The Minister of Local Government has pledged the Government’s commitment to improving the financing of the health sector, especially maternal health. “We cannot continue losing mothers and children. As a Ministry, and as Government, we are going to work with the Ministry of Health, and Ministry of Finance, to improve the financing of the health sector, especially, maternal health”. Honourable Raphael Magezi was meeting a team of UN Human Rights staff headed by the Country Representative, Mr Robert Kotchani and the technical staff of the ministry of local government in Kampala on 27 August 2020. The meeting was preceded by the official launch of the publication; Promoting Maternal Health in Uganda; A case digest on judicial court decisions on 26 August in a televised event with officials of the Ministry of Health, the judiciary, the Uganda Human Rights Commission and Civil Society.
Speaking at the launch, the Office of the United Nations High Commissioner for Human Rights Country Representative in Uganda commended the Government of Uganda for taking significant efforts in reducing maternal mortality rate in the country, though a lot needs to be done to bring down the rate from 336 to 70 death per 100,000 lives by 2030. Mr Robert Kotchani called for a multi-sectoral strategy and the application of a human rights-based approach to maternal healthcare so as to improve health in Uganda. “Work has been done with the Ministry of Health to improve the situation of mothers dying during childbirth, and there is need for a collective approach to bring down the maternal mortality rate,” He said.
In his presentation, Dr Placid Mihayo, a senior consultant with Ministry of Health said Uganda is committed to the SDG targets of reducing the curve further by putting in place strategies to address maternal mortality, though “COVID-19 has affected our outreaches leading to increased maternal deaths”. He said. He further noted that there still challenges of the inadequate human resource of midwives and doctors and other health workers. We are expanding the health infrastructures, but also “encouraging mothers to go to deliver in health facilities because, in most cases, they go when it is too late, and they end up dying! He noted.
While speaking at the same occasion, Ms Ruth Ssekindi, Director of Investigations and Inspections at the Uganda Human Rights Commission (UHRC) called on the State to protect the lives of women, as many of them bleed to death because there is no medication or due to long distances to the health centres on bad roads. She quoted article 33 of the Constitution of Uganda (1995 as amended) and implored the Government to put in place facilities and mechanisms for the well-being of Ugandans. “People should be able to access basic health. We have to ensure we have health facilities available”. She noted.
“People must be able to come to health facilities and find equipment and trained health workers”. David Kabanda, the lead consults on the compilation of the Case Digest noted. Adding that nutrition should be part of the antenatal package, as many mothers are dying because they are malnourished. “If mothers are not fed well, it is a violation of their human rights. When they start bleeding, they have to die”. He observed.
“We need to have laws that tackle real issues that affect people. If the most vulnerable are catered for, then everybody is”. Justice Lydia Mugambe advised. She noted that there is a problem with slow systems, including the court systems. Many mothers who have lost babies in rural areas have little chance to come to court. There is complacency in the communities, and responsible people in the community are comfortable with these wrongs.
About the Case Digest
In accompanying the efforts by Government of Uganda to address maternal mortality, OHCHR developed the Case Digest - a compendium of a number of maternal health court judgements and decisions issued in different courts of judicature in Uganda, as well as examples from other countries such as Kenya, India, Brazil and South Africa. These cases articulated the various elements of maternal health rights and parameters of what duty-bearers can be held accountable for. Some of these maternal health cases have issued structural interdicts and particular orders to local governments regarding maternal health in their local jurisdiction. The Case Digest was piloted along the draft Human Rights-based Approach (HRBA) strategy to reduce preventable maternal mortality in five districts of Pallisa, Kayunga, Busia, Adjumani and Moroto.
During it elaboration, the Case Digest befitted from contributions from various national stakeholders including Ministry of Health, the UHRC and Civil Society Organizations (CSOs).
The Case Digest avails jurisprudence to the duty-bearers, including at local government level, and engaging with them in terms of what this means in practice will enhance social accountability in the local settings, and has the potential to significantly prevent maternal mortality.
Going forward, OHCHR will develop with the Ministry of Local Government, a strategy for dissemination of the publication so that it reaches those who need it really to improve maternal care services in Uganda.