Exploring the association between the constitutional right to health and reproductive health outcomes in 157 countries

Panel data from 157 countries, between 1970 and 2007, were used to study the associations between introducing an explicit and enforceable right to health into national constitutions and subsequent reductions in neonatal, infant, and maternal mortality and the probability of dying for adult women. The introduction of a right to health in a national constitution was significantly associated with subsequent reductions in neonatal and infant mortality rates. However, it was not associated with reductions in maternal mortality ratios and the probability of dying for adult women. The reduction in neonatal and infant mortality rates was large in countries with high scores for democratic governance, but approximately half as great in countries with low scores for democratic governance. The results suggest that introducing a constitutional right to health is likely to be an effective mechanism for improving infant health in countries with a high level of democratic governance. This health benefit is not seen in maternal and women’s health outcomes. There is an imminent need to translate the constitutional promise of a right to health into the improvement of maternal health for all in the era of the Sustainable Development Goals.