A/HRC/14/20/Add.2 81. Maternal death reviews and EmOC indicators are not alternatives but complementary initiatives. Moreover, they need to be supplemented by other monitoring and accountability arrangements, including indicators for the other cornerstone interventions to reduce maternal mortality. 82. The “plus”: an independent body. As with the information generated by the maternal death reviews, it is extremely important that the data from the indicators go to an independent body for review, analysis and recommendations. This body should be empowered to check whether or not appropriate steps are swiftly taken to address any shortcomings exposed by the data. It may have specific powers, for example, to conduct supplementary studies. The Government of India must urgently establish an appropriate independent body that is responsible for using the indicators to hold the authorities accountable (the “plus”). One institutional option is briefly introduced in subsection 5 below. 4. Private sector 83. Under international human rights law, Governments have a binding legal obligation to ensure that third parties, including the private sector, are respectful of individuals’ and communities’ human rights. In the absence of adequate self-regulation, this requires a Government to establish an appropriate, effective regulatory framework. 84. India’s private health sector is enormous. While there are about 1.4 million health practitioners in India, only about 10 per cent of them are in government service. The private health sector has grown considerably in recent years, although more slowly in Rajasthan when compared to Maharashtra and all-India levels. Use of the private sector for maternal health services is lower in Rajasthan than Maharashtra. Nonetheless, in Rajasthan, 25 per cent of women use the private sector for delivery care.51 85. There is also a large informal sector in India that includes unqualified practitioners, practising paramedics, traditional healers, traditional birth attendants, and chemists who prescribe and dispense drugs. While informal care providers may have a limited role in providing delivery services, in Rajasthan they play a significant role in providing abortion services.52 86. Despite (or because of) its enormous power, India’s private health sector is largely unregulated. Moreover, there are few signs that it is willing to adequately regulate itself. In these circumstances, the Government has a legally binding responsibility to introduce, as a matter of urgency, an appropriate, effective regulatory framework for the private health sector, including public-private partnerships. 87. The National Rural Health Mission emphasizes that “the private sector health care is unregulated pushing the cost of health care up and making it unaffordable for the rural poor”53 and it confirms that one of the Mission’s “supplementary strategies” is regulation of the private sector.54 Unregulated markets raise human rights issues of safety, efficacy, cost and equity. However, the NRHM does not appear to have made any significant progress towards appropriate, effective regulation of the private health sector. The Clinical Establishments (Registration and Regulation) Bill (2007), for example, has not yet been enacted, although this is not to suggest that it is an adequate response to the challenge of private health sector regulation. 51 Iyengar, Iyengar and Gupta, “Maternal health”, p. 281. 52 Ibid. 53 India, National Rural Health Mission, para. 2. Ibid., para. 3. 54 GE.10-12866 19