Landmark Uganda case shows why, for women in Africa, the choice to have a baby is often also a choice to die


In Uganda 16 women die during childbirth daily. Only in Equatorial Guinea, Eritrea and Egypt is childbirth getting less dangerous.

A COURT case highlighting Uganda’s high maternal mortality crisis—where an estimated 16 women die during childbirth daily—adjourned Thursday, to the disappointment of human rights activists.

The case was brought by relatives of two women who died during childbirth, and a local non-governmental organisation. They sued the government in 201,  seeking a declaration from Uganda’s constitutional court that the preventable death of women during childbirth violates the constitution.

Their petition also seeks to compel the government to provide essential equipment in hospitals for safe deliveries.The case was dismissed in 2012, but the plaintiffs are appealing at the Supreme Court.

“The judiciary should use its power to take action to correct this crisis and compel the government to stop maternal mortality through life saving service delivery,” said Asia Russell, Director of International Policy at Health GAP, one of many activists in court on Thursday.

Unfortunately, this case reflects a sad reality on the continent. When tracking the MDGs, the goal least likely to be achieved by the vast majority of African nations is the one related to maternal health - Goal 5. 

Only three African nations are on track to meeting the targets: Equatorial Guinea, Eritrea and Egypt. 

This goal includes targets to reduce the maternal mortality ratio by three-quarters and achieve universal access to reproductive healthcare. Success is measured by improved maternal mortality ratio, the proportion of births attended by skilled health workers, antenatal care coverage, contraceptive prevalence rates, unmet needs for family planning and adolescent birth rates. 

The bad news

The key challenges to the goal include; maternal deaths due to haemorrhage, infection, obstructed labour, hypertensive disorders in pregnancy, and complications of unsafe abortion.  Another risk to expectant women is malaria. It can lead to anaemia, which increases the risk for maternal and infant mortality. HIV is also emerging as a major cause of maternal mortality in highly affected countries in southern Africa.

This goal is achievable, so the question remains, why is this goal lagging so far behind? UNDP attributes it to “poverty and lack of education” which perpetuate high adolescent birth rates. It also states that “inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health.” 

Access to family planning is key, yet the use of contraceptives continues to be low in many developing countries, the integration of sexual and reproductive health and rights in national policies and strategies is insufficient. 

The quality of care is also under the spotlight. Antenatal care is not readily available to many pregnant women and where there are health services they are inaccessible and unaffordable health systems and of poor quality. 

The failure by governments to make more notable progress on reducing maternal mortality is a serious let down and a clear reflection that maternal health is no longer at the centre of healthcare in Africa.  

Twitter: @Samooner

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