Of the Millennium Development Goals, Goal 5 on improving maternal health is the furthest from being achieved. This report discusses the human rights dimensions of preventable maternal mortality and morbidity, reviewing the international and regional initiatives and programmes in place, and the current legal framework. It concludes that a collective commitment from the international community towards developing a systematic human rights based approach is crucial to advancing progress.
Despite the difficulties in determining exact figures, estimates indicate that over half a million maternal deaths occur worldwide every year, and 10 million women suffer from pregnancy-related disease, injury or infection. Maternal mortality is overwhelmingly due to the ‘three delays’ preventing women from accessing essential health care. These are: 1) delays in seeking appropriate medical help in an obstetric emergency (because of cost, gender inequality, or poor education, information, or understanding); 2) delays in reaching appropriate facilities because of distance or poor transport/infrastructure; and 3) delays in receiving adequate care because of staff shortages or lack of water, electricity or medical supplies.
What are the human rights dimensions involved in maternal mortality and morbidity, and what initiatives are in place to address them?
- States are obligated under international human rights law to respect, protect and fulfil human rights in relation to surviving pregnancy and childbirth, including the right to life, the right to health, and the right to education and information.
- The human rights of equality and non-discrimination must be applied to ensure that states refrain from discriminatory actions and take positive steps to guarantee equality across the spectrum of race, ethnicity, colour, religion, language, political opinion, national/social origin or other status.
- Seven key principles form the basis of a human rights approach to maternal mortality and morbidity: accountability, participation, transparency, empowerment, sustainability, international co-operation and non-discrimination. Such principles ensure coherent, legitimate, long-term investment in health policies and programmes with international assistance to support infrastructure.
- There are a significant number of existing initiatives and plans for future programmes addressing causes of preventable maternal mortality and morbidity. Programmes cover a wide range of related areas, from improving midwifery practice, sexual/reproductive health education and family planning interventions, to targeting female genital mutilation, HIV, and unsafe abortion.
The value of a collective commitment to a human rights approach cannot be overestimated.
- Public health schemes should include the establishment of accessible, transparent and effective mechanisms of monitoring and accountability and of ensuring women’s rights to participate in decision-making processes affecting their pregnancy and childbirth.
- In order to integrate human rights dimensions of preventable maternal mortality and morbidity into the Human Rights Council’s mechanisms, Member and Observer States could systematically address these dimensions in their reporting under the universal periodic review processes and when reviewing other states. The HRC could invite UN agencies, funds and programmes that are undertaking initiatives in this area to systematically contribute information for the universal periodic review.
- Further consideration should be given to specific steps to implement/adopt a human rights-based approach to preventable maternity and morbidity. This includes how states ensure a range of constructive accountability mechanisms developed according to human rights principles and which are participatory, effective, and transparent.
- Such operationalisation requires systematisation, yet lacks a clear lead within the UN system. An initial step would be the collection of good practices from states and other actors.
