Applying a rights based approach in assessing maternal and child health services: a study of Nigeria and Ghana

Background: Maternal and child health (MCH) has been a major concern in public health for many years. One of the highest maternal mortality and Under 5 mortality rates in the world is found in Ghana and Nigeria. This study aimed to analyze how a human rights approach can be used to help address the different pathways that limits utilization of MCHS in Ghana and Nigeria using the CEDAW and CRC as references. Method: A systematic review of literature relevant to MCH in Ghana and Nigeria was conducted on sources retrieved through PubMed, Science Direct, The Lancet, and Google Scholar databases. Sources were selected for analysis based on the inclusion criteria and using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search yielded about 3023 studies, of which 95 studies were retained for analysis. Results: Government commitment, OOPE, various household factors (moms' education levels, ages, wealth quintiles, children's genders, and birth orders), autonomy, community variances as well as the use and affordability of MCHN services which revolve around mothers' decisions about their children's and own health were all found to be strongly correlated with MCH outcomes in Nigeria and Ghana. In order to realize transformative change, a human rights-based approach (HRBA) to the problem is necessary. This requires the government to fulfill its responsibilities as the major duty-bearer in the provision and enforcement of enhanced access, affordability, quality, and utilization of preventative and care health services as it relates to UHC towards tackling pathways to both MM and U5M. Conclusion: A HRBA also aims to realize women’s rights and especially SRHR to making decisions that will impact their health and the welfare of their children. Furthermore, disaggregated data must guide national and community interventions with an emphasis on assisting children from low-socioeconomic households. Giving women the freedom to make their own decisions (a gender-transformative approach) which tackles the power norms (patriarchy) present, implementing measures to empower and educate women.