Press Release: Landmark Hearing on Maternal Deaths Proceeds in Uganda’s Constitutional Court

(KAMPALA) Today a civil society coalition of more than 40 health rights organizations welcomed the start of Constitutional Court’s hearing of Petition 16 of 2011. This health rights case, filed on March 4, 2011 by the Centre for Health, Human Rights and Development (CEHURD), was triggered by the preventable deaths of Jennifer Anguko and Sylvia Nalubowa, two women who died while giving birth. The activists claim that Uganda’s government is failing to fulfill fundamental rights guaranteed under the Constitution, resulting in an epidemic of preventable deaths of women. Constitutional Court dismissed the petition in 2012, on the grounds that the Court lacked standing to hear the case on its merits. CEHURD appealed to the Supreme Court (Constitutional Appeal No. 1 of 2013) and on September 30 2015 the Supreme Court ruled that Constitutional Court’s dismissal was incorrect, and must hear the petition.

More than 16 women die daily in Uganda from preventable causes including hemorrhage, sepsis, unsafe abortion, obstructed labor, and pre-eclampsia. There has been no statistically significant decrease in maternal mortality in Uganda for the last eight years (source: Uganda Demographic and Health Survey 2016 Key Indicators Report, page 58). Uganda’s severely high rates of teenage pregnancy also contribute to preventable maternal deaths—25% of young women 15-19 in Uganda is pregnant or a mother, one of the highest rates in sub-Saharan Africa, a statistic that has remained unchanged since 2006 (source: Uganda Demographic Health Survey, 2016).

The primary defense argued by Government over the last 8 years the case has been in Court is that Uganda is too poor to fight maternal mortality effectively. Recent evidence contradicts that claim: the FY2019/20Appropriations Bill contains a 20.9% expansion in the overall budget compared with FY2018/19. The increase is largely for Security (increasing from 6.3% to 9.3% of the budget) and Works and Transport (increasing from 14.6% to 16.2%). The Health budget share shrinks from 7.1% to 6.4%. By contrast, “Classified Expenditure and Assets” increased dramatically from UShs 934 billion in FY2018/19 to UShs 2.582 trillion in FY2019/20—the same size as the entire health budget.

Compounding the crisis caused by government under funding, are a series of recent policy shifts. In 2018 Government shut down free maternal health care services provided by Mulago National Referral Hospital, and instead opened a USD25 million super specialized private women’s clinic with no public wing. The private hospital charges exorbitant user fees most pregnant women cannot afford. Although government a decade ago pledged to provide emergency maternal health care services at local level by equipping Health Center IVs with the surgical theatres, health workers and commodities needed to save pregnant women’s lives, that promise has been broken, forcing pregnant women to rely on the national referral hospital.

The corrective actions being sought through this Constitutional Court Petition would help remedy these gross inequities, according to the advocates. “Deaths from maternal mortality could be largely eliminated in Uganda,” said Noor Musisi of CEHURD. “What we are missing is political will.”

Contact: Noor Nakibuuka Musisi, CEHURD 0782 496 681 or Asia Russell, Health GAP 0776 574 729

What a shame! Stealing from the sick?

What a shame! Stealing from the sick? – Nakibuuka Noor Musisi

On the evening of June 17th 2019, I fell short of words. For the first time I watched television past 11:00pm. It was a shocker watching what I refer to as “a well-planned game” happening in my country, moreover in the health sector. I thought to myself, who is behind this, why steal from the sick? All these questions and thoughts ran in my mind. I waited to get responses from the video in vain. What a shame!

Efforts to put an end to this vice have been watered down by the government’s non responsive attitude towards clear evidence like the famous NBS /BBC video titled “stealing from the sick”  It is unfortunate that Uganda has shamelessly remained silent over this the ordeal, an indicator, in my opinion that the State has failed to account back to its citizens.

I have worked in the civil society health – human rights sector for close to 10 years. Throughout these years, I have interacted with various civil society organizations, government entities, private actors and development partners among others. These have had various approaches towards ensuring that the end beneficiary whom I will refer to as a rights holder does access better health care services wherever they are. The approaches used have been budget advocacy, trainings, human rights-based approach empowerment of communities to seek services, holding district health assemblies, talk shows, community dialogues, community score cards to mention but a few. While these approaches seem diverse, they all point to ensuring that service provision gets better, that you and I enjoy health care in this country.

On several occasions, and for this particular ordeal, social media has been used by people to express their dissatisfaction.  It is such a powerful tool that information does not only reach a wider part of society (nationally and globally) but the target people. I am very certain that the leadership in this country did view, read and analyse the video as well as reactions from people. My expectation was that the state would act. Unfortunately, to date, we have not received a formal communication from the government on what happened and why. What this means to me is that the state has breached the contract it has with its citizen- the social contract. What a shame!

Like any other citizen, and as a health service user as well as a rights holder, my so many questions have never been answered. I am hesitant to conclude that sections/ agents within the government are involved in stealing our medicine- we the sick. What a shame! Again, one would be hesitant to question why the investigative team was rather stopped (the video is not complete), put under police custody and no case has ever been opened against them.

These happenings have a very huge impact to the health sector now and in the years to come. I am certain that Uganda has all the expertise, resources and tools to put these vices to an end. It is very unfortunate that as a country we are silent yet health facilities have continued to deteriorate at the expense of these few people. Shame my beloved country, shame my government, shame, shame shame!!!. There is still room for improvement, something can always be done and this call goes out to the State to act.

The writer is a human rights advocate and a lawyer at the center for Health, Human Rights and Development (CEHURD).

Public shaming of women; an issue of Violence against Women!

Public shaming of women; an issue of Violence against Women!

On the evening of 11th July 2019, the public was startled by a confrontational sermon by Pastor Bugingo of House of prayers ministries that went viral on different social media platforms. In the sermon, the renowned pastor shamed his ex-wife and mother of his children over a disease she had had for close to ten years while the congregation cheered on. This unfortunately is a buildup on many other stories that are left in passing and continue to be normalized in Uganda today.

The World Health Organization (WHO) defines Violence against Women (VAW) as any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.  Violence against Women takes different forms including; Intimate partner violence which may be physical, sexual, and emotional abuse; forced and early marriages; female genital mutilation and trafficking. In Uganda today, Violence against Women is reported as remaining on the high with more than 51 percent of women experiencing physical violence where intimate partners are reported as the largest number of perpetuators at 60 percent (Uganda Demographic and Health Survey of 2016 reported).

While different players are key in fighting the vice of public shaming of women, the state has the obligation to protect women from these violations as indicated under section 128 (3) of the Penal Code Act, Cap 120 that clearly stipulates  that “any person who, intending to insult the modesty of any woman or girl, utters any word, makes any sound or gesture or exhibits any object, intending that such word or sound shall be heard, or that such gesture or object shall be seen by such woman or girl, or intrudes upon the privacy of such woman or girl, commits a misdemeanor and is liable to imprisonment for one year.” Furthermore, section 179 of the Penal Code Act, Cap 120 states that “any person who by print, writing, painting, effigy or by any means otherwise than solely by gestures, spoken words or other sounds, unlawfully punishes any defamatory matter concerning another person, with intent to defame that other person, commits the misdemeanor termed libel.”

Public shaming of women can never become the new normal as it’s not only a violation of human rights but also has grave effects on survivors (psychological consequences, vulnerabilities to diseases), children (injuries to children) and society (added health care costs).  

Joselyn Nakyeyune

Program Officer, Center for Health, Human Rights and Development (CEHURD).


It is mid-year now and children are in school for their second term, parents have paid school fees and some are completing the school fees balances. However there are some students who have not reported this term, for being pregnant, stigma or acquired diseases and some were expelled due to sexual violence accessioned to them while at school.

Some of these Children are below the age of 18 years, therefore they cannot consent to any sexual act or violence, in law, this is termed as defilement. In Uganda this vice is on rise especial in school, where teachers and their support staff continuously sexually abuse young girls placed under their care.

In the report or study of ministry of Education and sports, clearly indicated that 69.1 of children in private schools have been defiled by their teachers. If the said children do don’t drop out of schools, their performance declines because of psychological torture, stigma hence poor grades.Mostof these children are in boarding schools where their parents placed them under the care of school authorities.

Article 34(1) of the Constitution of the republic of Uganda gives the parents and school authority a constitution right to care for the children under their care. This has not been the case where many children are sexually  abuse in the school premises, sometimes children are silenced which affect them physiologically, emotional, leading to low grades or performance  which fact the teachers and parents in most cases do not realized in  early days.

 Under Article 34(4) of the Constitution of the republic of Uganda, provides that children are entitled to be protected from social or economic exploitation …’ Many Schools have failed to protect young girls while at school from being sexually abused, this is mainly because of system gaps, which ministry of education has continuously failed to regulate.

Further Ministry of Education has not put in place any mechanism of helping the young girls receive psycho social support or made any effort to follow up that these girls who have been sexually abused while at school are supported to continue with their education, and or are compensated by the school authority and the perpetrator.

 Under Article 34 (2) requires the State responsibility for children to receive basic education, by its failure to supervise both private and government schools to improve school environment which leads to sexual violation is a clear indicator of the government’s role and responsibility to see to it that all children get the basic education.

The Government’s failure to punish school authorities where this vice is found has  led to the wide spread of the same leading to many girls get un wanted pregnancy, school drop outs , HIV/ AIDS , low or poor performance .

In Conclusion, this is a call to all school authorities and the government to create an environment where children under their care are protected from any abuse for their well being, growth and better performance.

By Ms. Namaganda Jane

Program Associate at Center for Health, Human rights and Development (CEHURD).

Has the Government and the Judiciary failed to protect the women against the increasing maternal deaths?

For the preceding eight years, CEHURD (Center for Health, Human Rights and Development) a company limited by guarantee and established under the Laws of Uganda, has brawled tooth and nail to ensure that the government is accountable for its mandate under the 1995 Constitution of the Republic of Uganda, as amended. In 2011, the organization filed a public interest case in the Constitutional court under Constitutional petition 16 of 2011 questioning the multiple maternal deaths in Mulago hospital, a government established hospital, due to the reckless and negligent behavior of health workers and the limited medical machinery necessary to assist pregnant mothers with complications.

The Attorney General of the Government, stating that it was a political question doctrine, dismissed the first hearing on a preliminary objection. The political question doctrine is a ghost that has been haunting the Ugandan legal system and it was first encountered by the Constitutional court in Exparte Matovu, a 1966 decision which was challenging the Constitutionality of Obote’s government and the pigeon hall Constitution. Since then, until 2013 however, whoever questions performance of activities by government or any governmental institution is dismissed from continuing the process on grounds that the government is accountable to no one and the courts cannot question the performance of its activities.

However, in 2013, Justice Esther Kisakye gave a landslide ruling on behalf of the Supreme Court in Constitutional Appeal No.1/2013 that has formed such good jurisprudence for the Ugandan judicial limb. The court stated that the government could not hide behind the political question doctrine and fail to give accountability for the roles that were assigned to it since the constituent assembly sat in 1995 to promulgate the Constitution.

The learned justices made reference to Uganda’s broad obligations under international law such as the International Covenant on Economic, Social and Cultural Rights of 1966, The Maputo Protocol 2003 and the International Covenant on Civil and Political Rights 1954, which provide that the government ought to show a fulfillment of a ‘minimum core’ obligation towards all of its duties. It thus directed the Constitutional court to hear the merits of the case and determine whether the government has actually fulfilled its minimum core obligation as regards the inconsistencies pointed out by the petitioners, this was with regard to the decision in Government of the Republic of South Africa and others V Grootboom May, 2000.

It has taken the Constitutional court five years to adhere to this Supreme Court directive and we finally got a hearing date for 13 June 2019, after years of beavering to get a hearing date. This was a major delight and ecstasy for the organization as a whole, the affected mothers, victims and well-wishers. Various media houses rejoiced with CEHURD and a social media campaign commenced, stating that the delay to hear that case has led to an increased number of maternal and child deaths especially in government institutions.

Two weeks prior to the hearing, the team worked tirelessly to compile a list of authorities, make copies of all the volumes of our documents and file our substantive arguments and submissions.

At 8:00 AM on the 13th day of June 2019, the whole team effortlessly grasped the throng of documents and volumes required for the hearing and paraded to court. Our voyage was combined with heavy down pours of rain that intensified the traffic on the roads but by the grace of God, we were able to arrive at TWED Towers, in Kampala and we were settled by 9:00 AM to await the judges to make a determination as to when our case would be heard. The courtroom was filled to capacity as students, advocates, the public and nonprofessionals sat tolerantly to hear the substantive arguments for the eight yearlong case. Majority of the public had no space to sit but they stood and awaited the proceedings.

As expected, the judges arrived at their expediency, an hour and a half later and our case was slotted for 2:00 PM. To add salt to injury, when the time for our case hearing came, it began at about 3:00 PM and the Attorney General, representative of government, asked for a month’s adjournment because they were not equipped for the submissions. The five panel bench willingly granted this adjournment and the case was slotted for 17 July 2019.

This came with a horde of disenchantments owing to the mounting success of maternal and women rights as well as the unremitting struggle to launch the aspects of health and the law into our Ugandan system. For the past four months, various reports and media coverages have been trickling in concerning a number of maternal and child deaths from Mityana Hospital and on 11 June 2016, there was a report on the death of Sylvia Nantongo, a 19 year old who died while giving birth due to the negligence of the health workers.

These have been a few of the multiple reports that have been made since 2017 on the increasing rates of maternal deaths in the country. This questions whether the government essentially takes keen interest in protecting the maternal functions of women and their rights in society as guaranteed under Article 33 of the Constitution. Additionally, there were concerns about the Constitution of the bench. There was only one lady on the bench yet these are very sensitive and important issues to the society we live in.

A four-man panel cannot effectively make a determination of maternal health law issues when they do not have a clear understanding of the nitty grities involved with child birth and thus, a need to get a more constitutive panel of females that will be able to understand the plight of the mothers and the urgency of the issues.

Until this is done, am afraid the written law concerning the rights of women and their maternal functions in society will remain on paper and the practicability of seeing justice delivered in this respect, will continue to be deferred and create peril for the lives of both women and girls in this our Uganda. Something needs to be done more proactively!   

Authored by Khanani Daniella, intern at CEHURD.