A/61/338 relevant services more accessible, including through expansion of relevant services into underserved areas. It will also often depend on ensuring relevant interventions are affordable; (c) Accessible without discrimination. They must be sensitive to gender and to the rights and cultures of minorities and indigenous peoples.19 Preventing maternal mortality and enhancing access to maternal health care is not simply about scaling up technical interventions or making the interventions affordable. It is also vital to address social, cultural, political and legal factors which influence women’s decisions to seek maternal or other reproductive health-care services. This may require addressing discriminatory laws, policies, practices and gender inequalities that prevent women and adolescents from seeking good quality services; (d) Of good quality.20 The quality of care often influences the outcome of interventions and also influences a woman’s decision of whether or not to seek care. Underlying determinants of health 18. The right to health is not just a right to health care, but an entitlement to other social, economic, cultural and political determinants of health. These include participation in health-related decision-making processes, information on sexual and reproductive health, literacy, nutrition, non-discrimination and gender equality. The majority of these determinants have a direct influence on access to the health services that are essential for preventing maternal mortality. Some, such as nutrition, can be a direct cause of maternal mortality. Several of these issues are given further consideration in paragraph 22 below. Progressive realization, resources and international cooperation 19. States have a duty to devote maximum available resources, and to take legal and policy measures, to progressively realize the right to health.21 In many countries, health systems are chronically underfunded and in a state of collapse. Increased expenditure and policies which strengthen health systems and give priority to maternal health are essential for reducing maternal mortality. 20. The right to health gives rise to a responsibility of international assistance and cooperation on developed States to assist developing States realize the right to health.22 Developed States should support developing States’ efforts to reduce maternal mortality. This responsibility is reflected in Millennium Development Goal 8, which is a commitment to develop a global partnership for development. Developed States should ensure that their international development assistance, and other policies, support health systems’ strengthening and other relevant policies in developing countries (see also A/59/422 and A/60/348). The right to health and the “three delays” model 21. It has been suggested that maternal mortality is overwhelmingly due to delays in: deciding to seek appropriate medical help for an obstetric emergency (for reasons of cost, lack of recognition of an emergency, poor education, lack of access to information and gender inequality); reaching an appropriate facility (for reasons of distance, infrastructure and transport); and receiving adequate care when a facility is reached (e.g. because there are shortages in staff, or because electricity, water or medical supplies are not available).23 The “three delays” are interrelated.24 06-51997 7