As Eleanor Roosevelt once said, “Where, after all, do universal human rights begin? In small places, close to home - so close and so small that they cannot be seen on any maps of the world. […] Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.”
To us as health rights activists, this is more relevant today than, perhaps, ever. Breastfeeding week, auspiciously marked from August 1 -7 annually, offers us a perfect opportunity to reflect on how much we have done at ensuring that inalienable human rights, like the right to food and nutrition- including breastfeeding- is not only a dream, but a reality to all babies- upon which they attain a healthy foundation to life.
World’s Breastfeeding Week (BFW) has been celebrated since 1992 when it was first introduced by the World Alliance for Breastfeeding Action (WABA), an advisory board to Unicef. What legal lessons do we learn from honouring the week?
Despite various policies and programmes that the government has put in place to support and promote optimal Maternal, Infant and Young Child Feeding (MIYCF), Uganda still suffers a double burden of malnutrition: Some children and mothers are underweight while others are overweight. Although Uganda has a strong culture of breastfeeding, 40 per cent of children under six months are not exclusively breastfed, and, 52.5 per cent are breastfed within the first hour of birth, according to the World Breastfeeding Trends Initiative (WBTi) Uganda report, 2015.
Approximately, 54 per cent of children in Uganda are breastfed up to the age of two, compared to 84 per cent in Rwanda and 79 per cent in Burundi.
The human rights of babies in regard to their nutrition must be given a wider interpretation in the context of the existing legal framework. Article 25(1) of the Universal Declaration of Human Rights asserts that “Everyone has the right to an adequate standard of living and well-being, including food”.
The right is re-echoed in Article 11 of the International Covenant for Social, Economic and Cultural rights, to which Uganda is a party. Uganda has the mandate to take all appropriate measures to promote and protect children’s rights - right to be breastfed.
The 1995 Constitution and the Children’s Act, have little to say explicitly about breastfeeding babies. However, Article 31(4) says children have the right to be cared for by their parents, including the right to be breastfed. There is need for making stronger policies and monitoring tools in relation to child feeding.
There is also need for a system of accountability to assure that mothers observe their obligation. Yes, Uganda has registered credible progress in protecting and promoting maternal health. However, one wonders whether enough is being done in respect to new born babies?
Breastfeeding is an integral part of the reproductive process. The Lancet new series on breastfeeding, Vol 387, No. 10017, January 30, 2016 assert that breastfeeding makes the world healthier, smarter, and more equal
For example, the series confirm that breastfeeding reduces infant and maternal mortality by contributing to the realisation of Goal 3 of the Sustainable Development Goals. Thus, the world’s deaths of 823,000 children and 20,000 mothers could be avoided through universal breastfeeding.
Uganda’s maternal mortality rate (338 deaths per 100,000 per live births) and under five mortality rate (56 deaths per 1,000 live births) could be averted through health literacy on merits of breastfeeding from the moment the baby is born until they are six months old, according to the latest demographic and health survey.
However, breastfeeding alone cannot register the change we want. True, Uganda has a wealth of policies and strategies in place aimed at protecting mothers and their newborn babies.
But, little attention is paid to care for the newborn during postnatal period-when newborn deaths occur. This missed opportunity (implementation of existing policies) has a negative consequence for the potential success of breastfeeding.
As we celebrate BFW, I call upon all stakeholders and communities at large, to support and protect breastfeeding mother, promote food security, and reduce household poverty at every stage of the life cycle, starting from conception and provide Emergency Obstetric Care and neonatal care.
The message is simple: Protect and support breastfeeding mothers at every stage of nursing in order to attain the highest foundation to a baby’s life.
Ms Musoke is a lawyer - health law and policy at Semuyaba, Iga & Co. Advocates.