The accessibility and quality of safe motherhood to female inmates at Juba Main Prison, South Sudan

Abstract

Most surprising fact is that South Sudan has the highest maternal mortality rate in the whole world, with only 2045/100,000 live births. Using a case study approach of Juba main prison PHC, this dissertation (apparently the first of its kind) examines the accessibility and the quality of safe motherhood among female inmate in Juba main prison Juba South Sudan (prison has a clinic) for those women who are either incarcerated and pregnant or those who already have before reaching reproductive age at Juba main (and, in this case study, they are serviced by Prison PHC and Juba main Hospital) and other private and NGO /Religious Hospital facilities in Juba Using the overarching Women’s Law Approach, the writer, himself a safe motherhood specialist of the Reproductive Health Association of South Sudan (RHASS), implements an effective combination of methodologies, including the Grounded and Human Rights Approaches, to highlight the gap between Safe motherhood and Government’s promises to realize this maternal health rights standard and its actual failure to do so which has resulted in increasing mortality rates for mothers among those in prison as well those who not in prison. This study data implements collection methods which encompass a gender- sensitive methodological approaches’ ( this methods including, research into the relevant literature and law on the subject and also based upon interviews and discussions with carefully selected women respondents, official and government members and key informants and clinic staff). All of this information is collected, sifted, analyzed and presented as evidence of the ‘lived realities’ of these unfortunate iii poor, illiterate and ignorant women. It was established that, while giving birth, many mothers die or suffer life-threatening injuries in the most appalling and avoidable of circumstances in prison or on the way to, from prison or at the few and often far-flung and under resourced clinics and hospitals to which they are forced to journey on motor cycle .One finds that this dire situation is mostly due to the Government’s apparent deliberate breach of its duty to realize the women’s right to maternal health care by, inter alia, failing to: build, maintain, properly equip or administer sufficient and affordable clinics, referral hospitals and waiting women’s’ shelters; build and maintain critical supporting road and communication infrastructure and failing to train compassionate but frustrated and helpless PHC staff members in basic midwifery skills. The investigator directly back to the alarmingly insensitive attitude of Government policy makers who boast about their services but blatantly refuse to deliver on numerous commendable health policies which are squarely grounded in numerous regional and international Human Right Instruments which have been ratified by the Government. They apparently feel safe in the knowledge that their .Employer cannot be held accountable for breaching its duty to realize the right to maternal health care because of its deliberate failure to make the right specifically justiciable either locally and internationally. Finally, the writer makes some worthwhile recommendations for both GOs and NGOs, including: undertaking immediate legal reform to make the right to safe motherhood health care justiciable; officially recognizing, supporting and enhancing the skills of traditional midwives whose valuable and critical services have already saved the lives of countless desperate mothers and the immediate purchase and deployment of ambulance motorcycles. These measures can be partly financed by NGO funds which are currently available to the prison PHC.