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1. Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries

Author:
Laurie Zephyrin, Molly FitzGerald, Munira Z. Gunja, and Roosa Tikkanen
Publication Date:
11-2020
Content Type:
Policy Brief
Institution:
The Commonwealth Fund
Abstract:
The U.S. has the highest maternal mortality rate among developed countries. Obstetrician-gynecologists (ob-gyns) are overrepresented in its maternity care workforce relative to midwives, and there is an overall shortage of maternity care providers (both ob-gyns and midwives) relative to births. In most other countries, midwives outnumber ob-gyns by severalfold, and primary care plays a central role in the health system. Although a large share of its maternal deaths occur postbirth, the U.S. is the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period.
Topic:
Health, Health Care Policy, Women, and Reproductive Health
Political Geography:
United States and Global Focus

2. Midterm Report: Early Lessons from the Hewlett Foundation’s Principled Approach to Supporting Local Advocacy

Author:
David Devlin-Foltz, Susanna Dilliplane, and Rhonda Schlangen
Publication Date:
09-2019
Content Type:
Working Paper
Institution:
Aspen Institute
Abstract:
In 2016, the William and Flora Hewlett Foundation launched a new grant-making strategy to support advocacy for access to family planning and reproductive health (FPRH) services in Sub-Saharan Africa. The goal: support vibrant African organizations able to positively influence their government’s FPRH policies and funding decisions. The strategy seeks to shift power towards the local civil society organizations (CSOs) doing the advocacy work and to strengthen their capacity to advocate. During the first five years of the strategy’s implementation, the Foundation is working with the Aspen Institute’s Aspen Planning and Evaluation Program to assess and learn from the experience of its grantees and the CSOs they support. This midterm report summarizes key findings and recommendations based on evaluation activities conducted in 2017 and 2018.
Topic:
Civil Society, Local, Advocacy, Family Planning, and Reproductive Health
Political Geography:
Africa and Sub-Saharan Africa

3. What Is the Status of Women’s Health and Health Care in the U.S. Compared to Ten Other Countries?

Author:
Sara R. Collins, Shanoor Seervai, Roosa Tikkanen, and Munira Z. Gunja
Publication Date:
12-2018
Content Type:
Special Report
Institution:
The Commonwealth Fund
Abstract:
Women in the United States have long lagged behind their counterparts in other high-income countries in terms of access to health care and health status. This brief compares U.S. women’s health status, affordability of health plans, and ability to access and utilize care with women in 10 other high-income countries by using international data.
Topic:
Health, Health Care Policy, Women, and Reproductive Health
Political Geography:
United States and Global Focus

4. Understanding the Links Between Sexual and Reproductive Health Status and Poverty Reduction

Author:
Nata Duvvury and Philip Oxhorn
Publication Date:
01-2012
Content Type:
Policy Brief
Institution:
Institute for the Study of International Development, McGill University
Abstract:
The interrelationship between poverty and sexual and reproductive health status (SRHS) is widely noted in academic, policy and programmatic discourses, though none establishes causality. The primary emphasis in these discourses is that poor SRHS is an outcome of poverty, and thus can be addressed through poverty reduction programmes. The purpose of this brief is to understand what factors contribute to the interrelationship between SRHS and poverty, with a specific focus on understanding how SRHS impacts household poverty. Future studies may then focus specifically on these factors in order to address issues of causality. This brief is based on desk research involving two sources of data: 1) a review of global literature and 2) three country case studies. The global literature review examined literature documenting the nature, extent and strength of the interrelationship between poverty and SRHS. The literature search was conducted using keywords from different disciplinary perspectives demography, economics, development, women’s studies, sociology, human rights and public health. Key databases such as JSTOR, PubMed, MEDLINE and Elsevier Science Direct were consulted, as well as the specific library databases at National University of Ireland, Galway and McGill University. Researchers at McGill compiled an annotated bibliography of literature on India. The three country case studies were undertaken in Brazil, Ghana and Lebanon. Consultants in each country undertook an extensive search of academic, policy and programmatic literature including journal publications, research reports, policy briefs, and non-governmental organization (NGO) reports. The literature search in each country followed the same method as the global literature review, including identifying keywords from different disciplines and exploring different databases. In addition, the consultants searched grey literature through contacting various NGOs and research institutions. They also obtained statistical information from governmental and institutional databases. All country case studies explored three key questions: 1) Is there literature that demonstrates the impact of poor SRHS on poverty? 2) What factors have been highlighted in the literature as influencing the relationship between SRHS and poverty? 3) Are there trade-offs involved for women between education, fertility, status and work participation? and 4) Do programmes by civil society organizations, such as micro-credit or income-generating programmes, promote sexual and reproductive health?
Topic:
Development, Education, Poverty, Health Care Policy, and Reproductive Health
Political Geography:
Africa, Middle East, Brazil, South America, Lebanon, and Ghana

5. Case Study from Brazil Gender Equality, Sexual and Reproductive Health, and Poverty Reduction: Understanding the Links with Economic Growth and Improvements in Household Income

Author:
Rosana Heringer
Publication Date:
01-2012
Content Type:
Policy Brief
Institution:
Institute for the Study of International Development, McGill University
Abstract:
The general understanding about the status of women in Brazil show a reality of many advancements in many aspects, however not always followed by equivalent outcomes in terms of the status of women in private space. This means that women in Brazil have experimented increased education levels and increased presence in the labor market. However, Brazilian women are still subjected to prejudice and discrimination when it comes to their role in domestic space, playing a subordinate role in relation to husbands and other male roles in the family. This also has implications for the status of women in relation to sexual and reproductive health and rights and in terms of the participation of women in public sphere, including labor market and political participation. The status of women in the household, when subject to disrespect and lack of autonomy, leading to situations of economic dependence, unwanted pregnancy or domestic violence, to name a few, jeopardize the possibility of women developing themselves as independent citizens and with autonomy to participate in economic life. Although having recently elected the first woman president in the country, Brazil has also a low record when it comes to the political participation of women. The number of women as elected officials in the country is among the smallest in the world, and has been growing slowly along the last decade. It is also important to say that the status of women in Brazil is highly marked by the differences among women themselves in aspects such as class and race or ethnic background. Black and indigenous women in Brazil face the biggest burdens in terms of access to rights, with implications to their well being and to their status in society. It is also acknowledged that class differences, representing the inequalities in terms of education, occupation and income have great influence in the situation of women.
Topic:
Gender Issues, Poverty, Income Inequality, Economic growth, and Reproductive Health
Political Geography:
Brazil and South America

6. Lebanon: An Overview Context, Evolving Demographics for Women, Sexual and Reproductive Health, Poverty and Women, Gender and Rights

Author:
Jocelyn DeJong and Sonya Meyerson-Knox
Publication Date:
01-2011
Content Type:
Policy Brief
Institution:
Institute for the Study of International Development, McGill University
Abstract:
Lebanon, a small middle-income country located on the eastern Mediterranean, is typical of many developing nations as it is undergoing demographic and epidemiological transitions with limited resources at hand, and yet unique due to its diverse population and long history of conflict. The conditions of Lebanese women are also fairly unique: A gender analysis Lebanon’s development indicators reveals that Lebanese women experience relatively high levels of health and education, but are lacking a commensurate presence in the public sphere. According to a Lebanese NGO, a “key problem is that gains in health and education have not translated into women’s economic empowerment, advancement in politics, or full equality under the law” (CRTD-A, 2006, p. 8).
Topic:
Development, Gender Issues, Human Rights, Women, Sexual Health, and Reproductive Health
Political Geography:
Middle East and Lebanon

7. A Case Study from Ghana: Understanding the Links between Sexual and Reproductive Health, Gender Equality and Poverty Reduction

Author:
Akosua K. Darkwah
Publication Date:
01-2011
Content Type:
Policy Brief
Institution:
Institute for the Study of International Development, McGill University
Abstract:
Ghana is an interesting case study for this project for two reasons. First, it has an anomalous reproductive health profile. The country has the lowest Total Fertility Rate (TFR) in West Africa and one of the lowest in the sub-region. As at 2008, the TFR for the country was 4.0, for urban areas it was 3.1 and for the Greater Accra area, the most urbanized part of the country, it was 2.5 (GDHS 2008). This is a quite rapid decline from a TFR of 6.4 children per woman as at 1988. Even more interesting is the fact that the Contraceptive Prevalence Rate (CPR) stood at a low 24% in 2008. Some scholars such as Grey and Blanc (2002) argue that abortion rates help explain the gap between the CPR one should expect given the low TFR and what actually pertains as measured by the GDHS. Abortion in Ghana, however, inspite of a liberal law, accounts for between 13% (Sedgh 2010) and 25% (Baiden 2009) of maternal mortality cases in the country. In other words, in Ghana if the assertions of Grey and Blanc (2002) are valid, a low TFR has been achieved at the peril of women’s lives, quite contrary to what one would expect if reproductive health concerns were addressed systematically in the country. Second, the country exhibits quite some discord between its policies and its practices. Over the years, Ghana has been influenced and positively impacted by the global regimes in first Family Planning and later Reproductive Health. It joined the UN system of Population Censuses in 1960 and was an African Pioneer in the development of official Population Policy. It has an illustrious son, Fred Sai who is well known in international circles for his work on Reproductive Health. Fred Sai was the president of the International Planned Parenthood Association during the International Conference on Population Development (ICPD) held in Cairo in 1994 at which the conceptual shift from a narrow emphasis on family planning to the much broader notion of Reproductive Health was made. As president of such a key institution, he was instrumental in the processes that led to this effort and worked tirelessly to ensure that the Ghanaian State in its policies and practices reflected the conceptual shifts from Population Control to Reproductive Health. Two years after ICPD, the Ghanaian Reproductive Health Service Policy and Standards were developed and revised in 2003 to incorporate sexual health and gender based violence.
Topic:
Development, Gender Issues, Poverty, and Reproductive Health
Political Geography:
Africa and Ghana