Human right approach to maternal health

Ifound the technical guidance on the application of a human rights based approach to the implementation of policies and programmes to reduce preventable maternal morbidity and mortality a very useful tool if well implemented especially in Sub Saharan Africa will reverse the worrisome trend in maternal morbidity and mortality.

It is not only recommended to policy makers and duty bearers but also to advocates that engage government on daily bases to ensure the right services to women are available and accessible irrespective of creed, religion or location.

The technical guidance is a report of the Office of the United Nations High Commissioner for Human Rights (OHCHR). My objective in this article is to provide key highlights of the 20 page report with the hope that it will catalyse a response from relevant stakeholders to seek to read the entire report as well as to develop key messages and enhance capacity via trainings that will empower civil society organisations and media to do more advocacy as well as empower duty bearers and service providers to implement maternal health services from the angle of rights and not privileges.

The summary is apt as it captures the essence of the report as follows “The present report contains concise technical guidance, in accordance with the request made by the Human Rights Council in its resolution 18/2. The aim of the report is assist policy makers in improving women’s health and rights by providing guidance on implementing policies and programmes to reduce maternal mortality and morbidity in accordance with human rights standards. It highlights the human rights implications for multiple actors in the policymaking, implementation and review cycle, as well as the need for robust enforcement mechanisms and international assistance and cooperation.”

In its resolution 18/2, the Human Rights Council requested the Office of the United Nations High Commissioner for Human Rights (OHCHR), in cooperation with concerned United Nations agencies and other experts, to prepare concise technical guidance on the application of a human rights-based approach to the implementation of policies and programmes to reduce preventable maternal mortality and morbidity, and to present it to the Council at its twenty-first session.

The report observed that the maternal mortality and morbidity continue to exact a terrible toll on women, and especially impoverished women, in many countries worldwide. Some 287,000 women died of maternal causes in 2010, and between 10 and 15 million more suffer debilitating complications annually, severely affecting their well-being. The World Health Organization (WHO) estimates that from 88 to 98 per cent of maternal deaths are preventable.

It also reminded us that the Millennium Development Goal 5 aims at 75 per cent reduction in maternal mortality ratios from 1990 levels and universal access to reproductive health by 2015 and in 2010 at the High-level Plenary Meeting of the General Assembly on the Millennium Development Goals in 2010, the SecretaryGeneral launched the Global strategy for women and children to accelerate progress. As a result of the Global Strategy, an information and accountability commission was established, which issued a report recognizing the centrality of human rights to achieving progress, and made 10 recommendations, the implementation of which can support the guidance contained in the present report.

The report observed that human rights are about empowerment and entitlement of people with respect to certain aspects of their lives, including their sexual and reproductive health. International human rights law includes fundamental commitments of States to enable women to survive pregnancy and childbirth as part of their enjoyment of sexual and reproductive health rights and living a life of dignity. Sound public health practice is crucial to enable States to fulfil these basic rights, but it must be complemented by broader measures to address women’s empowerment.

It moved further to say that the technical guidance is grounded in the respect for sexual and reproductive health and rights, as set out in the Programme of Action of the International Conference on Population and Development and reiterated and expanded upon in subsequent United Nations documents and International law. States must take all appropriate measures to eliminate discrimination against women, including gender-based violence, forced and early marriage, nutritional taboos, female genital mutilation/cutting and other harmful practices. Maternal mortality and morbidity is a product of discrimination against women, and denial of their human rights, including sexual and reproductive health rights.

It also highlighted that accountability is not an afterthought in a rights-based approach, but fundamental to each stage of the process, from identifying accountability gaps in a situational analysis to ensuring appropriate monitoring mechanisms and remedies in a national plan, to allocating resources for these mechanisms and remedies, to ensuring feedback from the ground through to implementation in practice.

Under planning and budgeting, the guideline has made a strong case for a human rights-based approach which requires a multi-sectoral approach to economic and social planning and budgeting, including, at a minimum, coordination among a variety of Government ministries and departments, as well as with other key actors, such as the private sector, development partners and civil society. The guideline also places accountability at the heart of right based approach to maternal health as it has stress that accountability is central to every stage of a human rights-based approach. It requires not just transparency but meaningful participation by affected populations and civil society groups. It also emphasize the significance of monitoring in a human rights framework which requires the use of indicators to systematically track and evaluate policy and budgetary efforts.

In conclusion the guideline also emphasize the need for review and oversight through administrative, social, political and legal accountability.

All comments to Dr Aminu Magashi at healthweekly@yahoo.com