A/HRC/14/20/Add.2 I. Introduction 1. At the invitation of the Government, the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health visited India from 22 November to 3 December 2007. 2. In India there are numerous grave right-to-health issues, including mental health, tuberculosis, malaria, HIV/AIDS, water and sanitation and palliative care. This report, however, focuses on just one very serious right-to-health problem: maternal mortality. 3. In the context of the right to health, the mission looked at maternal mortality with a view to understanding the steps taken by India to address this serious issue. Considering the size and complexity of the country, it was agreed with the Government of India that the Special Rapporteur would focus on, and visit, Rajasthan and Maharashtra. While there are deep differences across India, the present report has relevance beyond these two states. Moreover, much of the report’s right-to-health analysis and many of the recommendations apply to maternal mortality in countries from every region of the world. 4. The agenda for the visit of the Special Rapporteur was prepared in close cooperation with the Ministry of External Affairs, Government of India and the Office of the United Nations Resident Coordinator. During the mission, the Special Rapporteur met with then Minister of Health and Family Welfare, Dr. Anbunmani Ramdoss; then Minister of State for Women and Child Development, Renuka Chowdhury; then Minister of State for External Affairs, Anand Sharma; then Chairperson of the National Human Rights Commission, Rajendra Babu; and Chairperson of the National Commission for Women, Girija Vayas, as well as with senior officials in Rajasthan and Maharashtra and the United Nations Country Team. The Special Rapporteur also met with judges and senior lawyers. 5. During his visit the Special Rapporteur went to numerous clinics and hospitals in rural and urban areas in Rajasthan and Maharashtra, and made some unannounced visits to health centres, such as in the slums of Jaipur, Rajasthan, and to a district hospital in Pune, Maharashtra. He also had the opportunity to meet with representatives of numerous civil society organizations, including national medical associations. 6. The Special Rapporteur is grateful to the Government of India, the state governments of Rajasthan and Maharashtra, the Office of the United Nations Resident Coordinator and the United Nations Population Fund (UNFPA) for their constructive cooperation, assistance and support. He is also grateful to civil society organizations, health workers, patients and their families for their critically important information and insights. II. Global and Indian contexts 7. The main purpose of the present report is to examine maternal mortality in Rajasthan and Maharashtra through the lens of the right to the highest attainable standard of health; for this reason the bulk of the report is found in chapter IV. However, because this report cannot exceed 10,700 words, a supplementary note has been prepared which provides some additional information about the relevant global and Indian contexts.1 8. The supplementary note briefly introduces some of the features of global maternal mortality, such as the biological, social and structural causes of maternal deaths. It also 1 4 A Supplementary Note on the UN Special Rapporteur’s Report on Maternal Mortality in India, available from www.essex.ac.uk/human_rights_centre/research/rth/index.aspx. GE.10-12866