Human Rights-based Approach to Maternal Health Policy and Implementation: An Analysis of Abiye Safe-Motherhood Policy of Ondo State Nigeria
Abstract
A human rights-based approach that recognizes that women deserve the right to health is critical to achieving equitable reduction of maternal mortality in Nigeria, a country that is the second largest contributor to global maternal mortality. This study evaluated the extent to which the Abiye safe motherhood policy of the Ondo State government of Nigeria incorporated human rights-principles in its formulation and implementation. The study involved interviews and focus group discussions and the OHCHR human rights principles served as the basis for the thematic analysis of data. Findings indicate that the Abiye initiative exemplified the core principles of human rights-based approach to maternal health. Whereas, the initiative showed stronger practice in terms of the principles of participation, empowerment, non-discrimination and international assistance, there was limited indication of adherence to accountability, transparency, and sustainability principles. The Abiye safe motherhood initiative responded to maternal health needs in fairly acceptable and equitable ways; allowing the creation of opportunities and enabling conditions for the fulfillment of the health rights of reproductive-age women. It is recommended that governments at all levels should prioritize incorporating human rights-based standards into new or existing programs in a way that meets the core needs of respect and welfare of every woman in pregnancy and childbirth.
Full Text:
PDFReferences
Abegaz, S. T. (2019). A Human Rights-Based Approach to Maternal and Child Health in Ethiopia: Does it Matter to Promote Health Equities?. In Democracy and Human Rights. IntechOpen.
Bankole, A., Sedgh, G., Okonofua, F., Imarhiagbe, C., Hussain, R., & Wulf, D. (2009). Barriers to safe motherhood in Nigeria. New York: Guttmacher Institute, 17.
Bayou, Y. T. (2014). Maternal health care seeking behaviour and preferences for places to give birth in Addis Ababa, Ethiopia (Doctoral dissertation).
Bustreo, F., Say, L., Koblinsky, M., Pullum, T. W., Temmerman, M., & Pablos-Méndez, A. (2013). Ending preventable maternal deaths: the time is now. The Lancet Global Health, 1(4), e176-e177.
Carpenito-Moyet, L. J. (2008). Nursing Diagnosis: Application to Clinical Practice (12th ed.). Making Health Policy: Understanding Public Health, Philadelphia: JB Lippincott.
Centre for Reproductive Rights. (CRR) (2018). Advancing Maternal Health as a Human Rights Issue. In Alliance, B. M. M. Black Mamas Matter: Advancing the Human Right to Safe and Respectful Maternal Healthcare. New York: Centre for Reproductive Rights. Pp.8-17.
Fathalla, M. F. (2006). Human rights aspects of safe motherhood. Best Practice & Research Clinical Obstetrics & Gynaecology, 20(3), 409-419.
Federal Government of Nigeria (FGN) (1999). The Constitution of the Federal Republic of Nigeria (as Amended). Lagos: Federal Government Press.
Federal Ministry of Health Nigeria (2014). Accelerating Progress to Achive the Health MDGs in Nigeria: Harmonized Country Plan of Priority Intervention for 2014-2015. In Izugbara, C.O., Wekessah, F.M. and Adedini, S.A. (2016). Maternal Health in Nigeria: A Situation Update. African Population and Health Research Center (APHRC), Nairobi, Kenya.
Grundy, J. & Annear, P. (2010). Health-seeking behaviour studies: a literature review of study design and methods with a focus on Cambodia. Health policy and health finance knowledge hub working paper series no, 7.
Human Rights Committee (1994). General Comment 18: Non-Discrimination (37th Sess., 1989), in Compilation of General Comments and General Recommendations Adopted by Human Rights Treaty Bodies, at 27-28, paras. 6-12, U.N. Doc. HRI/GEN/1/Rev.1.
Human Rights Committee (1999). Gen. Comment No. 6, supra note 13, at 177, para. 5; Human Rights Committee, Gen. Comment No. 28, supra note 15, at 229, para. 10; see also Special Rapporteur on Violence against Women, Its Causes and Consequences, Rep. of the Special Rapporteur on Violence against Women, Its Causes and Consequences, Ms. Radhika Coomaraswamy, in Accordance with Commission on Human Rights Resolution 1997/44 – Addendum – Policies and Practices that Impact Women’s Reproductive Rights and Contribute to, Cause or Constitute Violence against Women, para. 66, U.N. Doc. E/CN.4/1999/68/Add.4 (Jan. 21, 1999) (noting “[g]overnment failure to take positive measures to ensure access to appropriate health-care services that enable women to safely deliver their infants as well as to safely abort unwanted pregnancies may constitute a violation of a woman’s right to life…”).
Human Rights Committee, General Comment No. 6: Right to Life (Art. 6) (16th Sess., 1982), in Compilation of General Comments and General Recommendations Adopted by Human Rights Treaty Bodies, at 176, para. 1, U.N. Doc. HRI/GEN/1/Rev.9 (Vol. I) (2008) [hereinafter Human Rights Committee, Gen. Comment No. 6].
Hunt, P., & Bueno De Mesquita, J. (2007). Reducing maternal mortality: the contribution of the right to the highest attainable standard of health. University of Essex, European Union and the United Nations Population Fund (UNFPA). Retrieved at https://www.unfpa.org/sites/default/files/pub-pdf/reducing_mm.pdf.
Izugbara, C. O., Wekesah, F. M., & Adedini, S. A. (2016). Maternal health in Nigeria: a situation update. Nairobi, Kenya: African Population and Health Research Center.
Jolly, Y., Aminu, M., Mgawadere, F., & van den Broek, N. (2019). “We are the ones who should make the decision”–knowledge and understanding of the rights-based approach to maternity care among women and healthcare providers. BMC pregnancy and childbirth, 19(1), 1-8.
Liljestrand, J. (2004). Maternal Survival- A Question of Women's Value. Lakartidningen, 101(6), 478.
Maclean, G. (1996). Safe motherhood: A Basic Right or a Privilege of a Few?. Modern midwife, 6(9), 10.
National Population Commission (NPC) [Nigeria] and ICF International (2014). Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.
National Population Commission (NPC) [Nigeria] and ICF Macro. (2009). Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro.
Office of the United Nations High Commissioner for Human Rights (OHCHR) (2013). Who Will Be Accountable? Human Rights and the Post-2015 Development Agenda – Summary. Center for Economic and Social Rights (CESR) and the Office of the United Nations High Commissioner for Human Rights. Retrieved from Abridged_vers_WWBA_EN.indd (ohchr.org).
Office of the United Nations High Commissioner for Human Rights (OHCHR) (2020). Human Rights-Based Approach to Reduce Preventable Maternal Morbidity and Mortality: Technical Guidance. Retrieved from https://www.ohchr.org/Documents/Issues/Women/WRGS/Health/ TGReduceMaternalMortality.pdf (ohchr.org).
Office of the United Nations High Commissioner for Human Rights (OUNHCHR) (2012), Technical Guidance on the Application of Human Rights-Based Approach to Implementation of Policies and Programmes to Reduce Preventable Maternal Morbidity and Mortality, para. 85, U.N. Doc. A/HRC/21/22 (July 2, 2012). 30 ICPD Programme of Action, supra note 1, para. 14.3. 31 See ESCR Committee, Gen. Comment No. 14, supra note 9, para. 12.
Olonade, O., Olawande, T. I., Alabi, O. J., & Imhonopi, D. (2019). Maternal Mortality and Maternal Health Care in Nigeria: Implications for Socio-Economic Development. Open Access Macedonian Journal of Medical Sciences, 7(5), 849.
Ondo State Ministry of Health. (2017). The Concept of Agbebiye Initiative as a Strategy for Maternal Death Reduction in Ondo State. Akure: Ondo State Government.
Panel, A. P. (2010). Maternal Health: investing in the Life Line of Healthy Societies & Economies. Africa Progress Panel.
Pang, T., & Guindon, E. (2004). Globalization and risks to health. EMBO Rep. 5(Suppl 1): S11–S16.
Piane, G. M. (2019). Maternal Mortality in Nigeria: A Literature Review. World Medical & Health Policy, 11(1), 83-94.
Rosenfield, A., & Maine, D. (1985). Maternal mortality-a neglected tragedy: Where is the M in MCH?. The Lancet, 326(8446), 83-85.
Rudan, I., Kapiriri, L., Tomlinson, M., Balliet, M., Cohen, B., & Chopra, M. (2010). Evidence-based priority setting for health care and research: tools to support policy in maternal, neonatal, and child health in Africa. PLoS Med, 7(7), e1000308.
Shiffman, J., & Okonofua, F. E. (2007). The state of political priority for safe motherhood in Nigeria. BJOG: An International Journal of Obstetrics & Gynaecology, 114(2), 127-33.
Silverman, D. (2006). Interpreting Qualitative Data: Methods for Analysing Talk, Text, and Interaction. (3rd Ed.). Retrieved from https://www.amazon.com/Interpreting-Qualitative-Data-Analyzing-Interaction/dp/1412922453. Accessed 04/02/2017.
Stanton, M. E., Kwast, B. E., Shaver, T., McCallon, B., & Koblinsky, M. (2018). Beyond the Safe Motherhood Initiative: Accelerated action urgently needed to end preventable maternal mortality. Global Health: Science and Practice, 6(3), 408-412.
Storeng, K. T. (2010). Safe motherhood: The making of a global health initiative (Doctoral dissertation, London School of Hygiene & Tropical Medicine).
Strauss, N., & Ward, R. (2013). A human rights-based approach to maternal mortality in the United States. In Maternal Mortality, Human Rights and Accountability (pp. 94-112). Routledge.
Swedish International Development Cooperation Agency 2002, 7;
Ten Have, P. (2003). Understanding qualitative research and ethnomethodology. Sage.
U.K. Department for International Development 2007c, 3).
UNDP policy document (1997). Governance for Sustainable Human Development. New York: United Nations Development Programme; 1997:19.
United Nations Population Fund (UNPF) (2005). Human Rights Principles. Retrieved from https://www.unfpa.org/resources/human-rights-principles.
Universal Declaration of Human Rights (UDHR, 2005). UN Documentation: Human Rights. Retrieved from https://research.un.org/en/docs/humanrights.
WHO (2013). The Right to Health. Fact sheet N°323. Retrieved from http://www.who.int
WHO (2019). Maternal deaths: Maternal Mortality Ratio (per 100000 live births). Retrieved from https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicator-group-details/GHO/maternal-deaths
World Health Organization (WHO) (2001). Commission on Macroeconomics and Health. Macroeconomics and health: Investing in Health for Economic Development. P.40. Geneva.WHO.
World Health Organization (WHO) (2017). Human Rights And Health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/human-rights-and-health
Yamin, A. E. (2008). Beyond compassion: the central role of accountability in applying a human rights framework to health. Health and human rights, 1-20.
Yamin, A. E. (2008). Will we take suffering seriously? Reflections on what applying a human rights framework to health means and why we should care. Health and human rights, 45-63.
Yamin, A. E. (2013). From ideals to tools: applying human rights to maternal health. PLoS Med, 10(11), e1001546.
Yamin, A. E. (2013). Applying human rights to maternal health: UN Technical Guidance on rights-based approaches. International Journal of Gynecology & Obstetrics, 121(2), 190-193.
DOI: https://doi.org/10.5296/jpag.v10i4.18218
Copyright (c) 2021 Kikelomo Aboyowa Mbada
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Public Administration and Governance ISSN 2161-7104
Email: jpag@macrothink.org
Copyright © Macrothink Institute
To make sure that you can receive messages from us, please add the 'macrothink.org' domain to your e-mail 'safe list'. If you do not receive e-mail in your 'inbox', check your 'bulk mail' or 'junk mail' folders.
------------------------------------------------------------------------------------------------------------------------------------------------------