A/HRC/21/22 I. Introduction 1. In its resolution 18/2, the Human Rights Council requested the Office of the United Nations High Commissioner for Human Rights (OHCHR), in cooperation with concerned United Nations agencies and other experts, to prepare concise technical guidance on the application of a human rights-based approach to the implementation of policies and programmes to reduce preventable maternal mortality and morbidity, and to present it to the Council at its twenty-first session. 2. In 2011, OHCHR circulated a note verbale to all States and international organizations requesting information on existing technical guidance pertaining to human rights and maternal mortality and morbidity. 1 In addition to desk-based research, the present report was informed by responses to the note verbale, close cooperation with United Nations agencies, academics and civil society organizations working in the area of maternal mortality and morbidity, an expert group consultation and a public consultation. 3. Maternal mortality and morbidity continue to exact a terrible toll on women, and especially impoverished women, in many countries worldwide. Some 287,000 women died of maternal causes in 2010,2 and between 10 and 15 million more suffer debilitating complications annually, severely affecting their well-being. The World Health Organization (WHO) estimates that from 88 to 98 per cent of maternal deaths are preventable.3 4. Millennium Development Goal 5 calls for a 75 per cent reduction in maternal mortality ratios from 1990 levels and universal access to reproductive health by 2015, the latter being the target that is most off-track.4 At the High-level Plenary Meeting of the General Assembly on the Millennium Development Goals in 2010, the Secretary-General launched the Global Strategy for Women’s and Children’s Health to accelerate progress. As a result of the Global Strategy, an information and accountability commission was established, which issued a report recognizing the centrality of human rights to achieving progress, and made 10 recommendations, the implementation of which can support the guidance contained in the present report.5 5. The primary purpose of the present report is to assist policymakers in improving women’s health and rights by providing guidance on devising, implementing and monitoring policies and programmes to reduce maternal mortality and morbidity, and fostering accountability in accordance with human rights standards. 6 1 2 3 4 5 6 All submissions received are available on the OHCHR website at www2.ohchr.org/english/issues/women/. World Health Organization (WHO), Trends in Maternal Mortality: 1990 to 2010. WHO, UNICEF, UNFPA and the World Bank Estimates, 2012. Available from www.unfpa.org/webdav/site/global/shared/documents/publications/2012/Trends_in_maternal_mortali ty_A4-1.pdf. WHO, “Maternal mortality: helping women off the road to death”, WHO Chronicle, vol. 40, 1986, pp. 175–183. A/64/665, para 30. Commission on Information and Accountability for Women’s and Children’s Health, Keeping Promises, Measuring Results, WHO, 2011 (available from www.who.int/topics/millennium_development_goals/accountability_commission/Commission_Repor t_advance_copy.pdf), p. 2. Particular situations, such as emergencies, may require additional guidance with regard to compliance with human rights standards and other obligations under international law, including humanitarian 3