Poverty Reduction : Does Reproductive Health Matter?

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.