Reproductive rights groups in Africa and the US are calling upon the government of Mali to protect the lives of pregnant women, according to a report released today. The most visible cause of maternal mortality in Mali is the poor state of the health-care infrastructure, which leaves adequate obstetric care out of reach for many women, particularly those in rural areas. The Malian government needs to step up its efforts to protect the lives of pregnant women, the rights groups charge.
"Concerted national and international efforts are key to addressing these shortfalls in health care and their destructive impact on Malian women’s lives," d Laura Katzive, legal adviser at the Center for Reproductive Rights and an author of the report. "Contributing to the needless loss of lives are daily denials of women’s rights to reproductive self-determination and non-discrimination," added Katzive.
The human rights fact-finding report entitled Claiming Our Rights: Surviving Pregnancy and Childbirth in Mali, released today by the Center for Reproductive Rights and the Association des Juristes Maliennes, documents factors contributing to Mali’s high maternal mortality ratio, and recommends ways to secure women’s right to survive pregnancy. As is true of many countries in sub-Saharan Africa, women in Mali face an unacceptably high risk of dying during pregnancy and childbirth. An estimated one in 19 women dies from pregnancy-related causes in Mali (the risk for women in Switzerland is 1 in 6,900) and complications arising from pregnancy and childbirth are responsible for one third of the deaths of Malian women aged 15 to 49.
In Mali, only one in four births is assisted by a skilled attendant. But Mali’s high maternal mortality ratio – estimated by the United Nations at 630 deaths per 100,000 live births – is also a reflection of broader societal discrimination. Child marriage is common in Mali, with the median age of first marriage at 16.5 years. Female circumcision/female genital mutilation is practiced among 94% of Malian women. Moreover, denials of women’s right to reproductive self-determination, including the lack of access to family planning methods, undermine women’s ability to space births and thus protect their reproductive health and lives.
"In Mali, maternal mortality is seen as a part of life," said Fatimata Dembele Djourté, a lawyer with the Association des Juristes Maliennes and a co-author of the report. "But government action can save women’s lives. We are asking the government to meet its national and international commitments and take the necessary steps to reduce maternal mortality," added Djourté.
The right to survive pregnancy and childbirth is protected in binding international human rights instruments, which guarantee women’s right to life. The Malian government is a state party to these international human rights treaties and thus must fulfill its obligation to ensure women’s rights to survive pregnancy and childbirth.
Reproductive rights groups recommend that the government of Mali reinforce the health care system’s capacity to deliver maternal health services, reform laws to ensure women’s equality and reproductive self-determination, and conduct outreach aimed at encouraging women to claim their right to go safely through pregnancy and childbirth. The rights groups further call upon African governments, including Mali, and international and regional institutions to foster efforts to curb high maternal mortality ratios throughout the African region.
The report launches at the African Women’s Sexual and Reproductive Health and Rights Conference in Johannesburg, South Africa, organized by Amanitare, the African Partnership for Sexual and Reproductive Rights of Women and Girls. The conference marks the African Women’s Health and Rights Day, a day intended for all Africans to celebrate their rights to healthy minds, bodies and souls.
Testimony from the report (excerpt): one man tells his sister’s story
Kadja was my older sister. She died two years ago. She wasn’t even 20 years old…She was only 14 years-old when she married but all the girls in our community marry very young…Four years after she got married, she still didn’t have any children. In the beginning, people spoke behind her back, but after a while, they made fun of her, saying that she would never have any children and that her husband had better remarry. On the advice of his mother, her husband became engaged to another girl from the village. That’s when we started to notice that my sister was pregnant.
As the pregnancy advanced, my sister’s husband wanted her to rest but our aunt refused, saying that Kadja was not the only woman who ever got pregnant
One day her water broke while she was splitting wood. She carried on as if nothing happened because she didn’t understand what this meant…A couple of days later, Kadja had horrible pains. We did not take her to the hospital, which was far from the village. She died two days later, without anyone trying anything to save her.
I think that the baby died inside her. My mother said that this must have been meant to be, but deep down she has never accepted it and she still suffers….