people who are at risk or in a vulnerable situation, and they should be guaranteed access to medical health services on an equal footing.154 131. Accordingly, the State obligation to respect and to ensure the right to health acquires a special dimension in relation to the protection of people in a situation of vulnerability. The Court recognizes that people living in poverty often have unequal access to health services and information, which exposes them to a greater risk of infection and of receiving inadequate or incomplete medical care.155 The Court also notes the vulnerable situation of women living with HIV, especially those of child-bearing age. 132. That said, the Court has indicated that extreme poverty and the lack of adequate medical care for women during pregnancy and postpartum are causes of high maternal mortality and morbidity. Therefore, States must implement appropriate health policies that allow it to provide assistance with suitably qualified personnel during births; policies to prevent maternal mortality by providing adequate prenatal and postpartum controls, and legal and administrative instruments relating to health policies that record cases of maternal mortality adequately.156 The Court has also recognized that, under Article 19 of the Convention, the State must assume its special position of guarantor with greater care and responsibility and take special measures focused on the principle of the best interest of the child.157 133. In this regard, the Court notes that the Committee for the Elimination of Discrimination against Women recommended “that programmes to combat AIDS should give special attention to the rights and needs of women and children, and to the factors relating to the reproductive role of women and their subordinate position in some societies which make them especially vulnerable to HIV infection.” 158 Furthermore, the CESCR has indicated that “States should aim to ensure universal access without discrimination for all individuals, including those from disadvantaged and marginalized groups, to a full range of quality sexual and reproductive health care, including maternal health care, […] and the prevention, diagnosis and treatment of […] sexually transmitted infections and HIV/AIDS.159 134. The Court also notes that, in the eighth international guideline on HIV/AIDS and human rights, OHCHR and UNAIDS indicated that States “should promote a supportive and enabling environment for women, children and other vulnerable groups by addressing Cf. Case of Poblete Vilches et al. v. Chile. Merits, reparations and costs. Judgment of March 8, 2018. Series C No. 349, para. 123. 154 Mutatis mutandi, Case of the Xákmok Kásek Indigenous Community v. Paraguay. Merits, reparations and costs. Judgment of August 24, 2010. Series C No. 214, para. 233. 155 Cf. Case of the Xákmok Kásek Indigenous Community v. Paraguay. Merits, reparations and costs. Judgment of August 24, 2010. Series C No. 214, para. 233. 156 Cf. Case of the Mapiripán Massacre v. Colombia. Judgment of September 15, 2005. Series C No. 134, para. 152 and Case of the Sawhoyamaxa Indigenous Community v. Paraguay. Merits, reparations and costs. Judgment of March 29, 2006. Series C No. 146, para. 177. 157 Cf. United Nations. Committee for the Elimination of Discrimination against Women. General Recommendation No. 15: Avoidance of Discrimination against Women in National Strategies for the Prevention and Control of Acquired Immunodeficiency Syndrome (AIDS), 9th session, 1990, U.N. Doc. A/45/38, paragraph (b). 158 Cf. Committee on Economic, Social and Cultural Rights, General Comment No. 22 on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights), May 2, 2016, U.N. Doc. EC.12/GC/22, para. 45. 159 47