Summary

The Center for Reproductive Rights filed this case at the Bungoma High Court in 2014 on behalf of Josephine Majani, a Kenyan woman who was denied maternal health care and physically and verbally abused by hospital staff during her labor and delivery.

In August 2013, Josephine was admitted to the Bungoma County Hospital for an induced labor. Despite a national directive issued by the president instructing all public health care facilities to offer free maternity health care services as of June 1 that year, the hospital required Josephine—who had a low-income background—to purchase the medicine necessary to induce her labor. After taking the medicine, Josephine was not physically checked or monitored by nurses and was informed that if she needed medical attention, she would have to walk from the labor ward to the delivery room herself.

While at the maternity ward, Josephine was physically and verbally abused by hospital staff and left to deliver on the concrete floor while entering in and out of consciousness. Her treatment at the hands of the staff received widespread media coverage in part because evidence of the abuse was caught on camera by another patient.

Case background

Background

Unfortunately, Josephine’s story is not unique, save for the fact that her abuse was captured on video and subsequently aired on national television, sparking a national outcry. According to the Ministry of Health, poor quality of care was identified in the care of 92.4% of women who died in the hospitals involved in the Confidential Inquiry into Maternal Deaths in Kenya in 2014. According to the report, improving the care for 88.1% of the
women who died could have resulted in a better outcome.

The Constitution of Kenya guarantees every person the right to the highest attainable standard of health, which encompasses the right to health care services, including reproductive health care. In 2013, operationalizing the constitutional right to reproductive health care, President Uhuru Kenyatta issued a directive stating that free maternity services would be provided in public health facilities. Additionally, a patient’s charter was established which recognizes an individual’s right to the highest standard of health,
the right to emergency treatment, and the entrenchment of a provision on dispute resolution.

Despite a robust legal framework on reproductive health care, the quality of Kenya’s maternal care, especially with respect to labor and delivery, is dismal. According to a report by the Kenya National Commission on Human Rights, inadequate resources, insufficient infrastructure, and lack of physical access to health care facilities adversely impact maternal health care services. In addition, abuse and neglect in Kenya’s delivery and postnatal health care is systemic and widespread.

Case arguments

Case arguments

In bringing the case, the Center argued that:

• The 2010 Constitution of Kenya states that every person has a right to the highest attainable standard of health, which includes access to quality reproductive health care, including maternal care. The abuse, mistreatment, and denial of care experienced by Majani violated the Kenyan Constitution and her fundamental human rights.
• The hospital also violated the 2013 presidential directive instructing public health facilities to offer free maternity health services.
• The court should uphold the rights of all pregnant women in Kenya and hold the government accountable for violating its obligations under the Constitution.
• The national and county governments must ensure that Kenyan women have access to affordable, acceptable, available, and quality maternal health care. 

On March 22, 2018, the High Court of Bungoma issued a landmark judgment recognizing that the neglect and abuse of women seeking maternity health care services constitute a violation of rights as guaranteed by the Constitution of Kenya and international human rights law.

The Court found that Bungoma County Hospital, the Bungoma County government, and the Cabinet Secretary of Health had violated Josephine’s rights when she was denied quality maternal health care and was physically and verbally abused by hospital staff.

In its judgment, the High Court:

• Declared that the physical and verbal abuse experienced by Josephine amounted to a violation of her right to dignity and her right to not be subjected to cruel, inhumane, and degrading treatment.
• Found that the National and Bungoma County Governments failed to implement and monitor the standards of free maternal health care and services, thus resulting in the mistreatment of Josephine.
• Awarded Josephine KES 2,500,000 in damages for the harm she suffered.
• Emphasized the need to develop and implement policy guidelines so that quality and accessible health care services are available to all Kenyans, especially in the context of maternal health care.

Read complete details of the High Court’s judgment in the Center’s fact sheet here.

About the case

About the case

• This case is about the right of all Kenyan women to give birth in a safe, respectful and supportive health care setting, free from discrimination and abuse.
• Poor maternal health services are common in Kenya because of inadequate training and supervision of health care workers, negligence, and unethical practices. It is the duty of the national and county governments to ensure that all Kenyan women have access to quality reproductive health services guaranteed under the Constitution. 
• While Kenya has a high maternal mortality rate, according to a 2014 report by the Ministry of Health, access to quality medical care could have prevented almost 90% of the maternal deaths studied.
• Systemic denial of quality maternal health in Kenya is a violation of the Kenyan Constitution and international human rights.
• The government of Kenya must meet its obligations to guarantee safe, quality maternal health care.

Learn more

Learn more

Related news Legal documents

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