A/RES/S-23/3 women’s health for the further implementation of the Programme of Action of the International Conference on Population and Development. 4 12. Obstacles. Worldwide, the gap between and within rich and poor countries with respect to infant mortality and maternal mortality and morbidity rates, as well as with respect to measures addressing the health of women and girls, given their special vulnerability regarding sexually transmitted infections, including HIV/AIDS and other sexual and reproductive health problems, together with endemic, infectious and communicable diseases, such as malaria, tuberculosis, diarrhoeal and water-borne diseases and chronic non-transmissible diseases, remains unacceptable. In some countries, such endemic, infectious and communicable diseases continue to take a toll on women and girls. In other countries, non-communicable diseases, such as cardiopulmonary diseases, hypertension and degenerative diseases, remain among the major causes of mortality and morbidity among women. Despite progress in some countries, the rates of maternal mortality and morbidity remain unacceptably high in most countries. Investment in essential obstetric care remains insufficient in many countries. The absence of a holistic approach to health and health care for women and girls based on women’s right to the enjoyment of the highest attainable standard of physical and mental health throughout the life cycle has constrained progress. Some women continue to encounter barriers to their right to the enjoyment of the highest attainable standard of physical and mental health. The predominant focus of health-care systems on treating illness rather than maintaining optimal health also prevents a holistic approach. There is, in some countries, insufficient attention to the role of social and economic determinants of health. A lack of access to clean water, adequate nutrition and safe sanitation, a lack of gender-specific health research and technology and insufficient gender sensitivity in the provision of health information and health care and health services, including those related to environmental and occupational health hazards, affect women in developing and developed countries. Poverty and the lack of development continue to affect the capacity of many developing countries to provide and expand quality health care. A shortage of financial and human resources, in particular in developing countries, as well as restructuring of the health sector and/or the increasing trend to privatization of health-care systems in some cases, has resulted in poor quality, reduced and insufficient health-care services, and has also led to less attention to the health of the most vulnerable groups of women. Such obstacles as unequal power relationships between women and men, in which women often do not have the power to insist on safe and responsible sex practices, and a lack of communication and understanding between men and women on women’s health needs, inter alia, endanger women’s health, particularly by increasing their susceptibility to sexually transmitted infections, including HIV/AIDS, and affect women’s access to health care and education, especially in relation to prevention. Adolescents, particularly adolescent girls, continue to lack access to sexual and reproductive health information, education and services. Women who are recipients of health care are frequently not treated with respect nor guaranteed privacy and confidentiality, and do not receive full information about options and services available. In some cases, health services and workers still do not conform to human rights and to ethical, professional and gender-sensitive standards in the delivery of women’s health services, nor do they ensure responsible, voluntary and informed consent. There continues to be a lack of information on availability of and access to appropriate, affordable, primary health4 Report of the International Conference on Population and Development, Cairo, 5-13 September 1994 (United Nations publication, Sales No. E.95.XIII.18), chap. I, resolution 1, annex. 5