PHA-Exchange> Maternal Mortality catastrophic

[Claudio]

 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 maternal mortality a normal phenomenon.
Millennium Development Goal 5 aims at improving Maternal Health and Target 6 particularly is to reduce rates of unwanted pregnancies, 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 the trend.

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, absenteeism of doctors (e.g. due to migration or looking for alternatives during working hours etc) and poor health spending. 

Participants agreed that the Rights Based Approach through community based programmes will support the achieving of the Millennium 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, integrity, wellbeing, dignity and by enhancing Primary Health Care, there will be legal obligations by states to be held accountable. Practical time is necessary for states to be responsive 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 Blindness in Uganda and said that "neglected diseases affect neglected 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 enhancing the gender perspective in health for example with water services which are being privatized affecting women and girls who have a responsibility on drawing water and reducing their responsibility to take care of the disabled. The Right to Health is also potential in exposing and tackling gender discrimination. 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 Mortality is at a catastrophic scale right now. It is a scandalous situation. We have to look for other ways to prevent obstetric care."

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 responsible, 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 mortality will lead to Health Systems that are effective and affordable to all. The Right to Health is vital because it underpins our call for Health Systems that are effective and affordable for ALL."
     






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