Reproducing Inequities: Poverty and the Politics o

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.

M. Catherine Maternowska is an assistant professor in the departments of obstetrics, gynecology, and reproductive sciences as well as anthropology, history, and social medicine at the University of California, San Francisco.