On September 11th 2013, Member States, civil society organizations, activists, academics and UN agencies came together to discuss the impact of the Human Rights Council resolutions on maternal mortality and morbidity and remaining gaps in the realization of human rights, accountability and implementation in countries around the world. The event, co-organized by the Sexual Rights Initiative and Center for Reproductive Rights, with support from the Governments of Colombia, New Zealand, Burkina Faso, United Nations Population Fund, World Health Organization and the Office of the High Commissioner for Human Rights, was timely as diverse stakeholders continue to identify the shape and scope of the post-2015 development agenda.
Attended by over 75 people, the event featured as speakers Flavia Pansieri, Deputy High Commissioner for Human Rights, Alma Viviana Perez, Director of the Presidential Programme for Human Rights and International Humanitarian Law, Lilian Sepulveda, Center for Reproductive Rights and Karolina Wieckiewicz, Federation for Women and Family Planning and the Sexual Rights Initiative. The discussion was moderated by Amanda Ellis, Permanent Representative of New Zealand to the UN in Geneva.
Ambassador Ellis set the stage by emphasizing the critical links between women’s human rights and strategies to prevent maternal mortality and morbidity. It is therefore essential, according to Ellis, that a human rights-based approach, an approach that values women and girls’ lives, be adopted. Ellis said this also requires changing political and social structures that prevent the full realization of their human rights. Ellis affirmed that the technical guidance on maternal mortality and morbidity can serve as a tool for holding governments accountable to their human rights obligations in this regard.
Following Ambassad or Ellis’ opening remarks, Deputy High Commissioner for Human Rights, Flavia Pansieri, discussed the ways in which the technical guidance is being applied and promoted. Pansieri referring to the multiple partnerships, capacity building activities, dialogues and resource development currently under way, designed to facilitate the implementation of the technical guidance at the national level, said, “experiences transverse sectors, and are built on solid partnerships with Governments, UN agencies and civil society, adds to the strength of our arguments, and [give] us hope that human rights will occupy a prominent position in our future vision of global development.” According to Pansieri, the technical guidance responds to an important priority that the international community is voicing. Having attended the recent ICPD International Human Rights Conference, Pansieri recognized the increasingly important role human rights are playing in discussions related to sexual and reproductive health, including maternal mortality and morbidity.
Building on this, Alma Vivian a Perez, Director of the Presidential Programme for Human Rights and International Humanitarian Law, shared concrete examples of how this has been applied in the Colombian context. Concretely, the Colombian government has initiated a Women and Gender Equality policy, aimed at guiding the implementation of UN Human Rights Council (HRC) resolutions and resources on maternal mortality and morbidity, among others. The government has also designed a monitoring system, including the establishment of human rights-based indicators to track issues including perinatal mortality. Recognizing the added barriers facing adolescents and young people in their access to sexual and reproductive health services and information, the Colombian government has increased the number of youth-friendly health centers. Moving forward, the government is committed to increasing its engagement with civil society to address the issue of maternal mortality and morbidity, which, according to Perez, is about “discrimination and equality.”
Underscoring on the issue of discrimination, Lilian Sepulveda, from the Center for Reproductive Rights, recognized that “discrimination continues to be a barrier for many women seeking maternal health services, and puts poor, rural and indigenous women at a significant disadvantage.” One key example of such discrimination was made evident by the 2011 case decided by the Committee on the Elimination of all forms of Discrimination against Women (CEDAW), in Brazil. The case “established that governments have a human rights obligation to guarantee that all women in their countries—regardless of income or racial background—have access to timely, non-discriminatory and appropriate maternal health services.” Additionally, Sepulveda emphasized that the case established that governments should be held accountable when failing to protect such human rights obligations. Also worth noting, according to Sepulveda is that the Committee found that there had been compounded discrimination, on the basis of gender, socio-economic status, geographic location and race. Overcoming this requires the systematic implementation of a human rights-based approach through policies and programs aimed at eliminating preventable maternal mortality.
Speaking on behalf of the Federation for Women and Family Planning and the Sexual Rights Initiative, Karolina Wieckiewicz recalled the important issues recognized in UN HRC resolutions on the topic of maternal mortality and morbidity, including the need to examine the root causes associated with the issue, including patriarchy and gender norms and stereotypes, and the need for policies and programmes to recognize the linkages between particular human rights violations. Wieckiewicz drew attention to areas which she believes the Council must focus on, urging States to integrate specific recommendations related to maternal mortality and morbidity into the Universal Periodic Review process. She also called on governments and UN agencies to recognize the issue of maternal mortality and morbidity within the wider spectrum of gender equality, emphasizing that effectively securing maternal health requires ensuring many interlinked human rights. maternal health is a component of many human rights. Wieckiewicz identified women’s reproductive rights as central to the issue of maternal mortality and morbidity, including women’s right to access safe abortion services. According to Wieckiewicz, “unsafe abortions cause 13% of all maternal deaths and are one of the five major causes of maternal deaths. Each year, 47,000 women die due to complications of unsafe abortion and several million suffer severe injuries…It is well recognized within the UN system that unsafe abortions are a result of restrictive abortion laws…Restrictive abortion laws in practice force women to resort to clandestine and therefore unsafe procedures that risk their lives.” Wieckiewicz therefore called on governments to review laws and policies which limit women’s access to safe and legal abortion.
The ensuing discussion among panelists and participants was engaging. Numerous participants agreed that maternal mortality and morbidity constitutes the culmination of multiple and intersecting human rights violations. They also recognized that access to quality health services is a human right, coupled with the effective implementation of such services and that effective provision of such services is a State obligation. Along such lines, it was agreed that effective accountability mechanisms need to be established and sustained; with sufficient political will, capabilities, and resources. As highlighted by the Office of the High Commissioner for Human Rights, this is an area where it has been particularly important to build partnerships with civil society, among other stakeholders. Similarly, participants recognized the important role that civil society plays in holding governments accountable.
Reaffirming messages from panelists, interventions from participants placed similar importance on the role of the technical guidance. UNFPA provided examples of the ways in which the technical guidance is being used to build the capacities of country-level staff, beyond UNFPA, and expressed commitment to integrating a human rights-based approach to its programming as it relates to maternal mortality and morbidity. Further, civil society was encouraged to use the technical guidance to pilot programs with marginalized communities. Wrapping up the event, panelists and participants identified key areas requiring the attention of the Human Rights Council, including monitoring the implementation of the technical guidance; marginalized populations and those most at risk of experiencing maternal mortality and morbidity; the participation of women, among other diverse stakeholders, in the design, implementation and evaluation of programmes; as well as the engagement of men and boys on this critical issue.