Primera disculpa pública por muerte materna en México


Primera disculpa pública por muerte materna en México


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Estimados amigos,

Como recordarán, hemos acompañado a la familia de Susana, mujer tzotzil que perdió la vida dando a luz en octubre de 2013, para que el gobierno del estado de Chiapas se responsabilice por su pérdida y haga lo necesario para que este tipo de muertes no sigan ocurriendo. El reconocimiento de la negligencia y de que Susana murió por causas prevenibles forma parte de las medidas de reparación exigidas por las víctimas. Hoy, con enorme júbilo, puedo anunciarles que el pasado 19 de noviembre el Secretario de Salud de Chiapas, Carlos Eugenio Ruiz ofreció la primera disculpa pública por muerte materna ¡en México! Esto significa que el esfuerzo que las abogadas de GIRE han realizado está rindiendo frutos, que nos hemos hecho notar y que el gobierno chiapaneco no puede seguir ignorando los problemas que aquejan a las mujeres.
Al aceptar la disculpa del Estado, Romeo Pérez, esposo de Susana, dijo que “con este acto, el gobierno de Chiapas reconoce que la muerte de Susana se pudo haber evitado”, lo que significa que aún queda mucho trabajo por hacer. Queda pendiente que expliquen cómo se va a garantizar la educación y la atención especializada de los hijos de la Susana; así como la puesta en marcha de las acciones concretas e inmediatas que garanticen que las mujeres chiapanecas dejarán de morir por causas prevenibles.

La Comisión Nacional de Derechos Humanos emitió hace meses una recomendación que incluye algunas de las demandas de la familia, misma que fue aceptada por el gobierno de Chiapas. Ahora, le queda a la CNDH dar seguimiento a dicha recomendación de modo que situaciones como la de Susana dejen de repetirse.

GIRE dará seguimiento a las recomendaciones que faltan por cumplirse, pero no quisiera dejar pasar este enorme logro sin compartirlo con ustedes, dado que la realidad mexicana actual necesita con urgencia las buenas noticias. Gracias por todo su apoyo. Esperamos pronto tener más logros que compartir con ustedes y con las mujeres chiapanecas.




World’s Abortion Laws

The Center for Reproductive Rights is proud to unveil and share an updated version of the World’s Abortion Laws poster, one of the Center for Reproductive Rights’ signature publications and a powerful tool to visually compare the legal status of abortion across the globe and advocate for greater change. They are re-launching the abortion map this year in commemoration of the 20 year anniversary of the adoption of the International Conference on Population and Development’s (ICPD) Programme of Action. In addition to the World's Abortion Laws map, they are launching Abortion Worldwide: 20 Years of Reform, a new publication tracking changes to abortion laws since ICPD. Since this important milestone, more than 30 countries have liberalized their abortion laws, vastly expanding women’s right to access safe and legal abortion services.

We also invite you to visit our interactive version of The World’s Abortion Laws map, available at This innovative resource makes the abortion laws of more than 50 key countries easily available online, and provides links to helpful advocacy tools for abortion law reform and more information about the Center’s work on the implementation and reform of abortion laws.


Acceleration of the Reduction of Maternal Mortality and Morbidity


PAHO developed a progress report on the Plan of Action to Accelerate the Reduction of Maternal Mortality and Morbidity, which will be presented in September at the next meeting of the Directive Council. GTR has also contributed to the discussion about the new post-2015 maternal mortality goals within the framework of the Ending Preventable Maternal Mortality (EPMM) initiative. GTR wrote a statement with recommendations about global targets, and presented it in the plenary session of the EPMM meeting in Bangkok (April 14-16). Bremen de Mucio (PAHO) and María Isabel Cobos (ECLAC) participated on behalf of GTR.

Read here:

The next steps to move forward with the proposed goals will be discussed at the meeting of the PMNCH Partner’s Forum in South Africa (2014 Partner’s Forum, June 30-Jul 1)


Ensuring human rights in the provision of contraceptive information and services

WHO recently released new guidance on integrating human rights considerations into the provision of contraceptive information and services. The guidance notes that international and regional human rights treaties, national constitutions, and laws provide guarantees related to contraceptive access. The guidance includes several references to EC, making the following recommendations:

  • EC should be included in essential medicine supply chains and national formularies. Within this context, the guidance notes that sometimes ideology-based policies drive the lack of availability of contraceptive supplies. It highlights in particular that in some countries EC is not available on the false grounds that it causes abortion.
  • Special efforts should be made to provide comprehensive EC information and services to displaced populations, those in crisis settings, and survivors of sexual violence. The guidance mentions that women’s access to contraceptive information and services, especially EC, may be jeopardized by health-care providers’ refusal to provide services due to conscientious objection. The guidance states that while international human rights law protects this freedom, it also stipulates that in the professional sphere conscientious objection might be subject to limitations necessary to protect patients’ rights, including the right to access reproductive health care.
  • Every individual should have the opportunity to make an informed decision about using modern contraception, including EC, without discrimination.

This new guidance complements existing WHO recommendations for sexual and reproductive health programs, including guidance on family planning. Read the full report HERE


Latin American and Caribbean (LAC) Regional Caucus at Women Deliver

The Regional Task Force on Maternal Mortality Reduction in Latin America and the Caribbean (GTR)  is pleased to invite you to a Latin American and Caribbean (LAC) Regional Caucus at Women Deliver. This is one of the few opportunities at Women Deliver for colleagues from LAC to meet and discuss regional initiatives and priorities for improving reproductive, maternal, newborn and child health (RMNCH). The Day 1 caucus (May 29th) will focus on quality of care; and the Day 2 (May 30th)  caucus on tracking commitments and promoting accountability in RMNCH. Each day will feature three brief presentations followed by open discussion:

Download and see information related to this event


A manifesto for maternal health post-2015

Ana Langer, Richard Horton, Guerino Chalamilla

On Jan 15—17, 2013, over 800 experts in maternal health came together in Arusha, Tanzania, to present the latest evidence on improving the quality of care for women during pregnancy and childbirth. The past 25 years of the safe motherhood movement have seen extraordinary successes—notably a 33% reduction in maternal mortality from 409 053 in 1990 to 273 465 in 2011. These achievements have motivated and mobilised a welcome new generation of political and financial commitments to maternal health.

But with the era of the Millennium Development Goals (MDGs) drawing to a close in 2015, a moment of uncertainty hangs over the fate of more than 200 million women who become pregnant each year. As the world moves towards the next set of development goals, will the gains of the past for women be protected, and can the unfinished business for the future be addressed? As a contribution to the process of redefining human development for women after 2015, participants at the Arusha conference supported writing a manifesto for maternal health based on the best available evidence, the lessons of safe motherhood from the past 25 years, and the more recent experience of the MDGs. We welcome a vigorous debate about this manifesto.


A manifesto for maternal health

  • The global health community must build on past successes and accelerate progress towards eliminating all preventable maternal mortality within a time-bound period. To this end, a new and challenging goal for maternal mortality reduction is needed within the development goal framework for the post-2015 era, one that is led and owned by countries not donors.
  • This maternal mortality goal must be broadened to embrace the progressive realisation of political, economic, and social rights for women. One critical lesson from the history of women's health is that maternal health will not be improved to its full potential by focusing on maternal health alone.
  • As maternal mortality declines, the world must now focus on both prevention and treatment of maternal morbidities, the measurement of which is challenging but critical to tackle for the health, productivity, and dignity of the women involved.
  • The successful framework of the continuum of care must be redefined to make women more central to our notions of reproductive, maternal, newborn, and child health. The continuum needs to be more inclusive of frequently neglected elements — e.g., quality of care, integration with HIV and malaria programmes, non-communicable diseases, and the social determinants of health, such as poverty, gender disparities, sexual and gender-based violence, water and sanitation, nutrition, and transportation.
  • The global health community must devise a responsive financing mechanism to support countries in implementing their plans to reduce maternal mortality and improve sexual and reproductive health.
  • A much greater emphasis must be put on reaching the unseen women who are socially excluded because of culture, geography, education, disabilities, and other driving forces of invisibility. If we are serious about redressing gender and access inequities, we have to ask fundamental and difficult questions about the nature of our societies and the value, or sometimes lack of value, we ascribe to individuals, especially women, in those societies.
  • One critically important element to address women's health and needs is attention to improving comprehensive quality of care. Respectful maternal health care for all women is an ethical imperative, not an option.
  • The maternal health community must invite, include, and incorporate the voices of women themselves into writing the future of maternal health. Too often, women's voices are silenced, ignored, or reported only second hand. Women must be given the platform and power to shape their own futures in the way they wish.
  • For the mother, her newborn child is a precious and indissoluble part of her life and her future. Maternal health outcomes cannot be fully addressed without attacking the appalling global toll of preterm births, preventable stillbirths, and newborn deaths.
  • A critical gap that threatens the future health of women and mothers is the catastrophic failure to have reliable information on maternal deaths and health outcomes within and across countries. This gap in measurement, information, and accountability must be a priority now and post-2015.
  • A tremendous opportunity lies in technology. Mobile and electronic health technologies must ensure that women are effectively and safely connected to the health system, from education to emergencies, referral for routine antenatal care to skilled birth attendance. Putting the right technologies in the hands of women offers one compelling opportunity to make empowerment of those women a reality.
  • Finally, we must fulfill all of these actions sustainably, which means universal access to high-quality health services free at the point of demand, within a strong health system, supportive of the fully trained front-line worker—from family planning, to safe abortion, to emergency obstetric care, with respect for both providers and women.
  • Agnes Binagwaho, Rwanda's Minister of Health, opened the conference in Arusha by looking back at the genocide that overtook Rwanda in 1994. “We believed in the promise of our future”, she said. The maternal health community, a vital part of the movement for women's and children's health embodied in the UN Secretary-General's Every Woman, Every Child initiative, also believes in the promise of a future for women and mothers. This manifesto is one small contribution towards that future.
  • AL and GC co-chaired the Global Maternal Health Conference 2013, which was convened by the Maternal Health Task Force, the flagship project of the Women and Health Initiative at the Harvard School of Public Health and Management and Development for Health, a Tanzanian non-profit organisation.


1  Lozano R, Wang H, Foreman KJ, et al. Progress towards MDGs 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet 2011; 378: 1139-1165.  Summary |  Full Text |  PDF(7166KB)  | CrossRef  | PubMed

a Women and Health Initiative, Maternal Health Task Force, Harvard School of Public Health, Boston, MA 02115, USA
b The Lancet, London NW1 7BY, UK
c Management and Development for Health, Dar es Salaam, Tanzania



Trends in Maternal Mortality:1990-2010

Globally, the total number of maternal deaths decreased by from 543 000 in 1990 to 287 000 in 2010. Likewise, the global maternal mortality ratio (MMR) declined from 400 maternal deaths per 100 000 live births in 1990 to 210 in 2010, representing an average annual decline of 3.1 per cent.

All developing regions experienced a decline in MMR between 1990 and 2010, with the highest reduction in the 20-year period in Eastern Asia (69 per cent) followed by Northern Africa (66 per cent), Southern Asia (64 per cent), Sub-Saharan Africa (41 per cent), Latin America and the Caribbean (41 per cent), Oceania (38 per cent) and finally Caucasus and Central Asia (35 per cent). Although the latter region experienced the lowest decline, its already low MMR of 71 maternal deaths per 100 000 live births in 1990 made it more challenging to achieve the same decline as another region with a higher 1990 MMR value.

Chapter 2 provides an overview of the definitions and approaches for measuring maternal mortality. Chapter 3 is a detailed description of the methodology employed in generating the estimates and a brief comparison with alternative approaches for estimating the global burden of maternal mortality. Chapter 4 presents the estimates and interpretation of the findings. Chapter 5 assesses the progress towards MDG 5 and the importance of improved data quality for estimating maternal mortality. The annexes and appendices present the sources of data for the country estimates, as well as MMR estimates for the different regional groupings used by the contributing agencies.


Transforming health systems to serve the wellbeing of indigenous and minority populations

We have included in our publication section the report: Transforming Health Systems to Serve the Wellbeing of Indigenous and Minority Peoples published by the Royal Tropical Institute and the Institute of Development Studies under the Bellagio Center. This publication brings together the conclusions of the conference that was held in June 2012 at the Bellagio Study Center around three themes:
1. Territory, mobility, and access;
2. Traditional medical knowledge and intercultural, cultural sensitivity, health care and
3. Gender and sexual and reproductive health, including maternal and child health.

Download it HERE or click the image


New United Nations Human Rights Council Resolution on Maternal Mortality

Here we have published the latest Resolution on Maternal Mortality approved by the United Nations Human Rights Council on September 21, 2012. The resolution calls on member States to renew their political commitment to eliminate preventable maternal mortality and morbidity in the local, regional, national, and international levels and to renew their efforts to guarantee the full and effective implementation of human rights.

See also: Technical guidelines on the application of a human rights-based approach to reduce maternal mortality and morbidity.


Respectful Maternal Care

We have included on our webpage the materials produced by the White Ribbon Alliance for respectful maternal care and universal rights of women of reproductive age. According to these publications, “the concept of safe motherhood should expand beyond just preventing maternal mortality; it must include respect for fundamental human rights of women, including respect for women’s autonomy, dignity, feelings, decisions, and preferences, including support for maternal care.”


These publications focus on “interpersonal aspects of care for women seeking maternity services. The relationship of women with maternity care providers and the system of maternal care during pregnancy and birth is vital. These meetings are not only the vehicle for essential health services with the potential to save lives, but the experiences of a woman with health personnel during this period of time can empower, support, or cause lasting damage or emotional trauma, adding to or reducing their confidence and self esteem. Either way, a woman’s memories of her experience at the time of delivery will be with her for a lifetime and are often shared with other women, contributing to an atmosphere of trust or distrust of motherhood.”


Download here:

 •Publication about respectful maternal care and universal rights of women of reproductive age



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