A/RES/71/169 Intensification of efforts to end obstetric fistula Convention on the Rights of the Child, 10 recalling the International Covenant on Economic, Social and Cultural 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, Stressing the interlinkages between poverty, malnutrition, lack of or inadequate or inaccessible health-care services, early childbearing, child, early and forced marriage, violence against young women and girls and gender inequality as root causes of obstetric fistula, and that poverty remains the main social risk factor, 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 are at particular risk of maternal death and morbidity, including obstetric fistula, and conc erned 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 c hildbirth, Recognizing that lack of access to sexual and reproductive health, especially emergency obstetric services, remains among the leading causes of obstetric fistula, leading to ill health and death for women and girls of childbearing age in many regions of the world, and that a dramatic and sustainable scaling -up of quality treatment and health-care services, including high quality emergency obstetric services, and of the number of trained, competent fistula surgeons and midwives, is needed to significantly reduce maternal and newborn mortality and to eradicate obstetric fistula, Noting that a human rights-based approach to eliminating obstetric fistula and efforts to eliminate obstetric fistula should be underpinned by the principles of, inter alia, accountability, participation, transparency, empowerment, sustainability, non-discrimination and international cooperation, Deeply concerned about discrimination against women and girls and the violation and abuse of their human rights, which often result in reduced access to education and nutrition, compromising their physical and mental he alth and wellbeing and their enjoyment of the rights, opportunities and benefits of childhood and adolescence compared with boys, and often in their being subjected to various forms _______________ 10 Ibid., vol. 1577, No. 27531. See resolution 2200 A (XXI), annex. 12 United Nations, Treaty Series, vol. 2131, No. 20378; ibid., vols. 2171 and 2173, No. 27531; resolution 66/138, annex, and resolution 63/117, annex. 13 A/71/306. 11 2/8

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