A/HRC/45/19 65. The linkages between maternal morbidities and personal economic burdens fall across three areas: “the consequences of a lack of funds to provide and seek care; the encumbering costs of health care; and the implications of illness on earning capacity”. 54 Personal finances can act as a barrier to seeking health care for women’s morbidities, which can then exacerbate the condition and increases the chance for complications. Financial hardship resulting from onerous expenses for treatment contributes to uncertainty, stigmatization, pain, worry and interrupted treatment.55 E. Human rights-based approach to policies and programmes to address maternal morbidity 66. Ensuring women’s human rights in relation to maternal health requires more than avoidance of death. Increased attention to maternal morbidities is needed to ensure a more holistic approach to women’s health, in line with human rights obligations. High rates of maternal morbidity across the world are a result of multiple factors, which include inequality suffered by women throughout their lifetimes. Applying a human rights-based approach to preventable maternal morbidity should include paying attention to ensuring the availability, accessibility, acceptability and quality of treatment, as well as preventive services and measures; enhanced data collection to understand the scope of the issue; participatory approaches that engage directly with women and girls who are affected; and the strengthening of systems of accountability to address human rights denials. Such an approach would also ensure that attention was systematically paid to discriminatory causes and consequences of maternal morbidities. 67. Many stakeholders have made important efforts to ensure treatment for severe maternal morbidities. These efforts must be encouraged, and more attention is needed to ensure that treatment is reached by all women who need it, without discrimination, with particular focus on accessibility and affordability. It is also vital to ensure that the health workforce is equipped to respond to maternal morbidities, which, considering the vast number of conditions included as morbidities, may require specialist training. 68. In addition to treatment, it is essential for States and other relevant stakeholders to put in place strong, effective and comprehensive prevention measures that explicitly address gender-based discrimination and other determinants of health. With holistic prevention strategies, which would include removing all barriers to comprehensive sexual and reproductive health services, as well as dedicated efforts to ensure women and girls are empowered to claim their rights and access reliable information to make decisions about their health, it is feasible to bring maternal morbidity rates down. 69. Addressing maternal morbidities requires more robust information in order to understand their prevalence and typology, as well as disparities between groups of women and girls. Through human rights analysis, stakeholders can identify and address the reasons behind certain women’s heightened inability to access adequate and timely maternal healthcare interventions and services, causing complications during pregnancy and childbirth. Obtaining such data requires strong systems for documentation and monitoring, which serve as a basis for corrective action taken through changes in practice, policy or even law reform. 70. To address maternal morbidity from a human rights perspective, it is also critical to engage directly with women and girls in efforts to prevent and treat such morbidities. Through participatory approaches, women will have access to relevant information to enable their decision-making in matters affecting their health, pregnancy and childbirth. Following up with women after childbirth is also important for tracking potential morbidities and increasing the likelihood of treatment. It is also essential to pay special attention to certain groups of women and girls who are more likely to suffer maternal 54 55 Lange and others, “What maternal morbidities are”, p. 14. Ibid. 15