requires follow-up on diagnosed problems and proposed remedial responses by the duty-bearers identified. Appropriate channels must therefore be available at the facility, district, regional and national levels, and across sectors 36 E/C.12/2007/1, para. 5. 11