A/HRC/27/20 I. Introduction 1. The technical guidance on the application of a human rights-based approach to the implementation of policies and programmes for the reduction of preventable maternal mortality and morbidity (A/HRC/21/22), hereinafter referred to as the “technical guidance”, was requested by the Human Rights Council in its resolution 18/2 and was presented to the Council at its twenty-first session, in September 2012. In its resolution 21/6, the Council welcomed the technical guidance and called upon “all relevant actors, including Governments, regional organizations, relevant United Nations agencies, national human rights institutions, and civil society organizations to disseminate the technical guidance and apply it, as appropriate, when designing, implementing and reviewing policies and evaluating programmes to reduce preventable maternal mortality and morbidity”. Also in resolution 21/6, the Office of the United Nations High Commissioner for Human Rights (OHCHR) was requested to prepare “a report on how the technical guidance has been applied by States and other relevant actors”. The present report is submitted in accordance with that request. 2. The present report provides details of various activities and initiatives related to the implementation of the technical guidance. It also highlights barriers to implementation and recommendations for future actions. The report is based on submissions that were shared with OHCHR in response to a note verbale circulated on 28 January 2014,1 as well as on information obtained from relevant stakeholders via reports and correspondence. The report is not an exhaustive list of all activities relating to the technical guidance or rights-based approaches to maternal health. Rather, it provides illustrative examples of how the technical guidance has been utilized in a variety of contexts. 3. The technical guidance was the third in a series of reports to the Human Rights Council on the issue of maternal mortality and morbidity.2 It aims to assist States and other stakeholders in moving from theory to practice in operationalizing human rights in the area of maternal health, including sexual and reproductive health. As such, it presents concrete guidance, organized according to the policy cycle of planning, budgeting, implementation, monitoring, review and remedies, and international cooperation. 4. A human rights-based approach is premised on creating environments that enable rights holders to claim their entitlements and duty bearers to meet their legally binding human rights obligations. It represents a shift away from passive delivery of services to a culture of accountability for internationally guaranteed human rights. Understanding maternal mortality and morbidity as a matter of human rights requires recognition that the death and grievous injuries sustained by women during pregnancy and childbirth are not inevitable events but rather a direct result of discriminatory laws and practices, failures to establish and maintain functioning health systems and services, and a lack of accountability. 5. The notion that maternal mortality and morbidity is a human rights concern has gained considerable traction in recent years. Civil society and other experts have analysed maternal health, and wider sexual and reproductive health issues, through a human rights 1 2 Submissions were received from Argentina, Colombia, Cuba, Estonia, Germany, Guatemala, Lebanon, Mexico, the Republic of Moldova, Serbia, Slovakia and Switzerland, and from the United Nations Population Fund (UNFPA), Center for Reproductive Rights, Grupo de Información en Reproducción Elegida (GIRE Mexico), International Budget Partnership, International Initiative on Maternal Mortality and Human Rights, and Ipas. The first two reports were A/HRC/14/39 and A/HRC/18/27. 3