3. PROMOTING REPRODUCTIVE RIGHTS THROUGH A HUMAN RIGHTS-BASED APPROACH TO DEVELOPMENT serve is linked to internal accountability between health workers and the health systems in which they work. In Ceará, B ­ razil, the central government helped create such a synergy by actively establishing relationships between government, communities and health workers. Central government would only start a programme if communities demanded local government to co-sponsor it. Once started, the programme recruited health workers through transparent and public processes that informed communities about the nature of the programme, the qualifications required of health workers, and their expectations with respect to the services provided. In addition to community support and monitoring, health workers were supported through technical training, supervision, and morale building publicity campaigns. Lastly, central government ensured that all stakeholders stood to gain from supporting the programme and thus pre-empted negative interference from both supervising nurses and local party representatives.8 A NHRI can help to secure accountability and rule of law by carrying out its protective mandate, including by accepting complaints concerning alleged violations of human rights and by monitoring closely how the state adheres to decisions and recommendations. It can also help by advising government on how to design transparent and open processes. Sensitization campaigns should help build capacity among the rights-holders on how to hold the duty-­ bearers to account. 8 George, Asha, “Accountability in Health Services, Transforming Relationships and Contexts”. Harvard Center for Population and Development Studies, Harvard School of Public Health, Working Paper Series, Vol. 13, No. 1, February 2003. THE 3AQ – AVAILABILITY, ACCESSIBILITY, ACCEPTABILITY AND QUALITY Reproductive rights are directly connected to the right to health (among other rights, see Chapter 4). The right to health entitles women “to reproductive health care services, goods and facilities that are”9 available, accessible, acceptable and of good quality. HRBA applies the normative content of the right to health by ensuring that development outcomes and interventions are consistent with the guidance provided by the 3AQ framework. For instance, public policies aiming at universal access to sexual and reproductive health should include con- crete interventions and programme deliverables to ensure that health services meet a minimum level of quality and are culturally acceptable for the intended users. 9 10 Greatly inspired by and quoting from “UNFPA – A Human Rights-Based Approach to Programming”, 2010, pp. 177-178. Special Rapporteur’s Report A/61/338 to the UNGA, “The right of everyone to the enjoyment of the highest attainable standard of physical and mental health”, 2006 The 3AQ framework in relation to reproductive rights is further developed below:10 Availability: Sexual and reproductive health and health care facilities, goods and services, as well as programmes, should be available in sufficient quantity within the country. This includes not only hospitals, 83