Maternal Health: Implications of the ruling and the case

KABANDA DAVIDCENTER FOR HEALTH, HUMAN RIGHTS

AND DEVELOPMENT (CEHURD)

Maternal health

• What is the right to health---The right to health can be construed as (1) a right to health care and (2) a right to conditions that promote good health. Article 12 of the ICESCR.

• Maternal health is comprised in or from pregnancy, childbirth and in the postpartum period (up to the 42nd day after delivery

Maternal mortality and its causes in Uganda

• MMR in Uganda is high at 435/100,000 live births

Causes• hemorrhage (26%), sepsis (22%), obstructed

labour (13%), unsafe abortion (8%) and hypertensive disorders in pregnancy (6%).

• Three delays – delay to seek care, delay to reach facilities and delay to receive care. (see the road map to accelerate reduction of MM)

WHY LEGAL ACTION

• 16 women die every day in Uganda due to avoidable maternal health related causes.

• Government of Uganda phased out traditional birth attendants

• Government of Uganda scrapped the user fees in Uganda.

• Special rappotur on the right to health in 2001 highlighted that Uganda was not doing enough to realizing the right to health.

contn• Art 33 of the constitution on the right of women

as mothers• CEDAW made recommendations that you this un

acceptable death of women in giving birth is discriminatory.

• Women’s rights to life, health, non-discrimination entitle them to the services and care they need to go through pregnancy and childbirth safely. .

• Uganda ratified all the international instruments on the right to health.

• Art 45

The petition and ruling

• The main contention was/is that the avoidable maternal death is unconstitutional.

• That the government has neglected and has failed to respect rights of women.

The strategy?It was aimed at having every one involved and

this resulted into a coalition of over 40 CSOs

contn

• At the hearing an objection was raised –political question doctrine and the court upheld the same ‘The acts and omissions complained of fall under the doctrine of “political question”.”

Court further stated“Much as it may be true that government has not

allocated enough resources to the health sector and in particular the maternal health care services, this court is, reluctant to determine the questions raised in this petition”

Implications of the ruling/case on maternal health care

• NegativeNon vindicatation of the right tohealth/maternal

health rights.Demoralisation of some maternal health

activists Setting a bad precedent on the litigation of such

issues and particularly maternal health in uganda

contn• Positive• Even before the ruling we saw maternal audits in selected hospitals• Maternal kits have been and are continously being supplied in some

hospitals• Strengthen coalition on maternal health in uganda• Individual cases/litigation of maternal mortality have started sprung

up• Parliamentary activism—motion on maternal health and health

budget influence.• Opportunity for a wider platform for interpretation in the supreme

court and later at the international level---• Improved maternal health services in general hospitals

conclusion

Why we do and should do this work on maternal health is

• …….Not simply because these are women in the prime of their lives.... Not simply because a

maternal death is one of the most terrible ways to die....

But above all because almost every maternal death is an event that could have been avoided, and should never have been allowed to

happen.’

MANY THANKS

KABANDA DAVIDCenter for Health, Human rights and

Development (CEHURD)Kabanda & Co.Advocates

Plot 614 Tufnell Drive Kamwokya