The Politics of Global Maternal Health Initiatives
About the Project
This research is guided by an interest in understanding the impact of global maternal health initiatives on aid-receiving communities, which is poorly understood yet vital for the women and communities that are the targets of intervention. It seeks to answer the following research questions: What factors determine and shape global policies and initiatives for maternal health? How are global maternal health initiatives experienced by local women and their communities? And what do these experiences mean in both practical and symbolic terms?
This inquiry will contribute to scholarly debates concerning women's rights, namely the contestation over strategically-focused maternal health commitments and the broader goal of reproductive rights, and the impact of donor political priorities on social rights in the Global South. While some scholars (Maine and Yamin; Cook; Freedman) defend the global emphasis on maternal health promotion, others criticize it for its conservative, pronatalist character. This debate is vigorous and spans a number of disciplinary approaches, but has mostly endured in abstract, philosophical terms and has not been tested empirically. This research will fill this void. Given the levels of global commitment to Maternal, Neonatal, and Child Heath (MNCH) -- it was a prominent Millennium Development Goal and Canada continues to identify it as its top development priority -- it is imperative to assess global commitments in practice. It might be the case that while Western feminists cringe at the essentialist nature of commitments to maternal health, they are appropriate in practical terms, in that they are more politically neutral and easier to operationalize than reproductive rights.
The research will be guided by theory from two areas: feminist political theory and medical anthropology. The theoretical inquiry addresses conceptual problematics related to gender and maternal identity (Ruddick; Held; Young 1984; Stephens 2011), reproductive rights and social justice (Purdy; Meyers), social connections (Young 2011), social suffering (Kleinman, Das, and Lock 1997), and structure/ agency dilemmas (Farmer 2013; Erikson 2011; Johnson 2014). While this might appear to constitute an eclectic philosophical approach, these contributions combine to offer conceptual insights into theoretical imaginings of maternal identity (does the shared event of motherhood confer universal experience, identity, and meaning?), social and political solidarity (Churchill 2009; Deacon and Cohen 2011; Dean 1996; Scholz 2008) (can either a universal or divergent experience of motherhood provide a basis for cooperation across the North-South divide?), reproductive justice (of which maternal survival might only be one small piece) and global responsibility (what should relatively affluent governments and private donors do to address "remediable injustices" (Sen 2009: vii)). These conceptual problematics will provide philosophical context for the empirical research, which will be guided by the research questions indicated above.
The research will entail a political ethnographic study of donors (estimated 32 interviews in total), primarily Global Affairs Canada and the NGOs that are funded to establish partnerships with communities in Guatemala, in addition to the United Nations Population Fund, the World Health Organization and Pan American Health Organization (as global and regional policy generators), and the Bill and Melinda Gates Foundation. The research in Guatemala (estimated 60 interviews in total) will be community engaged participatory research. The empirical findings will guide policy assessment and theory re-development, which will make significant contributions to scholarly debate and development practice.