Maternal Mortality catastrophic
From: Mwajuma S. Masaiganah (PHM/EQUINET) - Tanzania
Maternal Mortality: A Serious Violation of the Right to Health
"Maternal Mortality catastrophic - a serious violation of the
Right to Health; Who is responsible?"
Paul Hunt, DELHI; September 25, 2005.
Maternal health services and care are essential for women's
health. Accessibility to health facilities and care, the quality
of care, the non availability and non affordability of essential
medicines etc. leads to poor emergency obstetric care making ma-
ternal mortality a normal phenomenon.
Millennium Development Goal 5 aims at improving Maternal Health
and Target 6 particularly is to reduce rates of unwanted preg-
nancies, unsafe abortions, maternal mortality and morbidity by
three quarters between 1990 and 2015.
Today, the reality is that every minute, one woman dies due to
early or unwanted pregnancies and childbirth related causes. The
majority of these deaths affect the rural poor, the marginalized
and the disadvantaged groups in developing countries.
During the 10th International Women and Health Conference held
in Delhi India from September 21 - 25, 2005 gave a platform to
women fro al over he globe to highlight issues of concern and
one of them was Maternal Mortality.
I chaired a session which made me very confused not to know
where we were heading to. I did not know whether we were making
any headway towards "Health for All" or "Health for Hell" as one
of our colleagues once said. I did not know! As a woman and as
an activist, I did not know! I got totally confused until hope
came when Paul Hunt, giving his valedictory address cleared my
thoughts and I hope of many others who attended my this meeting
and when he said that "we ought to rise and say NO TO MATERNAL
DEATHS and that they were a violation of Women's Right to
Health." At least I knew there are other people concerned with
During the meeting, it was well acknowledged that countries have
policies, constitutions and programmes that are set to address
the issue, yet many women are dying due to pregnancies, child
births, lack of nutrition, infectious diseases etc. The meeting
was critical to cite that lack of integration was a major block
towards success, and that vertical programmes, ignoring to offer
safe home births (which were said to be on the increase due to
privatization of medical facilities and care), poor access, ab-
senteeism of doctors (e.g. due to migration or looking for al-
ternatives during working hours etc) and poor health spending.
Participants agreed that the Rights Based Approach through com-
munity based programmes will support the achieving of the Mil-
lennium Development goals.
In his address, Paul Hunt said that the Right to Health Approach
is clearer now and maturing. The only thing left is to learn on
how to operationalise, making tools available and knowing how to
use them in measuring by making bench marks.
He said that Policy making give fundamentals like autonomy, in-
tegrity, wellbeing, dignity and by enhancing Primary Health
Care, there will be legal obligations by states to be held ac-
countable. Practical time is necessary for states to be respon-
sive to integrated systems essential to create incentives for
example for Health Workers to stay in neglected communities to
deal with neglected diseases. He gave an example of River Blind-
ness in Uganda and said that "neglected diseases affect ne-
glected communities, which makes it necessary to have and use
the Right to Health Approach."
The Right to Health Approach is also a powerful tool in enhanc-
ing the gender perspective in health for example with water ser-
vices which are being privatized affecting women and girls who
have a responsibility on drawing water and reducing their re-
sponsibility to take care of the disabled. The Right to Health
is also potential in exposing and tackling gender discrimina-
tion. It shapes and influences policy formulation processes
bringing fairness, justice and democracy.
Paul Hunt said that democracy is defined differently by states
to suit different context. "Some states say that the Right to
Health is vague", he said. The challenge is that, "Maternal Mor-
tality is at a catastrophic scale right now. It is a scandalous
situation. We have to look for other ways to prevent obstetric
The turning point and remarkable moment for me was when Paul
Hunt went on and said that "Women ought to stand up and SAY NO
TO MATERNAL DEATHS. Women have to start a Global Human Rights
Campaign against Maternal deaths because it is a violation of
the Right to Health. Who is a violator - it may be many: family,
community, facility, governments, international agencies etc."
"The answer is", he said; "It is a serious violation, who is re-
sponsible, I don't know. It is time now you look for evidence,
in order to STOP IT."
He concluded by saying that, "Right must shape policy. The
Global Human Rights Campaign should target avoidable maternal
mortality. Human Rights Campaign against avoidable maternal mor-
tality will lead to Health Systems that are effective and af-
fordable to all. The Right to Health is vital because it under-
pins our call for Health Systems that are effective and afford-
able for ALL."