A/HRC/21/22 situational analysis to ensuring appropriate monitoring mechanisms and remedies in a national plan, to allocating resources for these mechanisms and remedies, to ensuring feedback from the ground through to implementation in practice. Lessons learned through structures of accountability must inform the continual process of adjusting existing programmes and future planning. 19. The design, organization and coordination of the components of the health system should be guided by fundamental human rights principles, including nondiscrimination/equality, transparency, participation and accountability.13 20. Ensuring women’s sexual and reproductive health rights requires meeting standards with regard to health facilities, goods and services: (a) Availability of both the underlying determinants of health, as well as hospitals, clinics and other health-related buildings, trained medical and professional personnel receiving domestically competitive salaries, and essential drugs; (b) Accessibility in four overlapping dimensions: (affordable), non-discrimination, and regarding information; physical, economic (c) Acceptability in terms of respect for medical ethics and of the culture of individuals, minorities, peoples and communities, sensitive to gender and life-cycle requirements, as well as being designed to respect confidentiality and improve the health status of those concerned; (d) Quality, including skilled medical personnel, scientifically approved and unexpired drugs and hospital equipment, safe and potable water, and adequate sanitation;14 respectful care for women using health services is a critical dimension of both quality and acceptability. 21. States are required to use “maximum available resources” for the progressive realization of economic, social and cultural rights; if resource constraints make it impossible for the State to fulfil women’s sexual and reproductive health rights immediately, the State must demonstrate that it has used all the resources at its disposal to do so as a matter of priority.15 Multiple obligations relating to sexual and reproductive health rights are not subject to resource availability, including obligations related to a national plan of action, and the elimination of harmful practices and discrimination.16 Those obligations subject to “progressive realization” require the adoption of all appropriate measures in a deliberate, concrete and targeted manner, within the “maximum available resources”, including resources from international cooperation. 17 There is a strong presumption against any retrogressive measures in relation to sexual and reproductive health.18 22. States should protect against interference with sexual and reproductive health rights by third parties by enforcing appropriate laws, policies, regulations and guidelines. States are responsible for exercising due diligence, or acting with a certain standard of care, to ensure that non-governmental actors, including private service 13 14 15 16 17 18 6 WHO, Everybody’s Business, Strengthening Health Systems to Improve Health Outcomes (2007). The six components identified by WHO are service delivery; health workforce; information; medical products, vaccines and technologies; financing; and leadership and governance. E/CN.4/2000/4, para. 12 (a) – (d). Ibid., para. 47. Ibid., paras. 43 and 44; CEDAW/C/49/D/17/2008, para. 7.6. Committee on Economic, Social and Cultural Rights, general comment No. 3, para. 13; see also Convention on the Rights of the Child, art. 24(4). Committee on Economic, Social and Cultural Rights, general comment No. 3, para. 32.