Paper short abstract:

Reproductive health as an apical dimension in anthropopoietic processes. Anthropology as a discipline - a bridge between services and the universe of values of individuals and communities. Fieldwork in communities to renegotiate the very postulates of humanitarian work in "generative" health

Paper long abstract:

The neonatal, infant and maternal mortality rates in Sub-Saharan Africa and the impact on the resilience processes of societies are still unacceptably dramatic.

A solid experience in the field of maternal and child health programs leads us to recognize the inadequacy of contrast strategies due to the lack of integration, into national health systems, of the cultural specificities defining health seeking behaviours. Anthropological knowledge and practices are still myopically considered ancillary tools within strategies whose epistemology and evaluation criteria are anchored to the cost-effectiveness of interventions and to global standards and guidelines.

Anthropology, applied in its various declinations, is thought to become a key tool in daily work with communities, involving attention to social structures across generations, dynamic contexts, the relationships that define individuals’ agency and autonomy in decision-making processes.

Conscious choices that go in the direction of the universal right to access health should move from a "service provision" oriented approach to welcome a circularity and syndemic interdependence of the reproductive health of African communities. This could even renegotiate the lexicon towards a "generative" health, which recognizes the community as responsible and empowered actors.

Practices drawn from the authors’ experience will illustrate operating methods and their consequences in terms of impact of community choices on “generative health”. Moreover, it will also validate the work of analysis and revision of the assumptions of the humanitarian operators towards a daily commitment, both in development and humanitarian settings, aiming towards a new ecology of generative health as conscious choice of communities.