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After considerable progress in recent decades, maternal mortality and morbidity (MMM) either stagnated or worsened in most regions of the globe between 2016 and 2020. The world should be outraged given that we have known the key interventions necessary for preventing MMM for over three-quarters of a century. Since the 1990s, human rights advocacy on MMM has gained crucial ground, demonstrating that entitlements related to maternal health are judicially enforceable and delineating rights-based approaches to health in the context of MMM. Nonetheless, evident retrogressions, coupled with ballooning social inequalities, redoubled austerity post-pandemic, and a conservative populist backlash against reproductive rights, underscore the steep challenges we face. This paper offers five lessons gleaned from what we have achieved during the past 30 years of human rights advocacy on maternal health, and where we have fallen short: (1) maternal health is not a technical challenge alone and is inseparable from reproductive justice; (2) reproductive justice requires strengthening health system infrastructures; (3) we must center the political economy of global health in our advocacy, not just national policies; (4) litigation is part of a larger advocacy toolkit, not a go-it-alone strategy; and (5) we must use metrics that tell us why women are dying and what to do.

Abstract Overcoming continuing polarization regarding judicial enforcement of health rights in Latin America requires clarifying divergent normative and political premises, addressing the lack of reliable empirical data, and establishing the conditions for fruitful inter-sectoral, inter-disciplinary dialogue.

Abstract Applying a robust human rights framework would change thinking and decision-making in efforts to achieve Universal Health Coverage (UHC), and advance efforts to promote women’s, children’s, and adolescents’ health in East Africa, which is a priority under the Sustainable Development Agenda. Nevertheless, there is a gap between global rhetoric of human rights and ongoing health reform efforts. This debate article seeks to fill part of that gap by setting out principles of human rights-based approaches (HRBAs), and then applying those principles to questions that countries undertaking efforts toward UHC and promoting women’s, children’s and adolescents’ health, will need to face, focusing in particular on ensuring enabling legal and policy frameworks, establishing fair financing; priority-setting processes, and meaningful oversight and accountability mechanisms. In a region where democratic institutions are notoriously weak, we argue that the explicit application of a meaningful human rights framework could enhance equity, participation and accountability, and in turn the democratic legitimacy of health reform initiatives being undertaken in the region.

La salud ha permanecido en la práctica, en gran medida, en el ámbito de los médicos y profesionales de la salud, quienes han examinado la salud y los problemas de salud prácticamente con un enfoque biomédico basado en la presencia o ausencia de enfermedad. Esta división separa la salud del contexto social -relaciones sociales y de poder- en el que las personas viven. Los autores sostienen, a partir de las graves desigualdades e inequidades existentes en el estado de salud dentro y entre los países en los inicios del siglo XXI, que la salud no puede seguir siendo simplemente un concepto biomédico, sino que debe ampliarse para incorporar los conocimientos de otras disciplinas y, en particular, la de los derechos humanos. Nunca ha sido más importante para los futuros proveedores la necesidad de ser educados en un paradigma más amplio de la salud. No podemos decir que estamos formando "buenos" médicos -o buenos enfermeros y enfermeras, obstetrices o técnicos- hasta que se use un modelo de educación médica que considera no sólo los factores biológicos, sino también los factores que determinan la situación social y consideren a la salud como un derecho humano fundamental.

La ética médica es considerada entre los profesionales de salud como la disciplina que proporciona las bases para brindar una atención adecuada a los pacientes. En los últimos años, los conceptos de calidad de atención y derechos humanos - así como sus diversos discursos acompañantes - se han sumado al concepto de ética médica entre los paradigmas a tener en cuenta en la atención de las personas, tanto a nivel individual, así como a nivel de políticas de salud. El presente trabajo busca analizar tales paradigmas, utilizando como estudio de caso las políticas de salud sexual y reproductiva que se dieron en Perú en los últimos 10 años.Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years.

Alicia Yamin argues that applying human rights frameworks and approaches to maternal health offers strategies and tools to address the root causes of maternal morbidity and mortality within and beyond health systems, in addition to addressing other violations of women's sexual and reproductive health and rights. Please see later in the article for the Editors' Summary.

BackgroundLittle is known about the interconnectedness of maternal deaths and impacts on children, beyond infants, or the mechanisms through which this interconnectedness is established. A study was conducted in rural Tanzania to provide qualitative insight regarding how maternal mortality affects index as well as other living children and to identify shared structural and social factors that foster high levels of maternal mortality and child vulnerabilities.Methods and findingsAdult family members of women who died due to maternal causes (N = 45) and key stakeholders (N = 35) participated in in-depth interviews. Twelve focus group discussions were also conducted (N = 83) among community leaders in three rural regions of Tanzania. Findings highlight the widespread impact of a woman's death on her children's health, education, and economic status, and, by inference, the roles that women play within their families in rural Tanzanian communities.ConclusionsThe full costs of failing to address preventable maternal mortality include intergenerational impacts on the nutritional status, health, and education of children, as well as the economic capacity of families. When setting priorities in a resource-poor, high maternal mortality country, such as Tanzania, the far-reaching effects that reducing maternal deaths can have on families and communities, as well as women's own lives, should be considered.

La ética médica es considerada entre los profesionales de salud como la disciplina que proporciona las bases para brindar una atención adecuada a los pacientes. En los últimos años, los conceptos de calidad de atención y derechos humanos - así como sus diversos discursos acompañantes - se han sumado al concepto de ética médica entre los paradigmas a tener en cuenta en la atención de las personas, tanto a nivel individual, así como a nivel de políticas de salud. El presente trabajo busca analizar tales paradigmas, utilizando como estudio de caso las políticas de salud sexual y reproductiva que se dieron en Perú en los últimos 10 años.

This final webinar of the ‚International Pandemic Lawmaking: Conceptual and Practical Issues‘ Symposium will bring together leading scholars to critically discuss cross-cutting themes of the Symposium, and key points of contention and recommendation for the future of global pandemic governance.

Amid the unfolding „moral catastrophe“ of COVID-19, and across the entries in this symposium, we see a clamor for any pandemic law-making exercise to promote more justice in global health. However, this universally-embraced imperative masks a wide array of divergent views about the nature and sources of inequalities in global health, and in turn what should be done if we were to think beyond a narrow pragmatism of the moment.