A/HRC/39/26 rights is not a cluster unto itself, the health and protection clusters, and particularly the subcluster on gender-based violence, address issues related to sexual and reproductive health. 29 37. The Inter-Agency Working Group on Reproductive Health in Crisis30 developed the Inter-agency Field Manual on Reproductive Health in Humanitarian Settings, 31 which was revised and updated in 2018 and was in the final stages of publication at the time of issuance of the present report. Embedded in human rights standards and principles, the Manual provides authoritative guidance on reproductive health service provision during all phases of an emergency. Critically, it includes guidance on the implementation of the Minimum Initial Service Package, which identifies life-saving interventions and prioritizes implementation of the sexual and reproductive health services that are critically necessary to prevent morbidity and mortality. Integrated in the global health cluster guidance, it outlines a set of priority interventions to be implemented at the onset of an emergency, which should be in place within 48 hours through simultaneous and coordinated actions. That is then bolstered by longer-term and sustainable health-care solutions over time and aims to deliver on key objectives, including: maternal morbidity and mortality; sexual violence; sexually transmitted infections/HIV; unintended pregnancies, including the provision of voluntary contraception; and safe abortion care to the full extent of the law. 38. The Humanitarian Programme Cycle 32 sets out a series of actions to help prepare for, manage and deliver humanitarian response. It consists of five interrelated elements, including a needs assessment and analysis; strategic response planning; resource mobilization; implementation and monitoring; and operational peer review and evaluation. The policy cycle explained in the technical guidance — planning, budgeting, implementation, monitoring, review and remedies, and international cooperation — is comparable to the Humanitarian Programme Cycle. The technical guidance puts forth the concept of a “circle of accountability” that emphasizes that actions to ensure accountability need to happen across all stages of the policy cycle, not only in reaction to alleged violations. That concept is also applicable to the humanitarian programming cycle and can complement existing accountability frameworks in humanitarian contexts. 33 39. A human rights-based approach to maternal mortality and morbidity in humanitarian settings supports the calls coming from within the humanitarian community for a holistic and integrated approach, which seeks to bridge the humanitarian-development divide. In many cases, the onset of crisis exacerbates already weak health systems, which were not meeting human rights standards in terms of sexual and reproductive health and rights. A holistic response would include attention to strengthening national health systems before, during and after crisis, and ensure they are not replaced by short-term measures when crisis hits.34 This holistic approach also requires examining narrowly defined interventions and programming, which may result from funding and/or programmatic requirements, but which can also result in entrenching siloed paradigms and neglecting the experiences of certain categories of women and girls. For instance, programming for gender-based violence that provides access to comprehensive sexual and reproductive health services for victims of violence, while possibly excluding those who have not come forward as victims; or human rights monitoring that focuses narrowly on conflict-related sexual violence, neglecting to analyse human rights violations related to intimate partner violence or violations of sexual and reproductive health and rights. Increasingly, human rights and humanitarian advocates are calling for inclusive approaches that transcend dichotomous framings and place women and girls at the centre of response, capture the totality of every 29 30 31 32 33 34 10 See submission by UNFPA Burundi, in which it noted the absence of a subsectoral working group on sexual and reproductive health as a challenge and the need for better coordination of interventions, also in relation to data collection and usage. See http://iawg.net/. Available at http://iawg.net/resource/inter-agency-field-manual-on-reproductive-health-inhumanitarian-settings-2010/. See https://interagencystandingcommittee.org/system/files/hpc_reference_module_2015_final_.pdf. See also Independent Accountability Panel, p. 12. See A/70/709, para. 110.