Reproducing Inequities: Poverty and the Politics of Population in Haiti

Studies in Medical Anthropology

by M. Catherine Maternowska, Paul Farmer (Foreword)

Residents of Haiti-one of the poorest and most unstable countries in the world-face a grim reality of starvation, violence, lack of economic opportunity, and minimal health care. For years, aid organizations have sought to alleviate the problems by creating health and family planning clinics, including one modern (and, by local standards, luxurious) center in the heart of Cit Soleil. During its height of service in the 1980s and 1990s, the clinic boasted nineteen staff members, an array of modern contraceptives, an accessible location, and convenient hours-but very few clients. Why did this initiative fail so spectacularly despite surveys finding that residents would like to have fewer children? Why don't poor women heed the message of family planning, when smaller families seem to be in their best interest? In Reproducing Inequities, M. Catherine Maternowska argues that we too easily overlook the political dynamics that shape choices about family planning. Through a detailed study of the attempt to provide modern contraception in the community of Cit Soleil, Maternowska demonstrates the complex interplay between local and global politics that so often thwarts well-intended policy initiatives. Medical anthropologists, she argues, have an important role to play in developing new action plans for better policy implementation. Ethnographic studies in desperate, dangerous locations provide essential data that can point the way to solutions for the dilemmas of contraception in poor communities worldwide.  

Genres: Nonfiction, Anthropology, Gender, Academic

256 pages, Paperback

First published September 27, 2006

Reviews

[Antoine McGrath · Rating 5 out of 5]

An anthropologists findings from years within Cite Soleil; Haiti's poorest shanty town.
Maternowksa not only dissects the structure of partner relationships in Haiti, but the process of receiving aid and family planning. This book explores why family planning and other forms of aid have failed to improve life within Haiti and is a must read for all those interested in providing aid to Haiti.
We hope that Haitians, Maternowksa, and colleagues have all survived todays earthquake and will be safe as the infrastructure is restored.

[Sovatha · Rating 4 out of 5]

Political Economy of Fertility (PEF) is what the author used to explain the question of why reproductive health initiatives in Cite Soleil, an impoverished slum area in Haiti, have not been successful. The USAID has determined that Haiti has a problem. Its population kept increasing, and that's the what prohibits growth. So the USAID has directed their assistance towards addressing this problem, and this problem only. The problem with that approach is that it lacks an integrated approach to solving the population problem in Haiti. It's not that people don't have to have less children, but it's the social, economic & political systems that they are in that made them have many children. That's the explanation the author provided. So in order to solve population issues in Haiti, development interventions need to incorporate those social, political, and economic problems into their initiatives. In terms of ethnographic information, we can learn a few things about Haiti such as gender relations, men & women roles in a union, courtship, sexual relations, doctor-client interactions at a clinic, and a bit more on lives in that poor slum area. There's also information on the historical context that led to the establishment of Cite Soleil. However, it's important to remember that this is a case study of Haiti which does not reflect the whole country in general. What we learn about reproductive health issues in Cite Soleil might not be applicable to other places in the country.

[Jenna Garrett · Rating 4 out of 5]

I read this book for a class on qualitative research. It was one of the first serious ethnographies I had read, so it took me a while to get used to the anthropological terminology, but I really really enjoyed it. I found it accessible to a non-anthropologist and of course fascinating given it is about my field - reproductive health in developing countries. The main purpose is to explore the family planning paradox in Haiti - a country with the highest birth rate in the western hemisphere, where women seriously struggle to provide for the families they have and seem unable to access/use effectively modern methods of contraception. A must read for anyone working in this field - though specific to Haiti, the stories and lessons here certainly have relevance in other developing countries in LAC.

[Shelly · Rating 3 out of 5]

This book was rather biased and despite the author's role as a researcher and a cultural anthropologist, failed to really give the reader any good sound conclusions or assessments.