Author:Sonja Merten (Swiss Tropical and Public Health Institute)
Paper short abstract:
Fertility practices, moral economies and gendered power dynamics on which a conditional cash transfer for birth spacing in Congo-DR is founded are explored. Particular women’s subscription to narratives constructed by the program and how, why and which women resist these constructions are analyzed.
Paper long abstract:
Following 'disappointing' rates of contraceptive uptake after decades of investment in family planning education and contraceptive availability throughout sub Saharan Africa, health and development program implementers are turning to 'new' market-based, demand-side strategies such as cash transfers conditional on the adoption of certain reproductive behaviors. These programs operate on principles and assumptions of neo-liberal moral economies, including economic benefits and the inherent 'good' of using contraceptives, making generalized assumptions of the ways in which women can and 'should' make decisions surrounding fertility, sexuality and their reproductive health. Programs are often implemented with little understanding of or consideration for the contexts in which fertility decisions are actually made and the real consequences of those decisions for women implicated in these programs.
Using both ethnographic and quantitative data, this paper explores the foundational gendered assumptions of and body politics constructed and promoted by a conditional cash transfer program in eastern Democratic Republic of Congo aimed at encouraging women to practice longer birth spacing intervals. Regional colonial histories of reproductive coercion and the consequences of the global north's changing attitudes towards fertility for women of the global south set the stage for analysis. Program emphasis on the realization of reproductive freedom through individual choice, divorcing fertility from its greater communal context and consequences, is considered. Specifically, this paper discusses the gendered bodies and practices that are promoted by these market-based strategies, how and which women adopt/subscribe to these narratives and how, why and which women resist them.
African Women Interpreting and Redefining Public Health in late 20th and early 21st century Africa