For most people the day a child is born is a time of joy and celebration. It is a moment when families are afforded a brief glimpse into the future, and it is fi lled with hope and promise. In much of the world, however, this vision is far from reality. For women in many countries in the developing world, the day when she gives birth is a life-threatening event. For want of basic, known technologies and care over half a million women die unnecessarily in childbirth each year. The facts are stark: a woman in Sweden faces a one in 30,000 chance of dying in childbirth, while a woman in Sierra Leone faces chances of dying as high as one in six. When a mother dies, her newborn baby has much less chance of surviving the fi rst weeks. These gross inequities underscore the fact that the right to health of childbearing women and their babies globally is far from being assured.
What does it mean, precisely, to say that health is a human right? In 2002, during my tenure as UN High Commissioner for Human Rights, I welcomed the appointment of a Special Rapporteur on the Right to Health, Paul Hunt, who has defi ned the right to health in the following way:
“The right to health can be understood as a right to an effective and integrated health system encompassing health care and the underlying determinants of health, which is responsive to national and local priorities, and accessible to all. In other words, the health system must encompass both health care and the underlying determinants of health, such as adequate sanitation and safe drinking water. It must be accessible to all. Not just the wealthy, but those living in poverty. Not just majority ethnic groups, but minorities and indigenous peoples too. Not just those living in urban areas, but also remote villagers. The health system has to be accessible to all disadvantaged individuals and communities.”
To address the right to safe motherhood will require both strong political will and practical interventions based on evidence of effectiveness. The Cochrane Pocketbook on Pregnancy and Childbirth aims to put the best evidence of effectiveness of pregnancy and childbirth interventions in the hands of those who can advocate for change—public and private decision makers, as well as health workers responsible for the care of childbearing women. The Cochrane Pocketbook authors and editors are concerned both with ensuring that health-preserving procedures are accessible to women as well as the elimination of ineffective and humiliating traditional procedures.
This book provides user-friendly access both to the Cochrane Library and to the World Health Organization Reproductive Health Library, which is distributed free of charge to health workers in low income countries globally in English, Spanish, French and Chinese. It would be a great achievement to put these Cochrane Pocketbooks in the hands of health workers the world over. Let us join together to ensure that for every woman, anywhere in the world, the day she gives birth is one of the most hopeful days of her life.
Former President of Ireland,
former UN High Commissioner for Human Rights
December 18, 2007