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Solange Ngo Yebga

*Full article is in French

English abstract: The notion of civil society became popular and generalized in Africa during the 1990s, through the initiatives of international bodies like the World Bank and agencies for international development. In Cameroon, the economic recession caused by the deterioration of exchange rates and falling prices of agricultural raw materials (coffee, cocoa, and co on) has favored the emergence of these actors alongside the state in managing and improving the living conditions of those urban populations. In the field of reproductive health, civil society, through associations, is pursuing public orientation through services of education, promotion, and diffusion. Observing the Association for the Struggle against Violence against Women (ALFV in French) ALFV and Women, Health, and Development in Sub-Saharan Africa (FESADE in French) shows how a health policy is operationalized via endogenous initiatives. This research, which is mainly empirical, was conducted between 2006 and 2009 with institutional health managers and managers of associative structures in Yaoundé and throughout Cameroon.

Spanish abstract: La noción de sociedad civil se populariza y vulgariza en África hacia los años 90 bajo la iniciativa de instancias internacionales como el Banco Mundial y las agencias de desarrollo. En Camerún, la recesión económica debida a la caída de las tasas de cambio y a la baja en las materias primas agrícolas (café, cacao, algodón) favoreció la emergencia de dicha sociedad paralelamente al Estado en la gestión y mejoramiento de las condiciones de vida de las poblaciones urbanas. Por ejemplo, en el campo de la salud reproductiva, la sociedad civil, en la forma de asociaciones, lleva a cabo acciones públicas a través de los servicios de educación, promoción y difusión. La observación de los ejemplos de la Asociación para la Lucha contra la Violencia contra la Mujer (ALVF en francés) y de Mujer, Salud y Desarrollo en el África subsahariana (FESADE en francés) permite ver cómo se operativiza una política de salud a través de iniciativas endógenas. Esta investigación esencialmente empírica fue desarrollada entre 2006 y 2009 con los responsables institucionales de salud y con los responsables de las estructuras asociativas de Yaoundé y Camerún.

French abstract: La notion de société civile se popularise et se vulgarise en Afrique vers les années 90 à l'initiative d'instances internationales comme la Banque mondiale et des agences d'aide au développement. Au Cameroun, la récession économique due à la détérioration des termes de l'échange et à la chute des prix des matières premières agricoles (café, cacao, coton) a favorisé l'émergence de cet intervenant aux côtés de l'Etat dans la gestion et l'amélioration des conditions de vie des populations urbaines. Dans le domaine de la santé reproductive, la société civile, sous la forme d'associations par exemple, poursuit les orientations publiques à travers des services d'éducation, de promotion et de diffusion. En observant les exemples de l'ALVF et de la FESADE, nous étudions comment s'opérationnalise une politique de santé à travers des initiatives endogènes. Ce e recherche, essentiellement empirique, a été menée entre 2006 et 2009 auprès de responsables institutionnels de santé et de responsables des structures associatives à Yaoundé et dans d'autres villes du Cameroun.

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Reproductive Governance in the New Europe

Competing Visions of Morality, Sovereignty and Supranational Policy

Joanna Mishtal

While the European Union currently lacks a mandate to govern reproductive health services and policies, reproductive governance is increasingly debated both at the EU and the nation-state levels. The EU has taken formal positions to promote access to comprehensive reproductive health services. In tension with the EU's position is the Vatican, which promotes the use of conscientious objection to decline the provision of certain health services. Currently, the use of conscientious objection is mostly unregulated, prompting debates about supranational regulation at the Parliamentary Assembly of the Council of Europe (PACE) meeting in Paris in 2010. This article uses the lens of the PACE meeting debate to consider the cultural, historical and political specificities and agendas that give shape to competing arguments about rights, health and state sovereignty. I argue that political rationalities directed towards reproduction locally and the supranational rights debates work synergistically to paralyse European reproductive health policymaking.

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Joan Njagi

The use of helplines to deliver sexual and reproductive health (SRH) education to girls seeking such information and services can break down barriers created by low access and top-down approaches. However, it is important to interrogate their effectiveness in addressing the SRH needs of girls, particularly in contexts in which hierarchical social relations prevail and conservative religious and cultural norms dictate appropriate expressions and experiences of sexuality for girls and young women. In this article I use data drawn from a qualitative case study of a children’s helpline in Kenya to interrogate the interplay of power and culture in the delivery of SRH information to girls. The findings reveal that while this particular communication technology presents, potentially, a revolution in such delivery, power dynamics and cultural norms still pose barriers.

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Too Little, Too Late?

The Challenges of Providing Sexual and Reproductive Healthcare to Men on College Campuses

Lilian Milanés and Joanna Mishtal

Scholarship and advocacy work regarding reproductive health have often focused on women’s experiences. Concerns about men’s sexual and reproductive healthcare (SRH) have historically been on the margins in this context. In the United States, young men are at the greatest risk for sexually transmitted infections (STIs), yet are the least likely to seek SRH. Based on research with 18 healthcare providers in a large public Florida university clinic, we examined providers’ perspectives about expanding men’s SRH provision and utilisation. Research findings demonstrate inconsistent provider strategies in treating men’s SRH needs and a clinical environment that has low expectations of men receiving preventive care, further perpetuating the placement of SRH responsibility upon women. This article contributes to applied and medical anthropology scholarship on health inequalities through its discussion of the challenges and barriers that contribute to poor SRH for young men and the critical role of providers in this context.

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‘I’m Not that Kind of Doctor’

On Being In-Between in a Global Health Intervention

Erica Nelson

Within multi-disciplinary global health interventions, anthropologists find themselves navigating complex relationships of power. In this article, I offer a critical reflection on this negotiated terrain, drawing on my experience as an embedded ethnographer in a four-year adolescent sexual and reproductive health research intervention in Latin America. I critique the notion that the transformative potential of ethnographic work in global health remains unfulfilled. I then go on to argue that an anthropological practice grounded in iterative, inter-subjective and self-reflexive work has the potential to create ‘disturbances’ in the status quo of day-to-day global health practice, which can in turn destabilise some of the problematic hubristic assumptions of health reforms.

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Did Policy Change Work?

Oregon Women Continue to Encounter Delays in Medicaid Coverage for Abortion

Bayla Ostrach

Women in poverty experience greater delays in the process of seeking abortion. Timely access to both safe abortion care and early prenatal care reduces morbidity and mortality among pregnant women. This article examines the impacts of a policy change intended to facilitate poor women's applications for pregnancy-related Medicaid (a federally funded, state-administered health coverage programme for the poorest Americans), in Oregon (Western U.S.). The mixed-methods data from this applied anthropology study demonstrate that though health coverage waiting times grew shorter on average, poor women and the clinic staff who cared for them continued to perceive delays in obtaining Medicaid coverage for abortion. Implementation of the Affordable Care Act in the U.S.A. (aka Obama-care) is now thought to be contributing to a return to greater delays in accessing prenatal care and abortion. More research and advocacy are needed to improve access to reproductive health care through state Medicaid programmes.

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Growing Up a Girl in a Developing Country

Challenges for the Female Body in Education

Mathabo Khau

Girls' reproductive health matters are an important factor in their equal participation in educational settings. However, many girls worldwide still face challenges to participating fully in education because of the lack of supportive structures for their health needs. This paper uses autoethnographic writing to highlight some of the challenges that girls meet in school because of menstruation. It also discusses how a teacher's lived experiences of girlhood can change how she practises her teacher-hood in relation to girls' reproductive health. I argue that teachers' lived experiences are an invaluable resource in curricula- and policy-making procedures that are formulated to better recognize the particular concerns of girls and young women.

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Reports

Publications, Films and Conferences

Jennie Doberne, Danila Mayer, Soheila Shahshahani and Jocelyn DeJong

PUBLICATIONS

Stein, Rebecca L. (2008), Itineraries in Conflict: Israelis, Palestinians, and the Political Lives of Tourism (Durham, NC: Duke University Press). ix + 219 pp., notes, bibliography, index.

FILMS

Iranian Travelogues: Notes on Farhad Varahram, Iranian-Austrian Documentary Filmmaker

CONFERENCES

‘Thirty Years On: The Social and Cultural Impacts of the Iranian Revolution’, University of London, School of Oriental and Asian Studies (SOAS), 5–6 June 2009

Reproductive Health Working Group Annual Meeting, Istanbul, July 2008

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Sexy Health Carnival

One Small Part of Indigenous Herstory

Alexa Lesperance

Aanii! I am an Anishinaabe woman from Naotkamegwanning First Nation in Northwestern Ontario. I am a sister, cousin, bear (from the bear clan), friend, and auntie, and, as part of my many roles, I’m also a Youth Facilitator at the Native Youth Sexual Health Network (NYSHN). This is a by and for Indigenous youth organization that works across issues of reproductive health, rights, and justice, which is just another way of saying that we support community and youth awesome-ness!

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Anthropological Engagement at a Global Women's Health Conference

A Report on the Women Deliver Conference, Kuala Lumpur 2013

Margaret MacDonald, Debra Pascali Bonaro and Robbie Davis-Floyd

This past May a major international conference called Women Deliver took place in Kuala Lumpur, Malaysia. Women Deliver is a relatively new but significant force in the international reproductive health arena. Since its first conference in 2007 in London with 1,500 attending, it has rapidly grown in size and reputation. The second conference took place in Washington DC in 2010 with 3,000 attendees. Women Deliver Kuala Lumpur was the biggest conference of the decade devoted to women’s and girl’s health and well-being; it brought together 4,500 people from hundreds of organisations in 149 countries around the world, including heads of state, ministers of health and women’s issues, major UN agency representatives, non-governmental organisations, scientists and scholars, major donors (including Melinda Gates and Chelsea Clinton), mainstream media, youth, filmmakers and even royalty.