Exposing and filling the gap in the South African Maternal, Perinatal and Neonatal Health (MPNH) policy in terms of maternal nutrition

Abstract

The right to the highest attainable standard of physical and mental health (the right to health) is contained in the International Covenant on Economic, Social and Cultural Rights (ICESCR) and its underlying determinants as well as interrelated factors were elaborated by the Committee on Economic, Social and Cultural Rights in its General Comment no.14.1 General Comment no.14 recognises maternal health generally and particularly maternal nutrition as an important aspect of the right to health.2 In this regard it states that maternal health (pre-natal and post-natal) should be among the national health priorities in the attainment of the right to health and thus includes it within the minimum core obligations of state parties to the ICESCR.3 As such, as a state party to the ICESCR, South Africa has an obligation to put in place measures through legislation and policy. Legislation and policy aimed at improving maternal health should address maternal nutrition which under General Comment no. 14 is stated as an underlying determinant of the right to health, thus maternal health. Maternal nutrition and health are known to be important in terms of the health of the child as well as the mother. The United Nations Children’s Fund (UNICEF) states that ‘during pregnancy, poor diets lacking in key nutrients – like iodine, iron, folate, calcium, and zinc – can cause anaemia, pre-eclampsia, haemorrhage, and death in mothers.4 They can also lead to stillbirth, low birthweight, wasting and developmental delays for children.’5 Clearly the science emphasizes the importance of maternal nutrition and this data is informative of the need to ensure a rights based approach to the provision of nutrients to pregnant women as a policy directive within the context of the rights to health. In South Africa maternal health is governed by the Maternal, Perinatal And Neonatal Health (MPNH) Policy. The MPNH Policy is a tool that can aid in the fulfilment of the right to health in South Africa in regard to maternal nutrition.6 However, the policy only refers to maternal nutrition in a brief and overviewing manner through Policy Statement 2.2.7 thus, creating gaps through its broadness. It should also be noted that the policy was published in 2021 and is now 3 years old.