More than mothers

The Millennium Development Goal 5 (MDG5) set out to reduce maternal mortality by three-quarters and targeted universal access to reproductive health by 2015.

As of today, maternal-mortality globally has declined by 47 per cent over the last two decades with a decrease of two-thirds in Eastern Asia, Northern Africa and Southern Asia.

However, only half of pregnant women in developing regions receive the minimum of four prenatal care visits. Childbirth and complications during pregnancy are still the leading causes of death among adolescent girls. Under the MDG framework, sexual and reproductive health rights have only been addressed through the lens of maternal mortality and morbidity.

This narrow framing failed to incorporate critical aspects of women’s human rights which are not only necessary to improve maternal health, but in order to protect women’s human rights related to sexual and reproductive health more broadly, says Maarit Kohonen Sheriff, Deputy Chief of the New York Office of the UN Human Rights Office, at a special side event held during the 59th session on the Commission of the Status of Women, which was held at the UN Headquarters in New York.

Every year, the Commission meets to evaluate progress, identify challenges, and develop global policies for promoting gender equality and women's empowerment.

The event, “More than Mothers: Reflections on Sexual and Reproductive Rights in the MDGs and the Post-2015 Agenda”, explored the impact of the narrow focus of the MDGs on maternal health. The discussion also focused on the critical need for a human-rights based approach to the protection of women’s rights and gender equality, with regard to sexual and reproductive rights, in the post-2015 development framework.

According to Sheriff, a human rights-based approach to gender equality, particularly in the context of sexual and reproductive rights, means ensuring that States confront all of the root causes that contribute to gender inequality. These factors include poverty, gender-based discrimination and violence, stereotypes about women as caregivers and mothers, and restrictions on women and girls’ ability to make informed decisions about their health, sexuality, and reproductive lives. Daphney Conco, Director of the Democratic Nursing Organisation of South Africa (DENOSA) Professional Institute, agreed that the discussion of maternal health cannot exist without also reflecting on gender equality.

During the discussion, the panellists pushed for a paradigm shift in international development and called for specific commitments in the post-2015 framework on accountability and governance, as well as ensuring participation of the individuals who are impacted. Ariel Frisancho, National Coordinator of CARE Peru's Health Team, said that a key failing of the MDGs was a lack of robust mechanisms for citizen feedback. “We need more attention to the creation of conditions for empowerment,” he said. 

Frisancho also added that the emphasis of the MDGs was too focused on metrics and numbers. “The focus of the MDGs on national averages hid extreme inequalities,” Frisancho said. “In some regions of Peru, the rate of maternal death is five times the rate in Lima, the capital.”

The discussion also highlighted the fact that adolescent girls are disproportionately impacted by maternal mortality and morbidity. A critical step to improving this outcome is to provide adolescent girls with comprehensive sexuality education and full access to sexual and reproductive health services and goods.

Any future framework must build from sexual and reproductive health across the life cycle rather than reducing women’s health to only pregnancy and motherhood. “It is not just about being pregnant, but about a woman’s whole life,” Conco said.

The event, co-organized by the UN Human Rights Office, the Center for Reproductive Rights, and Amnesty International, also included Alicia Yamin, Lecturer on Global Health and Director of Health Rights of Women and Children Program at the FXB Center for Health and Human Rights at Harvard University; Madhu Malhotra, Programme Director for Gender, Sexuality and Identity; and Lilian Sepulveda, Director of the Global Legal Program at the Center for Reproductive Rights.

9 April 2014