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Creating A Circle of Accountability for the Prevention of Maternal Mortality and Morbidity: Recent Developments at the United Nations. Alicia Ely Yamin , JD MPH Lecturer on Global Health, and Director, Health Rights of Women and Children Program. UN Technical Guidance. General principles - PowerPoint PPT Presentation
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Creating A Circle of Accountability for the Prevention of Maternal Mortality and Morbidity: Recent Developments at the United Nations
Alicia Ely Yamin, JD MPH
Lecturer on Global Health, and
Director,Health Rights
of Women and Children Program
UN Technical Guidance General principles Planning and Budgeting Ensuring Implementation Accountability [International assistance and Cooperation]
Background
Thematic Report (A/HRC/14/39) Best Practices Report (A/HRC/18/27) 2012: “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” (Technical Guidance). (A/HRC/21/22)
Technical Guidance: General Principles
HRBA to health, not MMM Social determinants of SRH Health Systems
Accountability Non-discrimination/equality Participation Transparency
Planning and Budgeting
National Plan of Action on SRH Multi-sectoral Based on situational analysis Transparent and participatory process Review of legal and policy framework Redressing historic patterns of discrimination;
special concern for marginalized and vulnerable groups
Budgeting
“Maximum available resources” Confers added protection
If budget increases… If budget decreases… Low-income populations
Ensuring Implementation
Bottom-up diagnostic exercise (what,? where?, to whom?, why?, who,? how?)
Two examples: Women arriving late or failing to seek EmOC Adolescent MMM
Example of identified problem: women arriving late or failing to seek emergency obstetric care
Lack of availability
Lack of accessibility (economic, physical, information, non-discriminatory basis)
Lack of acceptability
Lack of quality
• Delay in making the decision to
seek help
• Delay in arriving to health facilities
• Delay in receiving adequate treatment
In a HRBA…
Proximate and underlying factors Health workers Accountability requires follow-up
Accountability (1): Monitoring Laws, policy, and budgetary efforts, results (inputs,
outputs, outcomes) Quantitative indicators should facilitate drawing
conclusions with respect to international obligations: comparable, objective; programmatically relevant; subject to disaggregation, local audit; frequently or continuously measurable (Yamin and Falb, 2012)
Should facilitate strengthening the health system, including the health information system.
Monitoring encompasses private actors.
Accountability (2): Forms of Review/Levels of Accountability
Administrative, Social, Political, National legal accountability, International accountability
Professional, Institutional, Health system, Private actors, Donors
Accountability (3): Remedies
Ensuring Implementation of Laws and Policies
Reforming laws, policies and budgets Challenging discriminatory barriers Redress for violations of SRH rights in
practice
Concluding Reflections
Implementation report in 2 years
Post 2015