A/HRC/21/22
(e)
International accountability calls for the systematic integration of information
on efforts to prevent and reduce maternal mortality and morbidity into reports submitted to
international human rights mechanisms, including regional human rights bodies, treaty
monitoring bodies and for the universal periodic review of the Human Rights Council,
together with implementation of recommendations thereof.
75.
A human rights-based approach depends on fostering accountability of
multiple actors and at various levels, within and beyond the health sector, including,
but not limited to:
(a)
Professional accountability. Although front-line health workers must not be
treated as scapegoats for institutional failures, effective standards should be in place to
ensure quality of care, and sanctions by professional associations, medical councils and/or
licensing bodies should be applied in the event of proven negligence, abuse or malpractice,
irrespective of whether providers are tenured;
(b)
Institutional accountability. Accountability at the facility level requires
continuous oversight and regular follow-up with regard to any gaps identified. Complaint
procedures should be instituted in all facilities for health system users, including appeal
procedures for decisions by institutional management or ethics committees denying access
to any form of sexual and reproductive health care. Furthermore, internal ombudsperson
procedures should be instituted for review of health workers’ complaints in each facility,
with possibility for appeal;
(c)
Health system accountability. In addition to continuous systemic
monitoring and regular diagnostics of obstacles, reviews of all maternal deaths should be
conducted routinely in order that lessons may be learned at all levels of the health system:from individuals’ behaviour and practices to national policies, and along the continuum of
care from home to hospital. Maternal death reviews should be conducted in the spirit of
shared responsibility rather than attributing blame, and to inform actions to prevent future
maternal deaths;
(d)
Private actor accountability. Corporate enterprises and other non-State
actors have a responsibility to respect women’s sexual and reproductive health rights,
which means that they should act with “due diligence” or appropriate care to avoid
interfering with such human rights.45 In turn, appropriate laws, policies, regulations and
guidelines should be established and enforced by the State with regard to such
infringements;
(e)
Donor accountability. Donors have obligations of international assistance
and cooperation with regard to sexual and reproductive health rights, including both
financial and non-financial obligations, as described below.
C.
Remedies
76.
Remedies are essential to give effect to rights. They may take the form of
restitution, compensation, satisfaction or guarantees of non-repetition.46 Remedies may be
administrative, but appeal to judicial review from administrative proceedings will often be
appropriate.47 Remedies may also be provided through a national human rights institution.
45
46
47
See A/HRC/17/31.
E/C.12/2000/4, para. 59.
E/C.12/1998/24, para. 9.
17
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