The importance of good health to a woman’s well-being – and that of her family – cannot be overstated. Without healthy mothers, we cannot have healthy children. Without safe motherhood, women cannot fully exercise their fundamental human rights, such as those relating to education and employment.
Although Uganda has a policy framework on maternal and child health, the national legal framework does not explicitly address the issue of maternal health. However, article 33(3) of the 1995 Constitution recognizes the need to protect the maternal functions of women including reproduction. It states that: “The State shall protect women and their rights, taking into account their unique status and natural maternal functions in society.” This provision recognizes that women have rights that arise from their maternal functions thereby implicitly places obligations upon the state to protect the sexual and reproductive health rights of women. Furthermore, article 33 (6) prohibits laws, cultures, customs or traditions which are against the dignity, welfare or interest of women or which undermine their status. Therefore any laws, cultures, customs which undermine the health of women including their sexual and reproductive health rights are null and void.
Uganda is a party to key international instruments which place upon her the obligation to provide maternal health. Article 12(1) of the International Covenant on Economic, Social and Cultural Rights (ICESCR) provides for the right to the highest attainable standard of physical and mental health. Article 12(2) outlines the steps that should be taken by states parties for the realization of the right to health. These include: the reduction of the stillbirth-rate and infant mortality and in effect improvement of maternal health.
The 1979 Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) calls upon member states, to ensure respect for women’s and girls’ human rights and fundamental freedoms. This instrument was ratified by Uganda on 30th July 1980 without any reservations. The Convention obliges states to ensure the right to protection of health and to safety in working conditions; including the safeguarding of the function of reproduction. In order to prevent discrimination against women on the grounds of marriage or maternity and to ensure their effective right to work, States Parties are obliged to take appropriate measures: to prohibit, subject to the imposition of sanctions, dismissal on the grounds of pregnancy or of maternity leave and discrimination in dismissals on the basis of marital status. States are also required to introduce maternity leave with pay or with comparable social benefits without loss of former employment, seniority or social allowances. The Convention further obliges states to encourage the provision of the necessary supporting social services to enable parents to combine family obligations with work responsibilities and participation in public life, in particular through promoting the establishment and development of a network of child-care facilities and to provide special protection to women during pregnancy in types of work proved to be harmful to them.
Within the African context, article 16(1) of the African Charter provides, “Every individual has the right to enjoy the highest attainable state of physical and mental health.” Article 16 (2) obliges state parties to the African Charter to take “the necessary measures to protect the health of their people and to ensure that they receive medical treatment when they are sick. The Protocol to the African Charter on Human and Peoples Rights on the Rights of Women in Africa of 2003, calls upon state parties to ensure that the right to health of women including sexual and reproductive health rights are respected. The Protocol calls upon states parties to prohibit and condemn all forms of harmful practices against women. Some of these practices included female genital mutilation and other harmful practices to women especially during pregnancy.
In conclusion, the right to maternal health, like all human rights, imposes three types or levels of obligations on States parties: the obligations to Respect, Protect and Fulfill. The question is, “Has Uganda adhered to her obligation to guarantee this?”
By Sandra Kiapi and Roselyn Vusiya