Writer: Labila Sumayah Musoke. PHOTO/FILE/COURTESY
As the world observes the 16 days of activism against gender-based violence, global conversations often spotlight violence in homes, workplaces, or public spaces like markets.
Yet, one insidious form of violence deserves urgent attention if we are intentional about achieving good health and well-being of everyone by 2030: the abuse and mistreatment of women in healthcare settings when they seek maternal healthcare. This silent and overlooked form of violence is devastating and violates women’s maternal health rights at one of their most vulnerable moments – during pregnancy, childbirth and postpartum.
Globally, the gap between what women need in maternal healthcare and what is currently offered is vast and the statistics are grim. While maternal health has improved in recent years, mistreatment and neglect during labour and delivery persist in ways that perpetuate inequality and reinforce systemic failures in healthcare delivery.
A 2019 World Health Organisation (WHO) report revealed that about 42 percent of women surveyed in four low-income countries experienced mistreatment during childbirth, ranging from physical abuse to verbal humiliation and neglect.
In Uganda, the story is not different.Take the story of Kongai, a young mother in Kumi District, who faced verbal abuse and was detained at a health facility after a complicated delivery because she could not pay her medical bills. Or consider Nakintu, an adolescent mother in Buikwe District, whose pleas for pain relief during labour were dismissed by the midwife with a harsh remark, “you should have thought about this before getting pregnant”.
Kongai and Nakintu’s experiences are not isolated cases of a “few bad actors” within the healthcare ecosystem. They are symptoms of structural and systemic failures coupled with deeply ingrained gender inequalities, social and economic power imbalances, and a medicalised culture that view women’s bodies as sites of control and power.Uganda has made significant strides to improve maternal health outcomes.
Upgraded and equipped healthcare facilities across the country and the development of the 2022 Essential Maternal and New-born Clinical Guidelines reflect progress. However, modern infrastructure and well-intentioned policies mean little when women continue to face abuse, neglect, and mistreatment within healthcare settings.The 16 days of activism remind us that gender-based violence is multifaceted and offer an opportunity to demand more than a patchwork of solutions.
The days challenge us to address and unsettle all forms of gender-based violence, including abuse and mistreatment of women within hospital walls.Incremental changes and piecemeal reforms are no longer sufficient.
What is required is a radical shift in the way maternal healthcare services are structured and delivered —a shift that centres women’s voices, acknowledges their lived experiences, promotes and protects their right to respectful and dignified maternal health care. To obstetricians, gynecologists, midwives, and anesthesiologists - women’s lives are on the line. Commit to addressing all forms of violence and abuse and ensure delivery of dignified, respectful, and compassionate care from pregnancy through postpartum.
To the Ministry of Health, no more empty promises or half measures. Take decisive action now. Conduct mandatory and comprehensive training of the entire health care workforce on respectful and dignified care; strengthen and enforce robust reporting and accountability mechanisms to ensure grievances are addressed swiftly and transparently; establish effective and accessible recourse mechanisms that empower women to seek justice without fear of retaliation or further harm. To everyone, let us unite to end violence against women seeking maternal healthcare because silence is complicity.
The writer, Labila Sumayah Musoke, is a programs officer at Initiative for Social and Economic Rights.
