Urgesall States to eliminate preventable maternal mortality and morbidity, to respect, protect and fulfil sexual and reproductive health and reproductive rights and the right to bodily autonomy, free from discrimination, coercion and violence, including sexual and gender-based violence, including by addressing social, economic and environmental determinants of health, through the removal of legal barriers and the development and enforcement of policies, best practices and legal frameworks that respect bodily autonomy and safeguard informed choice and informed consent for all procedures throughout pregnancy and childbirth, and to ensure universal health coverage throughout the life course, including access to available, accessible (including affordable), acceptable and quality sexual and reproductive health services, including maternal health and maternal mental health services, methods of prevention and treatment of sexually transmitted diseases and infections, such as HIV, evidence-based comprehensive sexuality education, a choice of safe and effective methods of modern contraception, emergency contraception, skilled birth attendance, midwifery models of care, emergency obstetric care, safe abortion, when not against national law, and post-abortion services and care;
2
UrgesStates to strengthen health systems, to ensure the integration of sexual and reproductive health services into national health policies, strategies and systems and to guarantee that sexual and reproductive health facilities, goods and services are available, accessible (including affordable), acceptable and of quality, including by allocating the necessary gender-responsive budgetary resources needed to ensure that sexual and reproductive health needs are met for pregnancy, childbirth, gynaecological examinations, fertility treatments, miscarriage, safe abortion, when not against national law, post-abortion care and contraception and in other health contexts, facilitating access to telemedicine or telecommunications to support sexual and reproductive healthcare services, including for obstetric emergencies, as well as the distribution of information about contraceptives and family planning, through toll-free services, combating misinformation and disinformation, both online and offline, and putting in place creative arrangements to support victims and survivors of gender-based violence, for example, hotlines and online services;
3
Also urgesStates to redouble their efforts to eliminate discrimination and disparities in health systems, in particular racial and ethnic disparities, to integrate an intersectional approach into policies and programmes aimed at improving women’s access to healthcare, including comprehensive sexual and reproductive health services and education, and at reducing the high rates of maternal mortality and morbidity and to take steps to remove restrictive and discriminatory legal and practical barriers to midwifery care, including those affecting midwives in communities of Afrodescendent persons, Indigenous Peoples and other individuals facing intersectional discrimination;
4
Calls upon States to address key social, economic and environmental determinants of health that render certain women and girls, including adolescents, and especially those facing intersectional discrimination, more vulnerable to maternal morbidity, such as obstetric fistula, uterine prolapse, perinatal distress, post-partum depression and infertility;
5
Calls upon all States and relevant international organizations to take comprehensive measures and support programmes that are aimed at combating undernutrition in mothers, in particular during pregnancy and breastfeeding;
6
Calls upon States to implement human rights-based approaches to maternal healthcare services, including community-based and midwifery models of care, by ensuring adequate resourcing, training and integration into health systems of providers and creating frameworks that enable trained, competent, licensed and regulated midwives to autonomously provide continuous and person-centred care across their full scope of practice throughout pregnancy, childbirth and the postpartum period, in order to ensure equitable access to respectful and high-quality maternal care for all women and girls, including those from marginalized communities and those in vulnerable situations;
7
Also calls upon States to take all necessary legislative, policy and programmatic measures, in particular by strengthening legal and regulatory frameworks, that enable midwifery models of care by integrating midwives into health systems, supporting interprofessional collaboration across all levels of the health system, supporting appropriate licensing and training and enabling care to be provided in various settings, including homes and communities, and recognizes that midwifery models of care uphold the principles of dignity, partnership, informed consent, choice and respect, thereby fostering respectful, empowering and individualized care as a cornerstone of quality sexual, reproductive, maternal, newborn and adolescent healthcare services;
8
EncouragesStates to respect and promote, in a manner consistent with the United Nations Declaration on the Rights of Indigenous Peoples, the right of Indigenous Peoples to the enjoyment of the highest attainable standard of physical and mental health and to maintain their distinct health practices, including by recognizing Indigenous midwifery and by establishing respectful collaboration with Indigenous midwives within national health systems;
9
UrgesStates and encourages other relevant stakeholders, including national human rights institutions and non-governmental organizations, to take action at all levels, utilizing a human rights-based approach, to address the interlinked causes of maternal mortality and morbidity, such as lack of available, accessible (including affordable), acceptable and quality health services for all, lack of information and education, including evidence-based comprehensive sexuality education, shortages of health providers, lack of access to medicines, medical equipment, perinatal facilities and specialized healthcare services, all types of malnutrition, poverty, stigma, lack of confidentiality of medical patient records, lack of access to safe drinking water and sanitation, poverty, underdevelopment, climate change, air pollution, exposure to toxic and hazardous substances and wastes, shortages in human and material resources facing health systems, shortages in humanitarian assistance and funding shortages affecting hospitals, technical assistance, capacity-building and training needs, harmful practices, including child, early and forced marriage and female genital mutilation, early childbearing and inequalities, including gender inequality and discrimination, and to take concrete measures to eliminate all forms of discrimination and violence against all women and girls;
10
Calls upon States to promote human rights-based, age- and gender-responsive and disability-inclusive multisectoral and cross-disciplinary coordination of policies, programmes, budgets and services designed to prevent and treat maternal mortality and morbidity, with the active participation of all relevant stakeholders, including civil society, and especially the full, equal, meaningful and inclusive participation of all women and girls, at the national, local and community levels, and to promote social accountability mechanisms to monitor such policies, programmes, budgets and services in order to accelerate the elimination of maternal mortality and morbidity and the achievement of universal access to sexual and reproductive health without discrimination or undue financial burden;
11
Emphasizes that effective and financially sustainable implementation of universal health coverage through a primary healthcare approach, including sexual and reproductive healthcare services, is necessary for achieving gender equality and human rights, and that this should be delivered through a resilient and responsive health system that provides comprehensive primary healthcare services with extensive geographical coverage, including for those living in remote and rural areas and islands, in humanitarian and conflict settings and under occupation, and with a special emphasis on access to populations most in need;
12
UrgesStates to strengthen the capacity and resourcing of health systems and the health workforce, to provide the essential services needed to prevent and treat maternal mortality and morbidity, including through sufficient budget allocations for health, including sexual and reproductive healthcare services and community-based and midwifery models of care, and the deployment and training of midwives, nurses, obstetricians, gynaecologists, doctors, surgeons and anaesthesiologists, including with comprehensive training on respectful maternity care grounded in anti-racism and anti-discrimination, upholding bodily integrity and autonomy and ensuring informed choice and informed consent in all aspects of care and services, in accordance with international medical standards, and to ensure holistic social integration services, including counselling, education, family planning, socioeconomic empowerment, social protection and psychosocial services, so that women and girls living with maternal morbidity can overcome stigma, discrimination, ostracism and economic and social exclusion;
13
Also urgesStates to strengthen their research, data collection and monitoring and evaluation systems to promote reliable, transparent, collaborative and disaggregated data collection on the availability, accessibility, including affordability, acceptability and quality of sexual and reproductive health services for all women and girls, including data collection on violations and abuses of human rights in pregnancy, childbirth and the postpartum period, as well as the sexual and reproductive health needs of all women and girls throughout their life cycles, and to conduct up-to-date needs assessments on emergency obstetric care and routine reviews of maternal deaths and near-miss cases as part of a national maternal death monitoring and response system, integrated within national health information systems in order to support more comprehensive policies to prevent and address maternal mortality and morbidity;
14
Calls upon States to build recognition, at the national, regional and international levels, that preventable maternal mortality and morbidity are human rights issues, including through more targeted research in this area, the allocation of sufficient resources and dedicated efforts to ensure the availability, in particular for women and girls, of information on the overlapping causes of specific maternal mortalities and morbidities and their prevention;
15
RequestsStates and other relevant actors to give renewed emphasis to maternal mortality and morbidity initiatives in their development partnerships and international assistance and cooperation arrangements, including by strengthening technical cooperation to address maternal mortality and morbidity, including through the transfer of expertise, technology and scientific data and by exchanging good practices with developing countries, while honouring existing commitments, and to integrate a human rights perspective into such initiatives, addressing the impact that discrimination against women and girls has on maternal mortality and morbidity;
16
UrgesUnited Nations agencies and development partners to provide tailored technical, financial and logistical support to developing countries’ health systems, at their request, in a predictable and sustained manner, including to least developed countries and small island developing States, taking into account their unique geographical, demographic and economic challenges, with a view to accelerating the elimination of preventable maternal mortality and morbidity and achieving the Sustainable Development Goals;
17
UrgesStates to ensure that laws, policies and practices respect bodily autonomy and privacy rights and the equal right to decide freely and responsibly in matters regarding one’s own life and health, including during pregnancy and childbirth, through guaranteeing informed choice and informed consent in all medical interventions and by promoting midwifery models of care that are in line with human rights and centre respectful support before, during and after pregnancy, by bringing relevant laws and policies concerning sexual and reproductive health and reproductive rights, including international assistance policies, into line with international human rights law and repealing discriminatory laws relating to third-party authorization for health information and health services, the criminalization of the provision of accurate and factual information on sexual and reproductive health and male guardianship laws and practices and by combating gender stereotypes, negative social norms and discriminatory behaviour;
18
Also urgesStates to ensure access to justice and accountability mechanisms and timely and effective remedies for the effective implementation and enforcement of laws and standards aimed at preventing violations of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health and sexual and reproductive health and rights, especially those aimed at preventing maternal mortality and morbidity, including violations linked to obstetric violence and restrictions on autonomous decision-making in pregnancy and reproductive health services, such as by informing all women and girls of their rights under relevant normative frameworks, improving legal and health infrastructure, strengthening accountability and oversight mechanisms, including through licensing bodies and professional associations, and removing all barriers to access to legal counselling, assistance and remedies;
19
Further urgesStates to ensure gender equality, women’s rights and children’s rights, and other relevant stakeholders as appropriate to take action, through inclusive public awareness-raising and evidence-based initiatives, tailored to the age of their audience, including in schools, through the media and online, such as by incorporating curricula on all women’s and girls’ rights into teacher training courses, including the prevention of sexual and gender-based violence and discrimination, and ensuring universal access to evidence-based comprehensive sexuality education in and out of school settings;
20
Calls upon States to convene and support multi-stakeholder meetings and consultations involving health workers, including midwives, and marginalized women and girls at multiple levels to discuss the application of a human rights-based approach to the elimination of preventable maternal mortality and morbidity, to identify opportunities within national-level processes and to prioritize concrete areas and plans for action;
21
Takes note with appreciation of the report of the Office of the United Nations High Commissioner for Human Rights entitled “Update to the technical guidance on the application of a human rights-based approach to the elimination of preventable maternal mortality and morbidity”, and encourages all stakeholders to implement the recommendations contained therein;
22
Requeststhe Office of the High Commissioner to facilitate inclusive and participatory virtual consultations on the implementation of the update to the technical guidance and best practice approaches to that implementation and to compile and analyse examples of best practices emerging from those consultations into a report to be submitted to the Human Rights Council at its sixty-sixth session, including a plain language version targeted at national stakeholders;
23
Also requeststhe Office of the High Commissioner to conduct the aforementioned consultations and compilation of best practice approaches in coordination with relevant entities of the United Nations system, in particular the United Nations Population Fund, the World Health Organization, the United Nations Children’s Fund and the United Nations Entity for Gender Equality and the Empowerment of Women, and in consultation with civil society organizations and other relevant stakeholders, such as health providers and women’s human rights organizations;
24
Decides to remain seized of the matter.
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