3. PROMOTING REPRODUCTIVE RIGHTS THROUGH A HUMAN RIGHTS-BASED APPROACH TO DEVELOPMENT deals with issues similar to UNFPA’s additional key element of a HRBA, namely being cultural sensitive and gender-responsive. Quality: Sexual and reproductive health facilities, goods and services must be scientifically and medically appropriate and of good quality. This requires, for example, skilled medical personnel, scientifically approved and unexpired drugs, hospital equipment and contraception, safe and potable water, and adequate sanitation. APPLYING A HRBA TO THE DEVELOPMENT OF POLICIES AND PROGRAMMES11 PLANNING AND BUDGETING Guaranteeing the right to health obliges states to adopt a national public health strategy and plan of action that contains a sexual and reproductive health and rights strategy, encompassing maternal health, sexuality education and access to voluntary family planning. In addition to having a sectoral health strategy that incorporates sexual and reproductive health, multisectoral strategies, such as national development strategies and poverty reduction strategies are key in addressing underlying determinants of health and reproductive rights issues that usually fall outside the responsibility of the health sector but are essential for achieving more sustainable and equitable health outcomes. Obviously, the obligation of adopting a national development strategy and a national public health strategy and plan of action goes beyond the capacity of a NHRI; nonetheless, the NHRI can be a key player in 11 The session has been inspired by the Report of the Office of the United Nations High Commissioner for Human Rights, A/HRC/21/22 Concise Technical Guidance on the application of a human rights-based approach to the implementation of policies and programmes to reduce preventable maternal morbidity and mortality, 18 May 2012. the development and monitoring of such strategies. A comprehensive national public health strategy requires a situational analysis, where the most severely affected rights-holders are recognized and the duty-bearers with corresponding obligations towards those marginalized and excluded rights-holders are identified. This situational analysis then identifies the capacity gaps of rights-holders to claim their rights and of duty-bearers to meet their obligations. This analysis will translate into policies and plans that address the identified institutional and capacity gaps. A HRBA to a situational analysis is guided by the following simple questions: • What is happening to whom and where? • Why is it happening? (What factors are e.g. preventing women, or certain women, from going safely through pregnancy and childbirth and enjoying their reproductive rights more broadly? • Who or what institutions are responsible for such factors, and for addressing the problem? 85