A/RES/73/147
Intensification of efforts to end obstetric fistula
Reaffirming also the Universal Declaration of Human Rights, 8 which marks its
seventieth anniversary in 2018, as well as the Convention on the Elimination of All
Forms of Discrimination against Women, 9 and the Convention on the Rights of the
Child, 10 recalling the International Covenant on Economic, Social and Cultural
Rights 11 and the International Covenant on Civil and Political Rights, 11 and urging
States that have not done so to consider, as a matter of priority, signing, ratifying or
acceding to those conventions and the optional protocols thereto, 12
Taking note of the report of the Secretary-General 13 and the conclusions and
recommendations contained therein,
Recognizing that intensified national ownership and leadership, political
commitment and scaled-up national capacity are urgently needed to accelerate
progress towards the elimination of fistula, including b y implementing strategies to
prevent new cases and treating all existing cases with special attention paid to
countries with the highest maternal mortality and morbidity levels,
Stressing the interlinkages between poverty, malnutrition, lack of or inadequ ate
or inaccessible health-care services, early childbearing, child, early and forced
marriage, violence against young women and girls, sociocultural barriers,
marginalization, illiteracy and gender inequality as root causes of obstetric fistula,
and that poverty remains the main social risk factor,
Stressing also that obstetric fistula can be a cause of devastating lifelong
morbidity if left untreated, with severe medical, social, psychological and economic
consequences, that approximately 90 per cent of women who develop fistula deliver
stillborn babies and that misperceptions about its cause often result in stigma and
ostracism,
Recognizing that the difficult socioeconomic conditions that exist in many
developing countries, in particular the least developed countries, have resulted in the
acceleration of the feminization of poverty,
Recognizing also that early childbearing increases the risk of complications
during pregnancy and delivery and entails a much higher risk of maternal mortality
and morbidity, and deeply concerned that early childbearing and limited access to the
highest attainable standard of mental and physical health, including sexual and
reproductive health, specifically timely access to high -quality emergency obstetric
care, cause high levels of obstetric fistula and other maternal morbidities, as well as
maternal mortality,
Recognizing further that adolescent girls, in particular those who live in poverty
or who are marginalized, are at particular risk of maternal death and morbidity,
including obstetric fistula, and concerned that the leading cause of death among girls
aged 15 to 19 in many low- and middle-income countries is complications from
pregnancy and childbirth and that women aged 30 and older are at increased risk of
developing complications and of dying during childbirth,
Recognizing that lack of access to sexual and reproductive health, especially
emergency obstetric, services, including in humanitarian settings, remains among the
leading causes of obstetric fistula, leading to ill health and death for women and girls
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8
9
10
11
12
13
2/8
Resolution 217 A (III).
United Nations, Treaty Series, vol. 1249, No. 20378.
Ibid., vol. 1577, No. 27531.
See resolution 2200 A (XXI), annex.
United Nations, Treaty Series, vol. 2131, No. 20378; ibid., vols. 2171 and 2173, No. 27531;
resolution 66/138, annex; and resolution 63/117, annex.
A/73/285.
18-22184