Editor's Note: This story is part of a two-article series on women and health care during COVID-19 in East Africa. Here is the second part.
Maternal health is a crucial part of sexual and reproductive health and an indivisible component of the rights to health. However, maternal mortality remains a threat to the health of women and girls worldwide, especially in sub-Saharan Africa.
In recent years, States have established priority measures to reduce unwanted pregnancies and dangerous abortions, and improve access to qualified health experts, in line with the United Nations Sustainable Development Goals.
The key to ensuring the effectiveness of these measures is to guarantee access to information for women and girls.
The COVID-19 pandemic highlights the fundamental obligation of States to ensure an adequate supply of information as a fundamental component of the rights to health. This requires proactive communication by nations in a timely and effective manner.
During the pandemic, some governments have struggled to ensure that women and girls have continuous access to information and education related to sexual and reproductive health, online and offline.
In Kenya, the public has not always received consistent, clear and accessible information regarding curfew exemptions and confinement restrictions. While the exemptions unreservedly allow pregnant women with obstetric emergencies to leave their homes to go to health care facilities, the lack of clear information about those exemptions and how they are applied can cause excessive stress and confusion.
Kenyans also do not have a full understanding of the role and roles of security officers and public transport providers in facilitating and ensuring the safe passage of pregnant women and girls to medical facilities. Access to this information allows them to claim their rights.
Excluded from online resources
Mainly, the dissemination of information online – especially through social media – is potentially dangerous because it excludes and discriminates against many women and girls who have limited or no access to mobile phones, internet services or the digital knowledge necessary to access to this information. Some have limited financial means or do not have the means to cover the costs of internet data.
According to the Web Foundation, despite the tremendous growth in internet use worldwide, there are still more men than women online due to existing gender disparities. In sub-Saharan Africa, only 28% of women have internet access. This means that disseminating information online or requiring consumers to access the internet to gain access to health services often excludes women.
In Kenya, 86% of women have access to mobile phones but only 32% have access and use internet services; From the latter group, it is not clear whether they enjoy regular and continuous access to internet services that requires economic resources to pay for internet packages and electricity to charge mobile phones.
Telemedicine for everyone?
The Kenyan Ministry of Health published guidelines for the continuity of reproductive, maternal, newborn and family planning care during the COVID-19 pandemic, including the use of telemedicine, an innovative model encouraged by many countries to ensure service delivery of health during the COVID-19 pandemic.
Telemedicine is essential to ensure access to health-related information, including access to emergency services during labor and to facilitate contact between healthcare professionals and patients.
However, telemedicine guidelines are mainly disseminated online, which is not accessible to everyone. This means that many communities may not know the phone numbers to call to access these services.
In addition, telemedicine is not available to women who do not have a mobile phone or who, due to lack of funds, must make phone calls, if the emergency phone lines are not free.
Standards related to the right to health
Nations are bound by ratified human rights treaties and conventions. As a consequence, the United Nations human rights treaty bodies, both regionally and globally, have developed universally accepted standards by nations to measure and facilitate the realization of rights to health, including maternal health.
The Committee on Economic, Social and Cultural Rights and the Committee for the Elimination of All Forms of Discrimination against Women prepared General Observation 14 and 22 and General Recommendation 24 outlining the obligations and norms of States in relation to with the realization of the rights to health.
At the regional level, the Commission on Human and Peoples' Rights in Africa elaborated General Comment 2 on the right to health, including reproductive health, contemplated in article 14 of the innovative 2003 Protocol to the African Charter on Human Rights and Peoples' Convention on the Rights of Women in Africa, popularly known as the Maputo Protocol.
Taken together, these human rights instruments outline the obligations of African States to ensure that high-quality health care is available, acceptable and accessible to all, including access to information and education related to Health.
Information should be accessible to everyone equally and without discrimination, especially vulnerable and marginalized populations such as those living in poverty, in rural and remote areas, and people with disabilities.
Direct public engagement
Using various forms of information dissemination and communication ensures that all women – young or old, living in rural, peri-urban or urban areas, of all income levels – have access to relevant health information.
In general, states could do more to ensure the provision of accurate information to the public, including the use of conventional media such as television, radio, and newspapers and the mass delivery of free text messages through the Short Message Service ( SMS) and USSD services.
Collaboration with community leaders, activists, groups, community health workers and volunteers also supports the open and transparent flow of information in communities with limited access to mobile phones, televisions, radios, newspapers, etc.
Regular access to health information – especially for women and girls – will undoubtedly improve access to maternal health care services. This will likely mitigate the expected increase in maternal and neonatal mortality and morbidity in Africa during the COVID-19 pandemic.
Lydia Muthiani and Nelly Warega are human rights lawyers who live and work in Kenya. They specialized in promoting the rights of women and girls and are part of Utu Wetu, a group of human rights experts that works especially with women's rights.