**2.1 Legal recognition of the right**

*Education, Human Rights and Peace in Sustainable Development*

includes community health workers [2].

features [3].

In order for governments to scale up primary health care and thereby to narrow health inequities, among other things, the declaration indicates the importance of universal health coverage, national health plans, and a health workforce that

Following Alma-Ata various attempts have been constructed to delineate some of the right-to-health features of health systems. Acutely aware of the centrality of a human rights-based approach (HRBA) to health to the creation of equitable health systems, Gunilla et al., for instance, have attempted to identify some of these to include legal recognition, standards, participation, comprehensive national planning, accountability, equity, equality and nondiscrimination, and respect for cultural difference and quality and proposed 72 indicators that reflect some of these

Maternal and child health is equally a central challenge of the Ethiopian health system, and health gain disparities concerning these categories of persons exist within the various parts of the country. This chapter examines the degree to which the Ethiopian health system (1) promotes awareness of the complementary relation between the Ethiopian health system and the right to maternal and child health; (2) selects a manageable set of indicators to assess the degree to which a health system includes some of the right-to-health features; (3) increases accountability in relation to the Ethiopian health system and the right to maternal and child health; and (4) deepens the understanding of the important role of indicators in relation to the

For the discussion on the human-rights features of maternal and child health and measuring Ethiopian compliance of its obligation to the right to health, this chapter relies mainly on current literature, General Comment 14, the Alma-Ata Declaration, and elements of the World Health Organization (WHO) building blocks of a good health system, the Convention of the Right of the Child, General Comments 3 and 4 of the Committee on the Rights of the Child, and the requirement that health facilities and services are available, accessible, and culturally appropriate—respectful of the culture of those concerned— and of good quality [4–11]. Further, it draws an examination of relevant Ethiopian laws, polices, plans and institutional mechanisms. Before discussing these features, the chapter

progressive realization of the right to maternal and child health.

attempts to highlight the conceptual framework of a HRBA.

**2. Understanding a HRBA in the maternal and child health**

Although conceptually rigorous, much has been written on the relevance of a HRBA to development and in particular to women and children's health care. There is consensus that the international community has lately achieved a full understanding that maternal and under-five mortality is no longer simply an issue of public health but a human rights concern [12]. This concern over a rights framework to maternal and child health grows due to the fact that a significant portion of maternal and under-five mortality is from preventable causes—an indication that avoidable maternal and child fatalities are potential violations of human rights constituting social injustice [13]. Essentially, a HRBA to maternal and child health aims to realize the right to the highest attainable standard of health (or "right to health") and other health-related complementary rights of vulnerable women and children. Various features can be used as useful indicators to measure compliance of state obligations to the right of health care of their population: (1) legal recognition of the right to health; (2) availability, accessibility, acceptability, and quality of healthcare facilities and services; (3) participation; (4) equality and nondiscrimination; (5) national health plans; (6) well-trained and motivated health workers; (7) and

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Similar to many other rights, recognition of the right to health takes different levels. In the main are the global and domestic dimensions, where the former is expressed through ratification of human rights treaties and the latter deals with the recognition of the right to health in the national constitution or other statutes. Legal recognition requires acknowledgment of the range of binding human rights obligations in the national legal and policy framework, and the jurisprudence and other pronouncements elaborating upon treaty provisions over the past decades [14]. This feature further requires avoiding euphemisms and rather urges to employ the language of human rights law in adoption of development laws and policies which laws and policies may include in the area of health-care [15]. This means, for example, that words such as "needs", "equity", "good governance" to identify things that are human rights or "citizens' rights" are employed in a manner that avoids reference to employ human rights standards and are reckoned to constitute euphemisms. The latter is distinguished as an "effort to depoliticize development discourse" whether they relate to issues of health care or education [14, 15]. But, why unambiguous recognition of rights is central?

Legal recognition is significant as it increases stakeholders' accountability and gives attention to ways of empowering marginalized children and women or their representatives to be aware of and claim their rights [16]. It can too cause the authorities accountable before courts, contributing to tangible improvements in maternal and child health care services. However, the realization of the right to maternal and child health can mean a commitment towards the recognition of the right, this does not necessarily warrant the actual operation or success of implementation [3]. China's law on Maternal and Infant Care, which specifically targets the health of mothers and young children, is a notable exception and is thought to possess a positive effect on child survival rates. Similarly, Vietnam's Child Protection, Care and Education law provides free health care for children under six. As well, in some jurisdictions, recognition has generated judicial decisions and non-judicial mechanisms of accountability that have improved the delivery of wellness-related services [17].
