Maternal health, human rights, and the politics of state accountability: Lessons from the Millennium Development Goals and implications for the Sustainable Development Goals

Abstract

Some scholars emphasize the significance of using human rights to hold states accountable to their commitment to global development goals, such as the Millennium Development Goals (MDGs) and the (renewed and expanded) Sustainable Development Goals (SDGs). Yet, others contest the extent to which such commitments indicate legal obligations, are enforceable, and can be fulfilled by developing states. This article draws on key informant interviews conducted with state and civil society actors in India, to explore the politics of using human rights to frame state accountability for maternal health (MDG 5 and SDG 3.1). The findings reveal that constitutional and institutional design peculiarities and lack of corresponding domestic legislative reforms complicate discursive framing of state accountability for maternal health using human rights, despite state commitment to MDG 5 obligations in form of resource allocation and agency creation. Yet, they also reveal the incremental opportunities to frame state accountability—rooted in citizenship entitlement, rather than human rights norms—made possible through ingenious civil society efforts, which leverage public investment in welfare that stem from state commitment to the MDGs. The findings are consequential to debates over the SDGs, which also lack discursive emphasis on human rights but reflect stronger human rights practices and standards, especially in Goal 16.

Notes

Acknowledgments

This study was made possible through an International Development Research Centre of Canada’s Doctoral Research Award. Earlier drafts of this article were presented at the Annual Meetings of the International Studies Association (2017) and the American Public Health Association (2016). I would like to thank Candace Johnson, Craig Johnson, Sharada Srinivasan, Dennis Baker, Fiona Robinson, Anne Roemer-Mahler, two anonymous reviewers, and the editorial team of Journal of Human Rights for their helpful comments on earlier drafts of this article.

Notes

1 On June 1, 2011, the Union Ministry of Health and Family Welfare relaunched JSY as the Janani Sishu Suraksha Karyagram (JSSK, or Maternal and Child Safety Program). The JSSK was not entirely rolled out until 2013, by which time field research was completed.

2 University of Guelph Research Ethics Board approval number 12JL039.

Additional information

Notes on contributors

Surma Das

Surma Das is an academic teaching staff member in the Political Science Department at University of Alberta and holds a PhD in political science and international development studies from the University of Guelph, Canada. She is interested in the politics of human rights, women’s rights, right to health, and development in South Asia. She is the coauthor of “The Human Rights Framing of Maternal Health: A Strategy for Politicization or a Path to Genuine Empowerment?” published in George Andrepolous and Zahra Arat’s The Uses and Misuses of Human Rights: A Critical Approach to Advocacy (New York: Palgrave, 2014). She was recognized for academic excellence and thought leadership (student scholar category) by the standing section on Population, Reproductive, and Sexual Health of the American Public Health Association in 2016. Her research has been funded by the International Development Research Centre of Canada.