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urges states to take appropriate measures to prevent women from dying
during pregnancy or childbirth. The UNHRC has also adopted a
Technical Guidance on maternal mortality, where it urges states to
adopt appropriate laws and policies to ensure safe motherhood and
prevent women dying during childbirth and pregnancy.25
At the regional level, all the three major human rights instruments;
the African Charter on Human and Peoples’ Rights (African Charter),26
the African Charter on the Rights and Welfare of the Child (African
Children’s Rights Charter)27 and the African Women’s Rights Protocol,
contain provisions on the right to health, including access to maternal
health care services. Article 14 of the African Women’s Rights Protocol
guarantees women’s rights to health care, including sexual and
reproductive health care. More importantly, article 14(2) enjoins states
to
(a) provide adequate, affordable and accessible health services, including
information, education and communication programmes to women
especially those in rural areas;
(b) establish and strengthen existing pre-natal, delivery and post-natal health
and nutritional services for women during pregnancy and while they are
breast-feeding.
The relevance of this provision to addressing maternal deaths in the
region is discussed below.
According to Hunt and de Mesquita, maternal health care services
must be understood broadly as an entitlement to an available,
accessible, adequate, effective, well-resourced, culturally acceptable
and integrated health system.28 They further reasoned that some of the
critical services that must be accessible to women in this integrated
health system so as to prevent maternal deaths include: emergency
obstetric care, a skilled birth attendant, education and information on
sexual and reproductive health, safe and legal abortion services, and
other sexual and reproductive health care services, such as family
planning or contraceptive services.
Hunt and de Mesquita have further examined how the elements of
the right to health as developed by the ICESCR Committee can be
applicable specifically to maternal mortality and noted that availability
requires states to ensure sufficient number of qualified health care
25
Human Rights Council, Practices in adopting a human rights-based approach to
eliminate preventable maternal mortality and human rights. 18th Session A/HRC/18/
27; 8 July 2011.
26
African Charter on Human and Peoples’ Rights OAU Doc CAB/LEG/67/3/Rev 5,
adopted by the Organisation of African Unity, 27 June 1981, entered into force 21
October 1986.
27
African Charter on the Rights and Welfare of the Child, OAU Doc CAB/LEG/24.0/
49 (1990) (entered into force 29 November 1999).
28 P Hunt & JB de Mesquita Reducing maternal mortality: the contribution of the
right to the highest attainable standard of health (2010) 6.