Welcome to the Health & Rights Observatory. This platform has been designed and created by the Global Center for Health Diplomacy and Inclusion (CeHDI), to empower health diplomats, decision-makers, and emerging leaders to actively engage with the Human Rights Council's Universal Periodic Review (UPR) mechanism.
On these pages you will find data and tools to review the ways in which countries have featured health in their UPR reporting cycles and show trends in national health outcomes, particularly in the areas of maternal health and family planning. We encourage you to browse the country profiles and we invite you to contact the CeHDI team at info@cehdi.org for more information or to give feedback.
The Right to Health is an inclusive right that 'extends not only to timely and appropriate health care but also to the underlying determinants of health.' As such, it is central to the fulfillment of broader human rights obligations, serving as a powerful tool to advance well-being, equity, and dignity across all sectors of society. The Right to Health comprises the State's obligations to:
- Respect: refrain from interfering directly or indirectly with the enjoyment of the right to health.
- Protect: take measures that prevent third parties from interfering with the guarantees of the right to health.
- Fulfill: adopt appropriate legislative, administrative, budgetary, judicial, promotional, and other measures toward the full realization of the right to health.
The Universal Periodic Review (UPR) is a State-led mechanism to evaluate each State’s 'human rights obligations and commitments.' Reviews involve interactive discussions during which any UN Member State can make recommendations to the States under review, which can either 'support' or 'note' the recommendations.
A preliminary analysis of recommendations related to maternal health suggests that higher engagement with the UPR process, in terms of the number of recommendations issued by reviewing states as well as support of recommendations by States Under Review, is associated with accelerated progress in reducing the maternal mortality ratio (MMR) over time:
We conducted a comprehensive longitudinal analysis of all recommendations made during the first three cycles of the United Nations' Universal Periodic Review (UPR), spanning from 2008 to 2022. The full dataset of recommendations, including the State Under Review's response (“supported” or “noted”), was sourced from the Danish Institute for Human Rights’ “SDG-Human Rights Data Explorer”. Their database in turn relies partly on UPR Info’s “Database of Recommendations”. This dataset formed the basis for our classification and subsequent statistical modelling to assess the relationship between UPR engagement and health outcomes.
To systematically analyze the recommendations, we developed a keyword-based classification system using R. Recommendations were categorized into non-exclusive thematic health areas (i.e. a single recommendation could fall into mutliple categories), such as health systems, communicable diseases, and environmental health. For this study's focus, we developed specific, detailed sub-classification definitions for themes related to Maternal, Newborn, and Child Health (MNCH) and Sexual and Reproductive Health and Rights (SRHR), with a particular focus on identifying recommendations pertaining to maternal health and family planning.
The below abbreviated definitions were compiled from the IHME's factsheets pages for the level 4 causes of maternal disorders:
Maternal haemorrhage includes both postpartum haemorrhage (defined as blood loss ≥500 ml for vaginal delivery and ≥1000 ml for caesarean delivery) and antepartum haemorrhage (defined as vaginal bleeding from any cause at or beyond 20 weeks of gestation).
Maternal sepsis is defined as a temperature <36°C or >38°C and clinical signs of shock (systolic blood pressure <90 mmHg and tachycardia >120 bpm). Other maternal infections are defined as any maternal infections excluding HIV, STI, or not related to pregnancy.
Maternal hypertensive disorders include gestational hypertension (onset after 20 weeks gestation), pre-eclampsia, severe preeclampsia, and eclampsia, but exclude chronic hypertension (onset prior to pregnancy or prior to 20 weeks gestation) unless superimposed preeclampsia or eclampsia develop.
Maternal obstructed labour and uterine rupture aggregates obstructed labour (arrest in the first or second stage of active labour despite sufficient contractions), uterine rupture (non-surgical breakdown of uterine wall), and fistula (an abnormal opening between the vagina and the bladder or rectum following childbirth).
Abortion is defined as elective or medically indicated termination of pregnancy at any gestational age. Miscarriage is defined as spontaneous loss of pregnancy before 24 weeks of gestation with complications requiring medical care.
Ectopic pregnancy is defined as pregnancy occurring outside of the uterus.
Indirect maternal deaths are due to existing diseases that are exacerbated by pregnancy. Examples include maternal infections and parasitic diseases complicating pregnancy, childbirth, and the puerperium, and diabetes in pregnancy, childbirth, and the puerperium.
Late maternal deaths are deaths that occur six weeks to one year after the end of pregnancy, excluding incidental deaths.
Maternal deaths aggravated by HIV/AIDS are deaths occurring in HIV-positive women whose pregnancy has exacerbated their HIV/AIDS, leading to death.
Other direct maternal disorders encompasses a wide range of maternal disorders that do not map to other diseases in the GBD cause list, including other fatal or non-fatal complications occurring during pregnancy, childbirth, and the postpartum period.