Capabilities, reproductive health and well-being

Abstract

Lack of reproductive health (or the health consequences of sexuality and reproduction) constitutes a significant deficiency in well-being in developing countries, yet the field is often marginalised within development studies. This paper explores whether applying Amartya Sen's capabilities framework to reproductive health may provide one means of bridging this gap. It asks whether it has advantages over prevailing approaches based on disability adjusted life years, which are disease-focused, or reproductive rights, which are often perceived as being too individualistic. The paper draws on analysis of three reproductive health problems, namely obstetric fistulae, maternal mortality and female genital mutilation, that occur disproportionately in developing countries. It argues that the capabilities approach offers an opportunity to address the social bases of health (including deprivation and poverty) and one class of societal claims to social justice. However, there are barriers to fostering the kind of cross-disciplinarity needed to undertake such research, which would combine the more technical orientation of economics and epidemiology on the one hand, with the more qualitative social sciences on the other. Even where such cross-disciplinarity can be achieved, however, there are both informational constraints and methodological challenges to illuminate health capabilities – as opposed to functionings as measured in quantitative surveys – in such a sensitive field.