In the following section, I will explore some of the significant trends in maternal health in recent decades and then discuss how and why maternal health contributes to women’s socio- economic status. This will provide an important foundation for my later discussion on the conditional impact that IMF programmes have upon maternal health.
Health is considered an investment into human capital which benefits individuals and society as a whole. Systemic gender inequality at a societal or governmental level has implications for female and maternal health care policy. Where adequate and appropriate health care for women not is provided, it is likely that there will be negative repercussions upon the wellbeing and thus the socio-economic status of women (Chirowa, Attwood and Van der Putten, 2013). Women as distinct from men, due to their different biological and physical makeup, have separate and additional health care needs. Specifically, women’s need for appropriate maternal health care is most important. Internationally, regions with greater gender equality have lower maternal mortality rates, and notably, more than 50 percent of all maternal deaths in 2008 occurred in just six countries, India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo (Hogan et al., 2010). However, these regions are also less industrialised and poorer. Poverty adds a further layer of complexity to the challenge of ensuring a healthy population and the majority of maternal death rates occur in poorer countries (Van Lerberghe and De Brouwere, 2001 and Kunst and Houweling, 2001). Industrialised countries cut their maternal mortality rates by 50 percent from 1900 to 1950, while the increased provision of neonatal health care, technological advances and access to
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midwives and medical professions at birth has resulted in historically low rates of maternal mortality leading into the twenty-first century (Loudon, 1992). It is clear that strategies such as increased provision of healthcare professionals and the usage of advanced medical technologies have had a huge impact in reducing maternal death overall (Jahn and De Brouwere, 2001). Trends in fertility rates have also much to tell, and there are huge differences between fertility rates of women in developing and developed nations. While Sub- Saharan fertility rates have lowered to five births per woman, in Europe and Central Asia fertility rates are less than two births per woman. While the provision of skilled health care professionals at birth is strongly correlated with lower maternal mortality, some less developed nations reach less than 10percent of the requirements in this area (World Health Organization, 2005).
Maternal health is an important consideration for women’s socio-economic status for a number of reasons. Firstly, inadequate levels of skilled birth professionals present at birth jeopardise the lives of many women and infants while failure to provide post-natal care and support can result in unnecessary infection or haemorrhaging of the mother or illnesses of the child. Such lack of medical care can result in women leading unhealthy lives post-partum, challenging their ability to enter or remain in the labour force, or ensuring their disability and thus dependency upon state or family. This contributes to a lowering of women’s socio- economic status. Secondly, recent studies suggest that the health and nutrition of the mother significantly impact the health of the foetus and the physical and cognitive development of the child in early years (Bradley and Corwyn, 2002). This has enormous implications for the socio-economic development of future populations, in particular, girl children. Unhealthy girl children may be viewed as a social and economic burden thus contributing to a worsening of women’s socio-economic status. Lack of cognitive development in girl children can generate additional reasons for families not to invest in education in them while also creating a further barrier for women in accessing the labour market as an adult. These factors contribute strongly to reducing the socio-economic status of women. Thirdly, studies also confirm that women who are oppressed, impoverished and ill-informed have the highest maternal morbidity and mortality rates (Bhatia, 1994). As such, women are kept in a cycle of continual poverty, lacking in real representation and influence, which guarantees the consistently low socio-economic status of women, leading to continued and heightened gender inequality. Maternal health is central to women’s socio-economic status representing the ability for women to remain healthy and be able to contribute to her home and community establishing her value and status. Importantly her health also allows her to improve her employment and income opportunities and her ability and propensity to access health care for herself and her family and thus increase her socio-economic status. The nuance of health requirements for women is lost through lack of ability to relate to or understand specific female health needs. The lack of female influencers – either at a policy or political level – ensures a failure to counter-balance male perspectives with female perspectives, who better understand their
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own health needs. This in-turn facilitates the continuous female dependency upon male family members who can contribute to women being seen as a social and economic burden when their health fails ensuring that women’s social status remains less than that of men. As such, it is then fundamental to my study to consider the interaction between IMF programmes and maternal health in the following section exploring my independent variable IMF Programmes.