A/HRC/39/26 commissioners, democratically elected local health councils, public hearings, camp committees, needs and impact assessments, data collection and analysis, and communitybased oversight of finances and quality of care at service delivery points. 58 Like health systems, mechanisms for accountability often break down in crisis settings, if they even existed prior to an emergency. More attention is needed to identify innovative and effective approaches to promote accountability, including social accountability, in humanitarian settings. 56. Independent review mechanisms, performed in a safe and ethical manner can play a fundamental role by identifying those most at risk of being left behind, addressing the root causes of violations and ensuring that everyone has equal access. This may include investigative bodies, such as commissions of inquiry and fact-finding missions mandated by various United Nations bodies, which can play a critical role in promoting an integrated agenda that recognizes and is responsive to the continuum of human rights violations suffered by women and girls in crisis settings. For instance, such bodies can provide critical analysis of trends concerning violations of sexual and reproductive health and rights, consider whether referral pathways and follow-up in practice are adequate and sensitive to the views, experience and needs of the individual concerned and whether effective remedies exist when sexual and reproductive health services fall short. Until now, concerns about human rights related to sexual and reproductive health have been rarely taken up, or only addressed in passing, in the work of such bodies.59 57. Reliable data on the accessibility, availability and appropriateness of quality sexual and reproductive health services for all affected women and girls remains rare. 60 In addition, there is a gap in data and effective documentation of the effectiveness of interventions, including a rights-based approach, and their follow-up and continuum of care after referrals.61 Reasons hindering adequate data collection include difficulties in gaining access to all segments of society and disaggregating data, a lack of ensuring confidentiality, a shortage of funding and a resistance to integrated standardized approaches and coordination, including in methodologies. 62 58. Women and girls affected by an emergency have a role to play in monitoring service delivery. In this context, awareness-raising and developing their capacity to claim their rights is essential. Accountability mechanisms should also be established within health-care institutions so that feedback from health users can inform reviews of service delivery, including by developing, implementing and monitoring an action plan in response. In addition, contextual data and analysis by humanitarian actors, including assessments that help inform their programming, could also be shared with women’s groups to strengthen their demand for accountability. 59. Transparency in policies, programming and coordination across sectors is critical for effective accountability. Rights holders and duty bearers should have a clear understanding of, inter alia: who is providing which services; how such services are coordinated; why certain services are prioritized over others; the locations where they are provided and how to reach them; how, by whom and why certain services are funded; how long services will continue; what services aim to achieve and if there is an exit plan; whom services do not reach; and the reasoning behind each of those decisions. 58 59 60 61 62 See http://governance.care2share.wikispaces.net/Social+Accountability. See, for example, the report of the detailed findings of the commission of inquiry on human rights in Eritrea, paras. 123–125, available from www.ohchr.org/EN/HRBodies/HRC/CoIEritrea/Pages/ ReportCoIEritrea.aspx; and A/HRC/25/63, para. 60. See in this context, OHCHR, Guidance note on the application of a human rights-based approach to data collection (2016), available from www.ohchr.org/Documents/Issues/HRIndicators/Guidance NoteonApproachtoData.pdf. See for both cases, submissions by the Democratic Republic of the Congo, Mali, the National Human Rights Commission of Nigeria and WHO. See all Blanchet et al. “Evidence on public health interventions in humanitarian crises”, The Lancet (8 June 2017). Submission by International Planned Parenthood Federation. 15