Poverty Reduction : Does Reproductive Health Matter?

Abstract

Funding for the reproductive health agenda agreed at the 1994 International Conference on Population and Development has fallen short of estimated requirements. In the changed funding environment, stronger evidence on the links between reproductive health and poverty reduction is needed. This paper reviews the evidence base on three reproductive health outcomes: early childbearing, maternal survival, and unintended pregnancy. Building on the "capacities" approach to poverty assessment advocated by Amartya Sen, this evidence is organized in a framework that includes health and education outcomes for mothers and children, as well as household consumption, and production effects. Generally speaking, the evidence on health effects is strongest, household well-being weakest, and education in between. Causal relationships are difficult to establish because reproductive health outcomes and other household-level explanatory variables are influenced by each other. An important finding is that relationships are context specific and that one cannot look at individual characteristics without reference to contextual variables. One reason why much existing research has not effectively addressed the effects of poor reproductive health on poverty is that studies have relied on survey data for a single point in time. Longitudinal surveys offer greater promise. Rather than propose new surveys, initial research could work with existing data resources. Research should focus on a country or countries where 1) there has been social and economic change over time, 2) rich-poor differences in reproductive health outcomes persist, and, 3) obtaining and working with promising datasets is feasible. Pursuit of causal relationships between poor reproductive health outcomes and poverty should not paralyze efforts to make better use of existing country-level evidence in Poverty Reduction Strategies and other documents that guide resource allocation.