A/HRC/18/27 enforcing protocols and improving care in vulnerable communities. This case, still pending, is the first individual communication on maternal mortality filed before a United Nations treaty body and is part of a strategy to ensure that rights-holders have access to international mechanisms when domestic remedies fail. 66. In Chile, the UNICEF guide Growing together was prepared, in partnership with local stakeholders, to assist Mapuche indigenous women during pregnancy and childbirth who face inequality and discrimination in their access to health care.58 The guide highlights Mapuche customs relating to maternal health and contains relevant information for daily practices for pregnant women and their families. 67. In 2008 and 2009, two non-governmental organizations partnered with health rights activists to develop a rights-based framework for holding the Government accountable for, inter alia, the high rates of maternal death and for its failure to use its resources to fulfil progressively the rights to reproductive health.59 The strategy aimed at (a) articulating the human rights obligations that should guide maternal mortality prevention efforts; (b) showing how the State’s maternal health interventions and fiscal policies were falling short of these; and (c) pushing for specific measures to bring health, budget and tax policy into line with human rights standards in the context of the Government’s ongoing health reforms and the 2010 budget process. A compelling picture of non-compliance emerged and detailed recommendations were made to the Government on the need for increased, equitable spending on maternal health. Specific budget and tax reforms, as well as enhancing citizen participation in the decision-making process, were also recommended. 68. The project forced institutions in Guatemala to bring a human rights-based approach to policy-making and monitoring. It succeeded in linking fiscal policy and preventable maternal mortality and morbidity and drawing the attention of United Nations treaty bodies, including the Committee on the Elimination of Discrimination against Women, the Committee on the Rights of the Child and the Human Rights Committee. It prompted a commitment to increase social spending for maternal health, and to implement the necessary fiscal reforms to enable this. It also enabled a joint congressional and civil society accountability mechanism to operationalize a human rights-based approach in their policy monitoring role at both the national and local levels. The monitoring framework has also been welcomed by donors and United Nations specialized agencies in the context of monitoring progress on Millennium Development Goal 5. 69. In Haiti, a Government-led project, supported by the Canadian International Development Agency, the Pan American Health Organization and the EC/ACP/WHO Partnership (a tripartite agreement signed by the European Community, African, Caribbean and Pacific Island countries and WHO, as well as by national ministries of eight countries, including Haiti, to support Millennium Development Goal 5), provided payment to 50 health institutions to offer pregnancy, childbirth and post-partum/post-natal care. Women are also reimbursed for their transport costs, and payments are made to traditional birth attendants. The system is also used to monitor performance. The project supports the rehabilitation of health institutions, purchase of equipment, training of providers and provision of supplies and essential drugs. In some areas, community members have been recruited and trained to support women. These community agents also serve on maternal mortality surveillance committees, referring women with potential complications and conveying feedback to hospitals. As a result, a decline in maternal deaths, a six-fold 58 UNICEF submission. Center for Economic and Social Rights and Instituto Centroamericano de Estudios Fiscales, Rights or Privileges? Fiscal commitment to the rights to health, food and education in Guatemala, 2009. 59 17