MDG 5, HUMAN RIGHTS, AND MATERNAL HEALTH IN AFRICA
At the root of other challenges relating to poor maternal health in Africa
and militating against meeting the benchmarks of MDG 5, particularly at
the individual level, is poverty. It is no coincidence that the region with the
worst maternal health indices is also the region with the greatest poverty
rate. 129 Poverty prevents mothers from seeking necessary health services.
Let us take access to antenatal coverage as an example:
[Antenatal care] is vitally important in detecting and managing conditions
that may complicate pregnancy and childbirth. Basic antenatal care
provides women with a package of preventive interventions, including
nutritional advice. Women are also alerted to danger signs that may
threaten their pregnancy and given support in planning a safe delivery.
Moreover, in countries where malaria is endemic, they may be provided
with intermittent preventive treatment. Women who are HIV-positive
receive help in avoiding transmission of the virus to their babies. 130
The importance of antenatal care is thus too critical to be ignored. Most
of the conditions associated with MMR are preventable, treatable, or
controllable by regular attendance at antenatal clinics. UNICEF and WHO
recommend a minimum of four visits at antenatal clinics. 131 Yet, only
forty-four percent of pregnant women in African met this threshold between
2000 and 2010, sharing the position of the worst percentage globally with
the Eastern Mediterranean region. 132 This is precisely because in many of
these countries, access to health care, including antenatal coverage, is a
function of cash. Knowing the importance of visits to antenatal clinics is
one thing, having the resources to pay for the services is quite a different
Cash, or lack thereof, is the main reason many women in Africa do not
avail themselves of the benefits of regular attendance at antenatal clinics.
Realizing this, a few countries in the region have started offering free or
subsidized health care to women. Ghana was the first to introduce an
exemption policy for delivery fees in 2004.133 A handful of other countries
129. E.g., HUMAN DEVELOPMENT REPORT 2009, supra note 31, at 176-78 (showing that
a majority of sub-Saharan African countries are ranked in the lowest tier of human
development with the highest ranks of poverty).
130. MILLENNIUM DEVELOPMENT GOALS REPORT 2011, supra note 39, at 30.
131. MILLENNIUM DEVELOPMENT GOALS REPORT 2009, supra note 31, at 27.
132. WORLD HEALTH STATISTICS 2011, supra note 47, at 100.
133. Sophie Witter et al., Providing Free Maternal Health Care: Ten Lessons from an
Evaluation of the National Delivery Exemption Policy, 2 GLOBAL HEALTH ACTION 1 (2009).
Although this scheme was subsequently abolished, in 2008 the President announced a policy
of free medical coverage for pregnant women in the country.