West African Reproductive Health Costs An in depth study into associations between poverty and access to emergency pregnancy health care

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The relationship between reproductive health and poverty is widely acknowledged at the international level, as suggested by the inclusion of universal access to reproductive health among the targets for measuring progress towards the Millennium Developmen t Goals. Maternal and pregnancy-related health is an essential component of reproductive health and provides an appropriate vantage point from which to study the dynamics of reproductive health and poverty. Today, maternal mortality occurs almost exclusiv ely in poor countries, and the unequal life chances of women in rich and poor countries is mirrored by inequities between rich and poor women within countries. Poverty is both as a cause and consequence of such poor maternal health outcomes. The proposa l is for a multidisciplinary research project in Burkina Faso and the Gambia into the dynamic relationship between reproductive health and poverty, focusing on women's use of pregnancy care, including emergency obstetric care and post-abortion care. It bu ilds on and expands existing research collaborations between the research communities in both countries, the University of Oslo and the London School of Hygiene and Tropical Medicine. The project is timely and can feed into existing policy initiatives in both countries are seeking to protect women against the impoverishing effects of high healthcare costs relating to maternity care. A work programme consisting of two complementary studies will use policy analysis, case studies, in depth ethnographic and quantitative economic methods to provide an in-depth analysis of the relationship between poverty and pregnancy-related health. In the Gambia the focus will be on women's use of healthcare throughout pregnancy, while in Burkina Faso the focus will be on women's use of abortion-related care. The project will develop West African research expertise, contribute to the scientific literature and inform policy.