Patna HC orders state to probe denial of maternal healthcare, finds data inadequate


NEW DELHI – (PRESS RELEASE) On March 11th 2014, the High Court of Judicature at Patna held that the State of Bihar had not satisfied information requirements concerning the state of affairs in Health Centres in 38 Districts. For the district of Munger District, in which there are 9 Primary Health Centres, the Court made a directive that the District Judge, who is also the Chairman of the District Legal Services Authority, shall inspect the facilities in light of the absence of viable information provided by the State. This case, CHARM v. State of Bihar and Others C.W.J.C. No.10724/2011 focuses on the district of Munger, where health conditions are emblematic of the poor quality of medical services available to pregnant women throughout the state of Bihar. In March 2011 the Centre for Health and Resource Management (CHARM), along with its partner, the Human Rights Law Network (HRLN) filed a public interest litigation before High Court of Judicature at Patna (High Court) seeking accountability for denials of maternal health care, including safe abortion services, in the state of Bihar. On March 20, 2012 the High Court issued an interim order requiring the Bihar Health Secretary to provide an expense report that accounts for every rupee spent under the National Rural Health Mission. The CHARM petition argues that the Bihar government is obligated to ensure access to maternal health services under the Indian Constitution as well as international human rights law, and cites the recent decision by the Delhi High Court establishing the right to reproductive health in two other maternal health cases brought by HRLN. The CHARM petition is based on violations of the right to survive pregnancy and childbirth documented by HRLN during a fact-finding mission in Munger, including explicit non-compliance with the Indian Public Health Standards and the National Rural Health Mission’s service guarantees. Some examples of the government’s failure to ensure these guarantees cited in the petition include collection of fees by health officials for referral and registrations of pregnancy, even though such services should be free for pregnant women; dilapidated and unsanitary health facilities that lack electricity, toilets, running water, and blood supplies; failure to provide transportation for pregnant women needing to reach health facilities; and the unavailability of safe abortion services. Further, women in Munger are routinely unable to obtain cash payments guaranteed to them under national maternal health policies. The petition also alleges that the absence of a grievance redressal system denies women due compensation for violations suffered, and leaves no mechanism to provide feedback to the government that could result in reform. Notably, this petition argues for the first time that the failure to ensure access to maternal health care and safe abortion services constitutes a violation of the right to be free from cruel, inhuman and degrading treatment (CIDT) due to the foreseeable pain and suffering caused to pregnant women. HRLN’s attorneys argue that this right is particularly violated for poor women seeking maternal health care in Munger’s government health centers, as they are effectively “imprisoned” by poverty. Like pregnant women held in state custody, poor women in Bihar are also left without an alternative to relying on the government for reproductive health care, and as such, the denial of life-saving maternal health care to poor women in Munger’s health facilities constitutes a violation of the right to be free from CIDT. This case highlights the shortcomings of the government in implementing the program and addressing existing gaps. The order affirms the obligation of the government to respect, protect, and fulfil the right to access to maternal health care. HRLN will continue the fight in its battle to attain maternal healthcare justice for the women of Bihar. To read the full order, please visit below