1. Godwin Chinedu Odo LL.D Candidate, University of Pretoria TOWARDS A RIGHT-BASED APPROACH TO ADDRESSING MATERNAL MORTALITY AND MORBIDITY IN AFRICA Me Gatete Thierry LL.M, University of Pretoria Centre for Human Rights - Rwanda

2. What is Maternal Mortality? Maternal death refers to the death of a woman while pregnant or within 42 days (just over 1.5 months) of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related or aggravated by the pregnancy or its management… World Health Organization (WHO), ICD-10 International Classification of Diseases and Related Health Problems: Tenth Revision 98 (2004)

3. Causes of maternal mortality Haemorrhage Infection Obstructed labour Unsafe abortion Toxamia/Eclampsia Anemia Malaria Others

4. Overview of global maternal mortality rates: Measured by the number of deaths per 100,000 live births Africa: Chad-1,100; Somalia 1000; sudan-730; Nigeria- 630; Liberia 770; Zimbabwe-570; Kenya – 360; South Africa- 300; Tunisia 56 Asia:India-200; Philipines-99; Japan-5; Singapore 3 Europe: United Kingdom 12; Belgium-8; Spain 6; Portugal 8; Italy 4; Greece-3 South America: Guatemala-120; Paraguay-99; Peru-67; Brazil-56; North America: Canada-12; USA-21

5. Analysis of the maternal mortality ratio reveals: Africa has a higher maternal mortality ratio compared to other parts of the world: Incidences of maternal mortality are high in poor, less developed countries Incidences of high maternal mortality are lower in countries that appear to be more advanced in implementing equality and non-discrimination norms The more human rights compliant a country is, the more likely its maternal mortality rate will be lower; MATERNAL MORTALITY IS PREVENTABLE

6. Women’s rights affected : The right to life The right to the dignity of the human person The right to equality and non-discrimination The right to access to healthcare The right to reproductive health information and services The right to enjoy the benefit of scientific progress

7. Normative framework The UN Women’s Convention (CEDAW) The African Charter on Human and Peoples’ Rights Protocol to the African Charter on the Rights of Women in Africa (Maputo – Protocol) National Constitutions that guarantee the right to health and access to healthcare; And MDG 5, which is an international commitment by all African countries

8. Mitigating measures: Human rights based approach Express application of the international human rights framework (the international bill of rights); Respect for the rule of law; Empowerment of rights holders on gender mainstreaming; Non-discrimination and prioritisation of vulnerable women; Mother-friendly laws Child-friendly laws

9. Rights-based approach as mitigating measure, cont.. Effective participation of women in setting the agenda for their own health (civic participation); Concrete Budgetary measures; Civil Society engagement; Accountability of duty-bearers to rights-holders (on process and impact) Performance Contracts factoring in prevention of Maternal Mortality); Women and children friendly policies

10. MURAKOZE