From Ideals to Tools: Applying Human Rights to Maternal Health

Alicia Yamin argues that applying human rights frameworks and approaches to maternal health offers strategies and tools to address the root causes of maternal morbidity and mortality within and beyond health systems, in addition to addressing other violations of women's sexual and reproductive health and rights. Please see later in the article for the Editors' Summar

Democracy and Health: Situating Health Rights within a Republic of Reasons

Patterns of population health are keen reflections of structural inequities in societies, yet they are rarely subject to the requirements of democratic justification that other systemic inequalities provoke. Nor are health systems generally subject to societal scrutiny regarding fidelity to normative commitments of dignity and equality. Increased recognition of social determinants of health has challenged the narrow biomedical view of health as a stochastic phenomenon. More recently the sweeping devastation of the COVID-19 pandemic has laid bare structural injustices across many democracies, which contributed to widely disparate rates of infection and mortality

Adjudicating Health-Related Rights: Proposed Considerations for the United Nations Committee on Economic, Social and Cultural Rights, and Other Supra-National Tribunals

This article examines how various supra-national tribunals have approached adjudication of health-related rights, and makes proposals with respect to some special considerations posed by health-related cases that the United Nations Committee on Economic, Social and Cultural Rights and other supra-national bodies will invariably face. After briefly setting out the contours of the right to health under international law, we stress the importance of an approach to adjudication that acknowledges underlying determinants, but also that defines the obligations of the health sector, explicitly acknowledging the interdependence and indivisibility of health with human rights. Second, reviewing some lessons from other supra-national tribunals, we address the question of when a supra-national tribunal should order interim measures in a health-rights related case. Third, we explore the uniquely important role of technical evidence in health rights cases, which are highly reliant on clinical and epidemiological determinations in establishing what reasonableness requires of the state. Fourth, we assert that achieving health equity goes beyond accounting for socio-economic marginalization or discrimination faced by certain populations, to examining priorities in relation to the “worst off” in terms of the seriousness of conditions. Finally, we argue both for the appropriateness of “dialogical” remedies in many health rights cases, and the need for developing innovative forms of monitoring and supervision of such remedies by supra-national tribunals

Using Rights to Deepen Democracy: Making Sense of the Road to Legal Abortion in Argentina

This Article situates the 2020 passage of a law legalizing abortion as an inflection point for Argentine democracy and a case study of how rights concepts can be deployed to advance reproductive justice. First, beginning with the transition to democracy, this study traces shifts in opportunity structures including political and institutional changes; key judicial decisions as well as legal reforms; and the construction of relations among traditional feminist organizations, health professionals, and new actors including key politicians and other decision-makers. Second, the Article focuses specifically on the last fifteen years of legal and social mobilization, the evolving networks of actors engaged in advancing abortion rights, and how the issue became embedded in public debates within and beyond formal institutions of the state. The third stage describes the process of passing legislation in the Argentine Congress and the social decriminalization that was essential for the passage and implementation of the law. Finally, the Article provides a brief overview of trends in Argentina in the first year after the legislation went into effect. The Argentine case illustrates the constructivist and recursive nature of using rights to advance abortion access, whereby the framework of universal human rights in international law interacts dialectically with the interpretations and further adaptation at the national level

Costs of Inaction on Maternal Mortality: Qualitative Evidence of the Impacts of Maternal Deaths on Living Children in Tanzania.

Little is known about the interconnectedness of maternal deaths and impacts on children, beyond infants, or the mechanisms through which this interconnectedness is established. A study was conducted in rural Tanzania to provide qualitative insight regarding how maternal mortality affects index as well as other living children and to identify shared structural and social factors that foster high levels of maternal mortality and child vulnerabilities. Adult family members of women who died due to maternal causes (N = 45) and key stakeholders (N = 35) participated in in-depth interviews. Twelve focus group discussions were also conducted (N = 83) among community leaders in three rural regions of Tanzania. Findings highlight the widespread impact of a woman's death on her children's health, education, and economic status, and, by inference, the roles that women play within their families in rural Tanzanian communities. The full costs of failing to address preventable maternal mortality include intergenerational impacts on the nutritional status, health, and education of children, as well as the economic capacity of families. When setting priorities in a resource-poor, high maternal mortality country, such as Tanzania, the far-reaching effects that reducing maternal deaths can have on families and communities, as well as women's own lives, should be considered

Silenciar el drama: ¿los indicadores de los ODS ponen al descubierto las injusticias que limitan la vida sexual y reproductiva de las mujer

No existe un ámbito de derechos humanos donde se libren batallas más dramáticas y brutales que el de la salud y los derechos sexuales y reproductivos (SDSR). Como señala David Hulme en su recuento sobre los ODM, “La salud reproductiva fue el factor determinante para llegar a un acuerdo: para lograr la aprobación de la Declaración del Milenio en la Asamblea General, fue necesario omitir la salud reproductiva”. En los Objetivos de Desarrollo del Milenio (ODM) que surgieron, la amplia agenda intersectorial de las conferencias de la ONU sobre la SDSR de la década de los 1990 se redujo a un objetivo sobre la salud materna (ODM 5). Además, el progreso en este objetivo se mediría con base en los Índices de mortalidad materna, lo que dejaba de lado las cuestiones relacionadas con las causas fundamentales de la mortalidad materna. Se perdieron de vista los obstáculos a la promoción de la SDSR entre grupos diversos de mujeres y niñas. Estas y otras inquietudes de derechos humanos se tomaron en cuenta, en cierta medida, en los ODS, gracias a una enorme movilización política y a los esfuerzos de incidencia estratégica. Sin embargo, aún hay problemas con respecto a qué se cuenta y qué es lo que realmente cuenta.https://www.openglobalrights.org/silencing-the-drama-do-the-SDG-indicators-expose-the-injustices-that-limit-womens-sexual-and-reproductive-lives/?lang=Spanis