(Kampala) Today a landmark case re-opened in Uganda’s Constitutional Court, Petition 16 of 2011, filed on behalf of two women who died in childbirth, Sylvia Nalubowa and Jennifer Anguko, by the health rights organization Center for Health Human Rights and Development (CEHURD).

 

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EHURD and the families sued government, arguing that lack of access to essential maternal health care
services that killed their relatives was a violation of the right to health and the rights of women as set out in the Constitution. The case was re-opened following a ruling by Supreme Court on October 30 2015 striking down Constitutional Court’s earlier dismissal of the case in 2012.

Supreme Court determined unanimously that the lower Court had erred when they ruled that they had no mandate to hear a case regarding the alleged violation of health rights and the rights of women and
dismissed the case. CEHURD had argued before the Supreme Court that the failure to provide the basic
maternal health services to pregnant women in Uganda was a human rights issue that the Constitutional
Court had the mandate to hear, citing Article 137 (3) of the Constitution, which states that Constitutional
Court has the mandate to determine whether any act, law or policy of the government is in violation of any provision of the Constitution.

“This case is a matter of life and death for Ugandan pregnant women,” said Ms. Lillian Mworeko, Director of the International Community of Women Living with HIV/AIDS East Africa (ICWEA). “We are calling on the Judiciary to play its rightful role–for too long the plight of pregnant women has been ignored by government.”

 

“In Uganda access to essential health services for pregnant women is a public health crisis; the country has made virtually no progress in combatting maternal death over the last decade,” said Samuel Senfuka of White Ribbon Alliance Uganda. We know that this can change, and that the Judiciary has a critical role in altering the deadly status quo.”

More than 16 pregnant women die every day in Uganda, with the leading direct causes of preventable death being haemorrhage (42% of deaths), obstructed or prolonged labour (22%) and complications from abortion (13%). Major indirect causes include malaria, a factor in 36% of maternal deaths recorded, anaemia (11%) and HIV (7%). A positive ruling in Constitutional Court could have multiple direct effects on access to life saving health care services for pregnant women, such as requiring the government to remedy health rights violations through actions such as drastically improving access to free maternal health care services in the public sector, including emergency obstetric care.

Press Release Make International Safe Abortion Day 28 Sept a UN Day

Open Letter to United Nations Leaders Re Making International Safe Abortion Day 28 September an Official UN… by CEHURD on Scribd

In the recent years, Monitoring and Evaluation (M&E) has become a critical concept in planning, implementation and tracking progress of implemented activities. Even internationally, donors and other partners have increasingly become interested in participatory M&E approaches not only as tools for ensuring value for money, but also as an assessment tool for evaluating impact of the projects and in setting priority areas for funding where impact has been realized.

The Safe Abortion Action Fund (SAAF) program set out to evaluate it’s 3^rd Round of funding that had been given to organizations in different countries. From these organizations, the most successful projects were to be evaluated to guide SAAF in choosing priority areas whilst structuring the 4^th Round of funding and as one of the 3^rd Round grantees, CEHURD was selected to evaluate its project titled, “Clarifying Uganda’s Legal and Policy Environment on Abortion”

After reviewing and compiling available literature on the project, the consultants set out to interact with the different partners that have in one way or the other impacted or contributed to the project as it was implemented in joint control with national and local authorities: Ministry of Health, Ministry of Justice and Constitutional Affairs, Manafwa district Health Office and District Police Office and professional actors: Legal Support Network (LSN), Association of Obstetricians and Gynecologists of Uganda (AOGU), civil society networks: Coalition to Stop Maternal Mortality from Unsafe Abortion (CSMMUA), Community Health Advocates in Buikwe and School health clubs in Manafwa, etc.

From the evaluation, it came out strongly that there is a significant divergence in what is considered monitoring and evaluation and what monitoring and evaluation actually is; especially when it comes to the impact of the work CEHURD has done in the communities. It also came to our attention that the community and different stakeholders view CEHURD as an authority on health and human rights and in litigating health rights in Uganda – in relation to the cases before court on health rights. In another community where health clubs were established in schools, the clubs grew to hold weekly debates on prevention of unintended pregnancy and as a result, there had been a 50% reduction in teenage pregnancies in the school and this was a result of an initiative we championed.

This evidence challenged us to revisit M&E, not from the perspective we have understood it- in terms of realizing indicators and objectives, but rather assessing the change created as a result of the initiatives established.   There has been undoubted growth in appreciation of M&E as an institution, and the only question is, are we missing the point of M&E in tracking change realized as a result of the programs implemented or can we use it to do more? There is need for further exploration and appreciation of M&E can indeed support valuable cross learning from CEHURD and the local communities.

 

By Sumaya Labira

CEHURD, alongside many other CSOs, has taken initiative to identify what they consider to be key SRHR pressing issues affecting young people in Uganda. SRHR issues are very intimate and private in nature and this creates a thick dark cloud around them, making advocacy and dissemination of meaningful information hard to achieve.

Why Sexual and Reproductive rights?

In his introductory overview, Loic Whitmore, Regional Programme Manager-Rutgers, stressed that Reproductive health is not just a health issue – It is a human rights issue that is central to gender equality and ultimately to sustainable development. Sexual and reproductive health encompasses health and well-being matters related to right to choose one’s sexual relations, have children, pregnancy, including safe medical abortion and access to family planning.

SRHR issues are very intimate and private in nature and this creates a thick dark cloud around them, making advocacy and dissemination of meaningful information had to achieve. And, yet, we cannot afford to become silent.

SRHR and young people

Young people (ages 10-24) currently account for 52% of the total population in Uganda as of January 2016 and as young people reach puberty, they face new challenges related to their sexual and reproductive health and rights. Young people undergo transformations of body change and identity, some become sexually active, yet little has been done to prepare them navigate their emerging sexuality.Young people must be free to decide on sexuality and reproduction. And, the state has an obligation to respect, promote and protect SRHR.

Barriers to SRHR…

Participants identified barriers to effective advocacy for SRHR issues and how they could be overcome. One working group laid out unsafe abortion, teenage pregnancy, early child marriages, and inadequate resources to finance SRHR issues while another group came up with more holistic issues such as, shortage of trained healthcare professionals in SRHR areas, inadequate training institutions to train enough skilled professionals, culture of silence around SRHR issues, and lack of community engagement.

In response to the challenges above, there is need to advocate for increased communication on SRHR issues among men, women and young people; increased integration of SRHR programs and services to maximize resource utilization and synergy, increase in financial and human resources for SRHR, supply of SRHR commodities including a wide range of contraceptives, condoms among others and finally, monitor and evaluate access to youth-friendly SRHR information and services.