Judith Bueno de Mesquita

Maternal mortality and human rights: landmark decision by United Nations human rights body

Despite global commitment and prevention through well-known interventions progress has been slow towards Millennium Development Goal 5 of reducing global maternal mortality. The United Nations (UN) Human Rights Council has highlighted maternal mortality as an issue bearing not just on development but also on human rights. In August 2011 the Committee on the Elimination of Discrimination against Women became the first UN human rights body to issue a decision on maternal mortality. The case Alyne da Silva Pimentel v. Brazil established that States have a human rights obligation to guarantee women of all racial and economic backgrounds timely and non-discriminatory access to appropriate maternal health services. After the death of this Brazilian woman who died from pregnancy-related causes after a misdiagnosis and delay in provision of emergency obstetric care the Convention of All Forms of Discrimination against Women (CEDAW) argued that there was no effort to establish professional responsibility and that she was unable to obtain justice in Brazil. The Committee found violations of the right to access health care and effective judicial protection in the context of non-discrimination; cases like this furnish opportunities for international and domestic accountability. The Committee made several general recommendations intended to reduce preventable maternal deaths which include ensuring women’s rights to safe motherhood and emergency obstetric care providing professional training for health workers and implementing Brazil’s national Pact for the Reduction of Maternal and Neonatal Mortality.

Rehabilitation and the Right to Health in Times of Transition

The harm to health of victims of civil and political rights abuses has been a focus of some reparations programmes. Rehabilitation has been the primary form of reparation for harm to health. Is this current approach an appropriate response by reparations programmes to violations of the right to health during conflict or repression? Given the nature of right to health violations in conflict or repression, we suggest that reparations programmes should broaden their focus to also address not only the health consequences of civil and political rights violations, but also the destruction or neglect of the health system, and policies which harm health. We consider whether rehabilitation is the only suitable form of reparation for such abuses. We also consider the relationship between the fields of transitional justice and public health in periods of transition, including whether some conflict-related right to health violations should be addressed in the health sector rather than reparations programmes and, if so, how this can be done successfully.