The High Court of Madhya Pradesh has passed a
landmark final judgment in the case of Sandesh Bansal v. Union of
India (PIL) W.P. 9061/2008, recognizing that a woman’s right to
survive pregnancy and childbirth is a fundamental right protected under
Article 21 of the Indian Constitution. Filed in 2008 by Sandesh Bansal,
a health activist and member of the Jan Adhikaar Manch, as part of
Human Rights Law Network’s national strategy to use litigation as a
means of addressing India’s high maternal mortality & morbidity, the
case sought accountability for the government's failure to respect,
protect, and fulfill the rights of pregnant women. Advocate Jayshree
Satpute, who argued the final hearings in the matter noted the judgment
as a "a significant step forward for women's health in India, as a
growing number of High Courts have begun to recognize reproductive
rights as fundamental rights and order life-saving reliefs."
Madhya Pradesh is
the India's third most populous state, and as noted by the Honorable
Court "afflicted with the worst indicators in India" such as high rates
of illiteracy, mortality, morbidity and people living below the
poverty line. Poor socio-economic conditions persist despite enactment
of the National Rural Health Mission (NRHM), a public health scheme
funded by the Central Government to address India’s shockingly high
maternal and infant mortality in furtherance of its public health duties
as provided by the Indian Constitution and international human rights
law. Relying upon extensive government research and reports, such as the
State Programme Implementation Plan, Common Review Mission, and
a Registrar's report submitted during the pendency of the litigation,
the Court documented the failure of the government to implement the
NRHM, noting dilapidated facility conditions, non-availability of
skilled personnel, essential medicines, and access to timely and
consistent matenal health services. The Court further rejected the
government's claim that financial constraints served as a barrier to
full implementation, noting that over 17100 lakhs remained unspent at
the end of 2009.
As the Court eloquently explained,
"
22. (…) we observe from the material on record that there is shortage
not only of the infrastructure but of the man power also which has
adversely affected the effective implementation of the [National Rural
Health Mission] which is turn is costing the life of mothers in the
course of mothering. It be remembered that the inability of women to
survive pregnancy and child birth violates her fundamental rights as
guaranteed under Article 21 of the Constitution of India. And it is
primary duty of the government to ensure that every women survives
pregnancy and child birth, for that, the State of Madhya Pradesh is
under obligation to secure their life.
In recognition of the fundamental nature of these
rights, the Court ordered immediate implementation of the NRHM, with
a focus on strengthening infrastructure, providing access to timely
maternal health services, skilled personnel, effective referral and
grievance redressal mechanisms. A timebound plan for “strict and timely”
implementation was ordered consistent with NRHM, with the Court setting
specific directives, such as:
• 24 hours availability of trained woman as
ASHA/Community health worker
• Two staff nurses at the primary
health centre to ensure round the clock service therein
•
Three staff nurses at the primary health centres to ensure round the
clock serrvice therein.
• Uninterrupted electricity supply and the water supply to the
sub-centres and public health centres.
• Ensure proper modern
sanitation.
• Ensure that in all 227 Community Health Centres
in the State of Madhya Pradesh the availability of 24 hours delivery
services including normal and assisted deliveries it has 30-35 beds. To
be equipped with man and machine at par with the Indian Public Heatlh
standards, which would include Essential and Emergency Obestric Care
Unit, so that round the clock hospital like services are available.
• Ensure availability of vehicle round the clock under Janani
Express Yojana.
• Ensure that every pregnant women and new
born is vaccinated with Tetanus, BCG, Polio, DPT
• To set-up
all 87 Rogi Kalyan Samitis
• Constitute monitoring committee at District Block level and
ensure complete documentation of each and every patient.
Please see detailed judgment
here
The Human Rights Law Network (HRLN) is a collective of lawyers
and social activists dedicated to the use of the legal system to advance
human rights in India and the sub-continent. To learn more visit hrln.org.
Or
Advocate Anubhav Jain
