Rights-based Approaches to Maternal Health: A Closer Look at “Accountability”
This blog post is cross-posted from Speaking of Medicine.
It wasn’t easy to choose sessions today on the last day of the Global Maternal Health Conference 2013, the variety and caliber of topics discussed being as outstanding as they were. I wanted to learn more about family planning, the revised WHO guidelines on safe abortion, integrating HIV into maternal health services, the role and needs of policymakers, and many more. I was also interested to follow-up with a thread I’d noticed over the first 2 days: how many presentations and conversations raised troubling questions about our push/promotion of institutional births when facilities in many regions are so ill-equipped, filthy, under-staffed, and otherwise inadequate to meeting women’s needs. I plan to write more about this in the future, and would welcome others’ views and experiences.
In the end I decided to attend two sessions devoted to human rights and maternal health, which hadn’t been addressed much in the first two days but was clearly the subtext of the inspiring opening session today on “respectful maternal health care,” during which speakers emphasized that women deserve to remember their births with joy, not humiliation. Respectful maternal care was said to be more than just means to an end, and can be framed as several issues: human rights, quality of care, equity, and public health. It was a moving and insightful opening plenary.
Rights-based approaches to maternal health were discussed in two parallel sessions, where speakers provided both high-level frameworks and community-level case studies. These were offered in light of the current international attention on “accountability” in global health but speakers wondered what this meant exactly for maternal health, and whether we were using consistent definitions. Alicia Yamin from the Harvard School of Public Health highlighted the role of a human rights approach and reminded us that the health care system has only a small and often limited ability to protect women’s social and reproductive rights, and questioned whether the global MDG program, as an example of global accountability, was being appropriately applied to identifying national progress. Ngemeera Mwemezi from Care International in Tanzania described their development of an accountability tracking tool that helps national bodies measure and evaluate their accountabilities to international commitments on MNCH by examining their own policies and strategies. Lucinda O’Hanlon from the UN Office of the High Commissioner for Human Rights presented their new Technical Guidance, which is intended to help push development partners and donors to be accountable to women’s sexual and reproductive rights, and implement a rights-based approach to maternal health. Nomafrench Mnombo from the University of the Western Cape presented a fascinating case study from Southern Africa to demonstrate how community participation is the ultimate accountability mechanism.
Ana Langer, co-chair of the Maternal Health Task Force, closed the conference tonight by saying she felt the enthusiasm, passion, evidence, and debates this week left no doubt that “the maternal health community is underway and accelerating.”
Richard Horton, editor in chief of The Lancet, presented a draft manifesto on maternal health, which will be circulated for comment and input in the coming days, with the aim to publish before March 5 when the next in-depth round of consultations for the post-2015 international targets take place in Botswana.
Check out the conference website to access archived videos of conference sessions.
Join the conversation on Twitter: #GMHC2013.