G8 development ministers should take a strong stand on fulfilling the global promise to reduce maternal and child mortality and eliminate health disparities among nations and communities, Human Rights Watch said in a letter to the Canadian government. The development ministers are meeting in Halifax this week to lay the foundation for the June 2010 G8 meeting. 

Human Rights Watch said that the Canadian government's pledge to make maternal and child health a G8 priority is a positive sign.  Canada and all G8 countries should work to reduce disparities in access to sexual and reproductive health care and to promote health system accountability, comprehensive sexual and reproductive health care, and increased health system financing. 

"The G8 governments should make this year's summit a turning point on global maternal and child health," said Liesl Gerntholtz, women's rights director at Human Rights Watch.  "For far too long, governments have neglected basic health system reforms, with devastating results for countless families."   

A study recently published in the medical journal The Lancet found that almost 343,000 women and girls around the world are estimated to have died in 2008 from pregnancy and childbirth-related causes, the majority of which are preventable.  Other estimates are even higher.  Ten years ago, most of the world's governments made a commitment to reduce their maternal and child mortality rates dramatically by 2015 as part of the Millennium Development Goals (MDGs).  Of all the MDGs, though, the least progress has been made in reducing maternal mortality.  HIV/AIDS has slowed progress in reducing maternal deaths in sub-Saharan Africa.

Many countries do not have functioning accountability systems for health care, Human Rights Watch said.  Accountability mechanisms enable patients and families to lodge complaints when they are mistreated in health care settings, and can enable health officials to identify and fix system-wide failings.  Accountability also includes monitoring and gathering health data, such as by recording births and deaths and investigating maternal deaths. 

"Governments seem to throw up their hands about maternal deaths, as if there is nothing they can do," Gerntholtz said.  "But some simple things, starting with tracking deaths and figuring out what caused them, would go a long way toward fixing fatal health system problems." 

Funding for maternal and child health should be a priority topic for the G8 discussions as well, Human Rights Watch said.  By all accounts, current levels of health system financing are inadequate.  Investing in this area could accelerate progress on all of the Millennium Development Goals, Human Rights Watch said.  But for investment to show better results, it should be tied to a mechanism to monitor whether the money poured in is actually spent on programs that address the health needs of pregnant women.

Human Rights Watch has investigated human rights violations in reproductive and maternal health care around the world.  One recent report examined maternal mortality in India. Tens of thousands of women die in India each year from pregnancy and childbirth, especially poor women and those from marginalized Dalit and tribal communities.

While India has taken important steps to improve access to maternal health care, many states are failing to gather information on when, where, and why deaths are occurring, and to provide redress to those poor and marginalized communities most affected by such deaths.  This may change if Indian states implement the national government's new maternal death audit initiative. A Human Rights Watch video on this issue, "In Silence: Maternal Mortality in India," has been nominated for a 2010 Webby Award