Toward Transformative Accountability: A Proposal for Rights-Based Approaches to Maternal Health in the MDGs and Beyond

Meaningful and equitable progress on reducing maternal mortality and meeting Millennium Development Goal 5 calls for the adoption of a human rights-based approach which emphasizes ‘accountability.’ This article focuses specifically on how to promote accountability for fulfilling the right to maternal health if we seek to transform the discourse of rights into practical health policy and programming tools that can affect development practice - and in turn to transform health systems to better meet women’s maternal health needs.

After briefly discussing the concept and purpose of accountability in the context of fulfilling women’s rights to maternal health, the article then sets out a circle of accountability at the national level that includes: development and implementation of a national plan of action; budgetary analysis; monitoring and evaluation of programs based on appropriate indicators; and mechanisms for redress, as well as facility-level initiatives. In the final section the article addresses donor accountability.