A Historical Ethnography of Safe Motherhood Reserach and Policy

The proposed study will take a historically informed anthropological approach to trace the emergence of international attention to maternal mortality in 'developing' countries in the context of public health, starting with the emergence of dedicated initi atives in international health organisations since the 1950s, and of scientific, mainly epidemiological, study of maternal mortality and the evaluation of maternity services. The focus will be on the solidification of a 'global' social movement for safe m otherhood in the 1980s. The project will seek to trace how and why maternal health has come on and off the international public health agenda during these decades. The project will consider the global policy shifts that have characterised the field in the last two decades, including training of traditional birth attendants, screening of high-risk women, and provision of skilled birth attendance. It will examine how historical changes in the health policy process emerge. The safe motherhood field will be t hought of as a policy community, comprising a range of actors, including multilateral organisations, government donor agencies, academics, professional organisations and NGOs. Their representations and practices will be the focus of the project. The prim ary concern is not with the nature and extent of safe motherhood policies and whether they are effective, but rather about how maternal health been problematised as part of public health discourse. To address these issues, the project will draw on theoret ical insights from anthropology, science studies and policy studies to consider how normative claims are produced in research and policy to present particular ways of defining problems that privilege some solutions while precluding others. It will aim to interrogate how major shifts in discourse and policy within public health are made authoritative, and what the mobilising strategies are for giving policies their legitimacy.