A/HRC/14/20/Add.2 provides some additional contextual information about India, Rajasthan and Maharashtra. The supplementary note explains that India is one of the world’s oldest civilizations, enjoying a rich, deep, cultural heritage. With a population of over 1 billion people, it is the world’s largest democracy and second most populous country. In recent years, economic reforms have turned India into one of the world’s fastest growing economies. Nonetheless, the country still suffers from high levels of poverty, illiteracy, malnutrition and widening inequality. 9. The supplementary note also signals India’s constitutional arrangements, international human rights commitments, national human rights institutions and recent substantial progress in the field of health. For example, longevity has doubled from 32 years in 1947 to 66 years in 2004. However, enormous health challenges remain. In the period 2001–2003 there was an average of 301 maternal deaths for every 100,000 live births in India.2 While it represents a decrease since the 1997 estimate of 398,3 this figure is higher than in many other middle-income and some low-income countries. 10. The supplementary note briefly sets out some of the Government’s health policies and initiatives, such as the highly commendable National Rural Health Mission (2005– 2012) (NRHM), and includes a few remarks about Rajasthan, with a maternal mortality rate of 445,4 and Maharashtra, with a maternal mortality rate of 149, i.e. approximately half the national average.5 11. A number of especially important contextual issues are not confined to the supplementary note; they are also set out in some detail in chapters IV and V below. For example, those chapters discuss the impressive NRHM, the private health sector in India, the constitutional division of responsibilities for health, and comparative maternal mortality data, as well as specific health initiatives, such as Janani Suraksha Yojani, Chiranjeevi Yojana, and a possible role for the National Human Rights Commission. III. A right-to-health approach to maternal mortality 12. In collaboration with colleagues, the Special Rapporteur has developed a right-tohealth approach to maternal mortality that derives from international human rights law. This approach is not specific to India but applies to all countries. It is not possible to describe fully this approach here. However, it can be found in the supplementary note (and on the website) referred to in chapter II above. 13. It would be convenient if the right-to-health approach to maternal mortality could be reduced to a simple checklist or one-size-fits-all plan of action. But the right to health is more nuanced, and maternal mortality more complicated, than that. The right-to-health approach is better understood as a dynamic working model to be applied in diverse contexts by those committed to the reduction of maternal mortality. 14. Briefly, the approach entails three steps. First, identifying a number of fundamental right-to-health values and principles, such as equity, non-discrimination, transparency, 2 3 4 5 GE.10-12866 India, “Maternal mortality in India: 1997–2003: trends, causes and risk factors (Sample Registration System)” (Registrar General), p. xv. While the Sample Registration System, Maternal Mortality in India: 2004–2006, was published too late for inclusion in this report, it suggests that the estimated number of maternal deaths is falling, but remains surprisingly high. Also see “Counting maternal deaths” in chapter IV below. India, “Maternal mortality in India”, p. xv. Ibid., p. 21. Ibid. 5