Groundbreaking legislation protects women’s, girls’ and newborns’ health rights in Nepal
By Stephanie Bowen, Director of Strategic Communication, White Ribbon Alliance
White Ribbon Alliance members across the world offer congratulations to our colleagues from the Safe Motherhood Network Federation Nepal (SMNF/WRA Nepal) on the passage of the Safe Motherhood and Reproductive Health Rights Act, 2018. This achievement is part of a larger effort to embed reproductive, maternal and newborn health and health rights into Nepal’s Constitution, accomplished in 2016, then strengthen the country’s laws to uphold these rights. After more than a decade of work, on October 15, 2018, Nepal’s House of Representatives unanimously passed the groundbreaking law, explicitly protecting the health and rights of women, girls, adolescents and newborns.
“Achieving this victory was far from simple or straightforward,” said Dr. Arzu Rena Deuba, Founder of SMNF/WRA Nepal “It took years of hard work and remaining focused on our goal of embedding quality, respectful maternal and reproductive healthcare for women and girls into Nepal’s constitution and its laws.”
The journey began in earnest in 2008, when SMNF/WRA Nepal initiated active advocacy for the Safe Motherhood and New Born Health Care Bill. They held consultations with stakeholders including members of parliaments, Nepal’s medical and nursing associations, and more than 200 organizations to secure buy-in at every level of governments and civil society. While they were making progress, the bill unfortunately stalled.
SMNF regrouped and in 2014, came back stronger, involving many of the same stakeholders as before, but this time, advocacy to and from the community was central to their efforts. They also explicitly included respectful maternity care (RMC) as a central framework to the bill.
At the same time the issue of abortion was front and center in the country. Nepal routinely prosecuted and imprisoned women and their family members for terminating a pregnancy and unsafe abortion was the source of more than half of all gynecological and obstetric hospital admissions, accountable for extremely high maternal mortality rates. Abortion was legalized in 2002, and over the next several years women gained increasing rights to abortion; this included the landmark Supreme Court decision Lakshmi Dhikta v. Nepal that in 2009 reinforced a woman’s right to abortion, emphasizing abortion as a human right. Despite these breakthroughs, access to safe abortion remained difficult and women who terminated their pregnancies were often stigmatized. In 2014, the Safe Abortion Bill was drafted and SMNF/WRA Nepal, as part of the Reproductive Health Rights Working Group, advocated for its passage.
With both maternal health and abortion bills pending in the Ministry of Health and Population (MoHP), SMNF jointly organized the 4th Safe Motherhood Conference in 2016 with MoHP, and created an umbrella bill of maternal, newborn and reproductive health rights. This new, comprehensive bill included the five major issues of women’s health: maternity and newborn health, family planning, safe abortion, adolescent health and women’s morbidity, enshrining them as human rights and calling for the financing of these vital women’s health services.
The legislation went through the same consultative process with government ministries, health workers, professional associations, civil society organizations and, of course, women, girls and families. After approval of Minister of Parliament, it continued to progress due to continuous advocacy from SMNF/WRA Nepal and other civil society actors. Finally, Nepal got Safe Motherhood and Reproductive Health Right Act in 2018.
This is a huge accomplishment for Nepal, but also the world. From what our research and outreach to our considerable coalition of RMC advocates, this is the first time that respectful maternity care has been enshrined in national legislation, anywhere in the world.
“Now that the bill has been passed, we are working on developing guidelines for effective implementation to ensure that every woman, girl and newborn in Nepal realizes their rights to quality health and well-being,” said Deuba.
WRA’s Global Alliance will be here to support that work, but for now, we invite SMNF/WRA Nepal and all those who made the legislation a reality to take a bow, accept our thanks and enjoy this much-deserved recognition.
Dr. Arzu Rana Deuba founded Safe Motherhood Network Nepal in 1996 and shortly thereafter brought together maternal and newborn health advocates from across the country to form WRA Nepal. Since its inception, SMNF/WRA Nepal has promoted a rights-based approach for maternal and newborn health. As the movement grew, so did its influence. In the past two decades, Nepal has reduced the maternal mortality ratio by 76%, under-five mortality by 73%, infant mortality by 67% and neonatal morality mortality by 42% — but there is still more work to be done. By providing information on safe abortion services to communities, training health providers on the importance of Respectful Maternity Care, and building and equipping birthing centers, SMNF is making sure that safe motherhood is the right of all women in Nepal.