Cairo Conference Research Articles

Rehabilitating Iraq: MH Priorities

Back to table of contents Previous article Next article From the PresidentFull AccessRehabilitating Iraq: MH PrioritiesMarcia Goin, M.D.Marcia GoinSearch for more papers by this author, M.D.Published Online:5 Sep 2003https://doi.org/10.1176/pn.38.17.0003Late in July I flew to Cairo, having been invited by the World Health Organization (WHO) to attend a conference July 28 to 30 organized by WHO and the World Psychiatric Association (WPA). The topic: mental health and rehabilitation of psychiatric services in Iraq.Seated around the conference table were experts from Afghanistan, Bahrain, Egypt, India, Islamic Republic of Iran, Iraq, Lebanon, Morocco, Pakistan, Saudi Arabia, Switzerland, Tunisia, United Kingdom, and the United States. The participants were informed and knowledgeable psychiatric leaders in their countries.What were we all doing there? Where does mental health fit into the hierarchy of survival needs of an occupied country with a massively damaged infrastructure?In Iraq, a nation the size of California beset by low-level guerrilla warfare, there are grave problems of security, economic instability with massive unemployment, power-grid failures, unsafe water, and a severely decimated health care delivery system. The pervasive looting of hospitals and health posts, down to copper wiring and pipe, has severely damaged one of the most advanced public health systems in the Arab world. While reconstruction efforts addressing this catastrophic situation proceed, mental health imperatives must also be given a high priority.Baghdad—the site of the world’s first psychiatric hospital (established in A.D. 753)—now, after 30 years of prolonged conflict and violence, faces an acute shortage of human and medical resources.There are long-term needs to increase the medical workforce, update medical training, and develop outreach to families and communities in urban and rural areas. A small measure of the breadth of the human problems was seen in Baghdad when 800 acute and chronic psychiatric patients spilled into the streets and countryside during the urban battles.The Cairo conferees worked to outline acute goals, as well as chronic and long-term agendas. We were reminded of the special needs of countries such as Afghanistan, where 40 percent of the children in Kabul have lost their parents, two-thirds have seen dead bodies or parts of bodies, and 90 percent believed they would die during the conflict. These experiences have an immediate psychological impact, as well as a long-term effect, on mental health.Examples of successful interventions that were developed in other Eastern Mediterranean countries were presented by representatives from India, Iran, and Pakistan. Their education programs and work integrating mental health with primary health care demonstrated positive results.The conferees were divided up into small groups to work on the following topics: needs assessments; training and human resources development; peoples’ initiatives for mental health; service development, including integration of mental health care within primary health care; and issues of administrative support, including research, monitoring, and evaluation.As the representative of the American Psychiatric Association I felt fortunate to spend time participating with our Eastern Mediterranean region colleagues in this joint venture to ensure that mental health was given a priority and was on the front line of any discussion about the rebuilding of Iraq. From the experiences of American psychiatrists in the developing world who have had long-term projects, we recognize the hurdles public health and psychiatry have to clear to achieve appropriate recognition from the policymakers who set priorities.In the near term, Iraq’s security, power restoration, a revamped educational system, adequate nutrition, potable water supplies, and reconstruction of hospitals are all powerful competitors for mental health funding in the country’s rehabilitation. From psychiatric epidemiological research and empirical experience, we have data showing that violence, poverty, and disasters accelerate neuropsychiatric disorders and thus affect the DALYs (Disability Adjusted Life Years). Mental health properly requires recurrent expenditures in a national budget. Planners may tend to minimize these realities as well as the long-term impact of untreated depressive disorders on work productivity and its negative effect on a country’s gross domestic product.At the Cairo conference, representatives of many nations with different political histories—democracies together with single-party nation states—and different racial, societal, and religious backgrounds joined together to advocate for a vision of mental health being integral to health care in general. The Cairo meeting reflected advance mental health planning in the service of children, families, communities, and the nation. This was an international effort at nation building at its best. ▪ ISSUES NewArchived

Book of the Month: Under the Banyan Tree

Book of the Month: Under the Banyan Tree

The Fifth Asian and Pacific Population Conference: Towards a repositioning of population in the global development agenda?

The Fifth Asian and Pacific Population Conference, held at Bangkok in December 2002, followed a little more than 10 years after the Fourth Asian and Pacific Population Conference, held at Bali. The Bali Conference was one of the regional conferences leading up to the path-breaking International Conference on Population and Development, held at Cairo in 1994, and was important in the context of providing input into the Cairo Conference, but also in its own right as reflecting the consensus among the Member States making up over 60 per cent of the world’s population.

The 2nd Annual Asia Pacific Conference on Reproductive and Sexual Health: Critiques, Challenges, and Cautious Optimism

From October 6-10 2003 almost 1500 delegates primarily from Asia and the Pacific gathered in Bangkok for the 2nd Annual Asia Pacific Conference on Reproductive and Sexual Health (APCRSH.) With only a handful of attendees from the United States and Europe the debate at the APCRSH provided unique insight into what are perceived to be the overarching issues and challenges to achieving reproductive and sexual health in Asia. Because many of the issues that were raised in Bangkok have global implications or were specifically targeted at donor countries the following summary is intended to share the central points of this debate with a broader international audience. The overall tenor of the APCRSH was one of cautious optimism where the progress of the reproductive health approach over the past decade was juxtaposed against the present challenges posed by growing fundamentalism and shifting global priorities. An undercurrent of disappointment also ran through the proceedings as delegates recognized the regions failure to achieve the ambitious goals set out at the 1994 Cairo International Conference on Population and Development (ICPD). Much of this disappointment took the form of frustration with the Bush Administrations policy and funding shifts that have taken place since the Cairo conference. Perhaps because of this disappointment even though it was a conference intended to address the theme of Moving into Action prescriptions for reproductive health activism were less forthcoming than were assessments of current challenges. This article documents the most important of these challenges that were identified by participants and highlights the strategies that were put forth to help overcome them. Following a brief overview of the composition and theme of the APCRSH the discussion below details the major themes of the conference. It begins by outlining the numerous critiques that were lodged against American reproductive health policy provides an overview of the other central points of the conference and concludes with a look at the strategies proposed for pursuing reproductive and sexual health and rights in the current political environment. (excerpt)

The Johannesburg Summit on Health and Sustainable Development

The World Summit on Sustainable Development was held in Johannesburg, South Africa, 26 August‐4 September 2002. The meeting was a follow‐up to the United Nations Conference on Environment and Development (UNCED) that took place in Rio de Janeiro in 1992 but with a mandate broader than that of the Rio conference: the Summit was to consider strategies toward sustainable development in all its dimensions. According to the opening paragraph of the Plan of Implementation adopted by the Johannesburg Summit, the Rio conference “provided the fundamental principles and the programme of action for achieving sustainable development.” But while reaffirming commitment to the Rio principles, the Plan states that it intends to “further build on the achievements made since UNCED and expedite the realization of the remaining goals.”A topic conspicuously missing from the deliberations of the Rio conference was population, even though rapid population growth has a plausible bearing on sustainable development and specifically on the problem of poverty, an issue at the center of the discussions concerning sustainability. It had been expected that Johannesburg would make amends for that omission. In the ten years between the two conferences, the size of the world's population increased by some 790 million persons. Of this growth, 754 million, or 95 percent, occurred in the countries the United Nations classifies as “less developed.” The population of these countries grew by 18 percent between the two conferences, as compared with a 3 percent growth in the more developed countries. The countries classified as “least developed“—a subset of the less developed countries consisting of 48 countries, predominantly African, with a 2002 population of nearly 700 million—grew during the interconference period by 29 percent.This record of population growth since the Rio conference may be supplemented by the projections of the United Nations up to 2050. The medium variant of these projections for the next 48 years envisages a slight population decline in the more developed countries and an addition of some 2 billion persons to the less developed group. For the least developed countries, the UN projects a population of more than 1.8 billion in 2050, some 164 percent larger than the current population size.Although the magnitudes of past population growth and its likely future dynamics are well known, they attracted very little attention at the Johannesburg meeting. The Johannesburg Declaration on Sustainable Development, a concise political document issued at the closing of the conference along with the Plan of Implementation, pledges “to place particular focus on, and give priority attention to, the fight against the worldwide conditions that pose severe threats to the sustainable development of our people.” It then proceeds to specifics: “Among these conditions are: chronic hunger; malnutrition; foreign occupation; armed conflicts; illicit drug problems; organized crime; corruption; natural disasters; illicit arms trafficking; trafficking, in persons; terrorism; intolerance and incitement to racial, ethnic, religious and other hatreds; xenophobia; and endemic, communicable and chronic diseases, in particular HIV/AIDS, malaria and tuberculosis” (Paragraph 19 of the Declaration,).The Plan of Implementation, a 27,000‐word document, was the main product of the Johannesburg meeting. Apart from a mention of the Cairo conference on Population and Development, the Plan's treatment of population issues is confined to health. The relevant section—section VI, titled Health and sustainable development—is reproduced below in full. (Paragraph numbers have been retained.) It presents a statement of goals couched in general exhortative terms (“integrate,”“promote,”“provide,”“improve,”“develop”), and specifies some quantitative targets, notably to reduce “by the year 2015, mortality rates for infants and children under 5 by two thirds, and maternal mortality rates by three quarters,” and “reduction of HIV prevalence among young men and women aged 15–24 by 25 per cent in the most affected countries by 2005 and globally by 2010.” The full text of the Plan can be found at http://www.un.org/jsummitlhtmlldocumentslsummit_docsl21Q9_planfinal.htm

Hong Kong, Empire and the Anglo-American alliance at war, 1941-1945

General Editor's Preface Acknowledgements Abbreviations Chronology Maps Introduction Return and Departure: The Fall and Recapture of Hong Kong, 1941 and 1945 The Meaning of Empire: Imperial Consensus, Whitehall and Hong Kong The Anglo-American Relationship at War, 1941-45 An Empire Brought into Question, 1942 China Claims Hong Kong 1942-43 London's Hong Kong Planning, 1943-44 Anglo-American Military Strategy in the Far East, 1942-44 The Cairo Conference Hard Choices: November 1944-June 1945 Yalta, the Death of a President, and San Francisco Return of the Empire: The Defeat of Japan, July-September 1945 Conclusion Epilogue Notes Bibliography and Sources Index

Challenges to reproductive health in Australia

Reproductive health in Australia is assessed using the parameters outlined in the UN 1994 Cairo conference; some limitations of that approach are noted and further aspects of reproductive health identified and discussed. While many of the basic goals of reproductive health, for example low maternal mortality and widespread contraceptive use, have been largely achieved in Australia, the gains have not been uniform and certain groups such as indigenous Australians, those in rural and remote areas, young people and men remain disadvantaged. The remaining challenges cannot be met within the health system alone but require broader systemic interventions.

Racing populations, sexing environments: the challenges of a feminist politics in international law

In 1994, feminist activists made headlines at the United Nations Cairo Conference on Population and Development for their highly organised and influential lobbying. The final agreement negotiated at Cairo reflected this involvement by specifically referring to women's reproductive rights, and by recognising the complex relationship between population policy, environmental security and economic growth. International population policy, defined broadly as the array of international projects and actors involved in efforts to curb population growth, is an increasingly important arena for the contestation of social values and the meaning of global community. In this paper, I offer a re-reading of the 1994 Cairo agreement, and population policy more generally, in the context of colonial discourses around race and gender, which articulate with constructions of the population ‘problem’. Focusing on the language of environment and economic growth, I examine how racialised conceptions of ‘dangerous’ fertility are reinforced rather than challenged by the Cairo agreement. Through this analysis, I attempt to first, make explicit the international inequality that structures international law and policy, and secondly, outline some of the challenges facing feminist engagement with international law.

Reproductive health needs worldwide: constraints to fertility control.

Reproductive health, defined in the 1994 UN Cairo Conference on Population and Development, is discussed and its limits identified. Mortality and morbidity impacts of components of male and female reproductive health are quantified. Use is made of survey data and the estimates of deaths and disease burdens provided by the Global Burden of Disease Inquiry. Maternal causes are the greatest contributors to the total disease burden among women aged 15-44 years. In developing countries, up to half of those who want to delay or avoid further pregnancy are not using contraception. Worldwide, induced abortion accounts for 61,000 deaths annually. Sexually transmitted diseases and other illnesses also result from unsafe sexual practices, resulting in at least 1 million deaths each year. These deaths-and an overall disease burden of 50 million disability-adjusted life years-are entirely preventable. Constraints include, lack a of international commitment to improving reproductive health, social and economic factors, lack of biomedical research, insensitive social science research, and inadequate knowledge. Men and women have the right to demand better services and the knowledge and conditions in which to use them. Those in the more developed countries have the responsibility of ensuring adequate financial and technical support to make reproductive health possible everywhere.

Quality of Family Planning Services: Lessons from Concurrent Evaluation

The concept of reproductive health received global recognition in the International Conference of Population and Development (ICPD) at Cairo in 1994. A reproductive health approach means: people have the ability to reproduce and regulate their fertility; women are able to go through pregnancy and child birth safely; the outcome of preg nancy is successful in terms of maternal and infant survival and wellbeing; and couples are able to have sexual relations free of the fear of pregnancy and of contracting disease. In 1995, after the Cairo conference, the Government of Rajasthan took the initiative to translate the concept of reproductive health into policies and programmes. The innovative interventions, one in Bundi district with UNFPA support, and the other in the two districts of Tonk and Dausa under the Vikalp project were imple mented, abolishing the method-specific targets. Later, in April 1996, the government abolished the targets in all districts and introduced micro district level planning in which the emphasis was laid not on numbers but on the quality of care. In the light of a target-free approach, the quality of family planning services in Rajasthan has been examined by using data from Concurrent Evaluation of Reproductive and Child Health Services. The quality framework evolved by Bruce (1990) was adopted to evaluate the total quality of care of family planning services. Nearly 86 per cent of couples were informed about three spacing methods, namely, condoms, oral pills, IUD and sterilis ation. Less than three-fifths of the users mentioned the method of their own choice. Nearly half of the couples were not informed about the side effects and risks of the methods at the time of adoption. About one-third of the female health workers did not have correct knowledge of IUD insertion. About 79 per cent women were visited by health workers three months prior to the survey. The present study concludes that there

The United Nations on the Implementation of the Cairo Program of Action

Progress and challenges in implementing strategies on population and development were the focus of a Special Session of the United Nations General Assembly that met at UN headquarters in New York, 30 June‐2 July 1999. Participating at the Assembly were representatives of nearly 180 governments, with some 150 of these, and a number of observers and nongovernmental organizations, making statements. The delegates reviewed and appraised the implementation of the Program of Action adopted at the International Conference on Population and Development held at Cairo in 1994. The main topics discussed concerned women's rights, reproductive health issues, and abortion. The Assembly's work culminated in the adoption of a 106‐paragraph statement titled Key actions…, formally issued as United Nations Document A/S‐21/5. The document is reprinted below in full. It affirms the comprehensive approach to population and development issues articulated at the Cairo conference and identifies needs for further action.Also reproduced below is the address delivered at the Special Session by Kofi Annan, Secretary‐General of the United Nations. According to a popular lapidary characterization of the program adopted at the 1994 conference, that program concluded that “population is not about numbers.” Thus the Secretary‐General's address is particularly notable for a clear affirmation of the importance of the quantitative dimension of the population issue. “[W]e have to stabilize the population of this planet. Quite simply, there is a limit to the pressures our global environment can stand.”

World Ministerial Conference on Organized Transnational Crime

As we head toward the end of the millennium we, as specialists and experts in the field of international criminal justice, must pause to reflect seriously on the issue of global organized crime. Study in this regard requires that more rigorous attention be focused on the future directions of research, the creation of a network of regional and worldwide scholars to perpetuate a collaborative agenda, and data collection for comparison of various activities associated with law enforcement and correctional operations. We must find a more unified systemic approach to crime control. Regardless of whether a nation is large or small, developed or underdeveloped, rich or poor, every society is confronted with the task of controlling organized crime. Organized crime is indeed a universal phenomenon. It has long been predicted that international organized crime will become a major force in the commercial, financial and military sectors of every country, eventually affecting directly the destiny of all countries. We may soon be confronted with an economic and financial crisis, in that governments everywhere cannot afford to watch events unfold by saying “there is no solution to the problem because it is beyond our ability to control the problem.” We must find a solution. On June 26, 1995, American President William Clinton, commemorating the 50th anniversary of the United Nations at the ceremony held in San Francisco called for, “Support through the UN of the fight against forces of disintegration from crime syndicates and drug cartels. They cross borders at will. Nations can and must oppose them alone, but we know, and the Cairo Conference reaffirmed, that the most effective opposition requires strong international cooperation and mutual support.” The original idea for a global high‐level conference on organized crime came from a magistrate who devoted his life to fighting the Mafia, Judge Giovanni Falcone, who died in a bomb attack in May 1992, in Italy. Following Judge Falcon's death, the Minister for Justice in Italy took on the idea of holding this conference in his address to the General Assembly that year. The conference was held in Naples two years later, organized by the Crime Prevention and Criminal Justice Branch of the Secretariat of the U.N., under the guidance of the Commission on Crime Prevention and Criminal Justice and in accordance with the Economic and Social Council resolution 1993/29 of July 27, 1993, and the recommendation of the Commission was made at the second session. The 142 states represented at the Conference unanimously adopted the Naples Political Declaration and Global Action Plan Against Organized Transnational Crime, which was later approved by the General Assembly by resolution 49/159 on December 23, 1994. For further information regarding the topic of international and transnational organized crime and associated issues, see World Ministerial Conference on Organized Transnational Crime, Naples, Italy, United Nations, Crime Prevention and Criminal Justice Newsletter, No.26/27, November 1995; speech by President William Clinton on the occasion of the 50th anniversary of the U.N., San Francisco, June 26, 1995; A Law Enforcement Source book of Asian Crime and Cultures: Tactic and Mindset, Douglas D. Daye, CRC Press, Boca Raton, 1997; Transnational Criminal Organizations, Cybercrime and Money Laundering: A Handbook for Law Enforcement Officers, Auditors, and Financial Investigators, James R. Richards, CRC Press, Boca Raton, 1999; and Global Report on Crime and Justice, by UN Office for Drug Control and Crime Prevention, Graeme Newman, ed., New York, Oxford University Press, 1999.

Should prenatal sex selection be restricted? Ethical questions and their implications for research and policy

Sex-selective abortion following prenatal sex testing is so blatantly discriminatory that many observers have, understandably, called on governments to condemn and restrict the practice. Yet ethical questions that counterbalance these sentiments have been neglected. Restricting the practice would seem to interfere with reproductive freedoms and maternal empowerment, the twin goals adopted at the recent Cairo conference. The restrictions may also increase human suffering if sex discrimination is then shifted into the postnatal period. Consideration and empirical testing of this substitutive dynamic has been precluded by limitations in the comparative design of recent research and a lack of appropriate data. Nevertheless, this dynamic has always been presumed to exist by pro-choice advocates. Moreover, extending anti-discriminatory legislation to the prenatal realm may awaken and justify similar demands among other disadvantaged groups whose foetal counterparts have previously engendered less public sympathy, which may result in further restrictions on abortion.

Francis Hutcheson on the Rights of Society

In Enlightenment tradition came chiefly to mean human rights, reposing in individuals. Initially few general-in a classic enumeration, life, liberty, pursuit of happiness-human rights have multiplied in modern times through international declarations, convenants, conventions. Several of these rights concern demographic matters, notably reproductive rights. The Universal Declaration of Human Rights, adopted in December 1948 (its 50th anniversary being celebrated in 1998), states in Article 16: Men women offull age ... have right to marry to found a family. The Proclamation of Teheran, issued by International Conference on Human Rights held in Teheran in 1968, states that Parents have a basic human right to determine freely number spacing of their children (Paragraph 16). The World Population Plan of Action formulated at 1974 Bucharest conference changed parents to all couples added words and to have information, education means to do so (Paragraph 14(f)). This is also phrasing that appears as Principle 8 in Chapter 2 of Programme of Action of 1994 Cairo conference. The qualifier responsibly must presumably be read as a restriction on right to reproduce, limiting freedom to choose to decisions made with reference to a larger set of interests. Those interests are spelled out in Bucharest statement in these terms: the responsibility of couples individuals in exercise of this right takes into account needs of their living future children, their responsibilities towards community. Similar language, with added to community, is found in recommendations of 1984 Mexico City conference (Paragraph 26). Consideration of obligations of individuals to society-in other words, rights of society over its members-is a complementary line of thought to human rights, older but in recent times far less emphasized. (The comparative neglect of such obligations of need for a balance between two sets of rights has been a criticism of modern human rights movement.) This is subject treated

Reproductive health care: services oriented to couples

Historically, the combination of women's rights to care, population concerns and the development of female-oriented contraceptive methods resulted in family planning programs focusing on women's contraceptive needs and little else. The 1994 United Nations Population Conference in Cairo called for an expansion of programs to cover reproductive health in its broadest interpretation. As this concept has developed and been put into practice it has become evident that a key element in reproductive health services should be the inclusion of the sexually active couple.

The bodies of Christ as international bodies: the Holy See, wom(b)an and the Cairo Conference

This article examines how the various bodies of Christ, such as the Catholic Church, the Holy See and the Pope, use their spiritual power to define, assign and confine woman as wom(b)an, or woman defined in relation to her body, specifically her reproductive capacities. In particular, it explores how this power was deployed at the UN-sponsored International Conference on Population and Development (ICPD in 1994). It was here that attempts were made by the bodies of Christ to advance the particular - the Catholic articulation of woman, reproductive options and sexuality - as the universal, in the international. The article begins by examining the spiritual sovereignty and the power of the Pope, which is followed with an inquiry into a particular power performance, namely, the Catholic articulation of woman, reproductive option and sexuality. The following section examines the politics of the spiritual as they pertain to the Holy See's words and deeds both before and during the ICPD. The paper concludes by offering some insights into the power relations that mediate the relations among the bodies of Christ, woman and the ICPD.

Book review: Population and development:a message from the Cairo Conference, Robert Cliquet and Kristiaan Thienpont. Kluwer Academic Publishers, Dordrecht, 1995. xx + 180. NLG 120.00. ISBN 0–7923–3763–8.

International Journal of Population GeographyVolume 3, Issue 3 p. 281-282 Book Review Book review: Population and development:a message from the Cairo Conference, Robert Cliquet and Kristiaan Thienpont. Kluwer Academic Publishers, Dordrecht, 1995. xx + 180. NLG 120.00. ISBN 0–7923–3763–8. Musa Samha, Corresponding Author Musa Samha University of Jordan, JordanUniversity of Jordan, JordanSearch for more papers by this author Musa Samha, Corresponding Author Musa Samha University of Jordan, JordanUniversity of Jordan, JordanSearch for more papers by this author First published: 04 December 1998 https://doi.org/10.1002/(SICI)1099-1220(199709)3:3<281::AID-IJPG52>3.0.CO;2-TAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume3, Issue3September 1997Pages 281-282 RelatedInformation

Population and Fairness

Cultural theory identifies the following active forms of social solidarity: individualism hierarchy and egalitarianism. These forms inform distinct cognitive frameworks institutional styles world views and discourses. They can be perceived of as discourses which when embedded in policy arguments compete for legitimacy in the public policy debate. Much if not most of the debate about world population policy is not a traditional scientific debate about what is the correct underlying model but actually a contest between these competing normative views of fairness. It is argued that while superficially egalitarian in tone the population policy orthodoxy which emerged from the 1994 Cairo International Conference on Population and Development is fundamentally individualistic. The ecological view that rapid population growth is a problem in its own right was lost at the Cairo conference.

Levels and Determinants of Gynecological Morbidity in a District of South India

This article presents the results of an assessment of gynecological morbidity among 385 women with young children residing in a district of Karnataka State, South India. All three main modes of assessment (clinical examination, laboratory tests, and self-reports) reveal a high burden of reproductive tract infections. The two most common conditions, identified by laboratory tests, were bacterial vaginosis and mucopurulent cervicitis. Approximately one-fourth of the women had clinical evidence of pelvic inflammatory disease, cervical ectopy, and fistula. The contribution of sexually transmitted diseases to overall gynecological morbidity appears to be relatively modest; 10 percent were so diagnosed. Associated conditions of anemia and chronic energy deficiency were common. Severe anemia was found in 17 percent of cases and severe chronic energy deficiency in 12 percent. These results indicate that radical improvements in women's health in India will require far more than the diagnosis and treatment of reproductive tract infections.

Preserving the pot and water: A traditional concept of reproductive health in a Yoruba community, Nigeria

Within the background of the outcome of the 1994 Cairo Conference, this paper describes a traditional conceptualization of prenatal care in a Nigerian community and draws their implication for effective delivery of reproductive health services in the area. The data used were from qualitative interviews during 2 field trips to the community in 1988–1989 and 1991. The finding of the study highlights a local metaphor that likened the risks of pregnancy and child birth to a group of women that trekked to a local brook to fetch water with their earthen pots: some fell, broke their pots; some missed steps and spilt their water but kept their pots, and others returned without any mishap. The first group represented cases of maternal mortality; the second group were cases of miscarriage, still-births or infant deaths, and the third group represented successful outcomes for both pregnancy and the resultant baby. Various steps that were traditionally taken to ensure that the mother neither lost her pot nor spilled her water are described. The implications of these findings for policy and research are discussed in the paper.