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  1. 1
    140084
    Peer Reviewed

    Skirting the issue: women and international health in historical perspective.

    Birn AE

    American Journal of Public Health. 1999 Mar; 89(3):399-407.

    Despite conceptual advances that incorporate broad structural approaches, international agencies embrace a persistent reliance on "reductionist reproductive terms" to define women's health. This article locates the origins of this phenomenon in the policies and activities of the Rockefeller Foundation's (RF) public health program in Mexico in the 1920s and 1930s. After an introduction, the article describes the Mexican work of the RF and how it "stumbled upon" gender health differentials during a hookworm eradication campaign and then furthered gender stereotypes in its health education materials. The article continues with a consideration of the RF's eventual dual targeting of women as patients and as public health workers (nurses) during the effort to create permanent health units and institute a system of nurses who visited homes as proponents of the supremacy of modern medicine. Next, the article describes how the RF further entered women's domain by identifying, monitoring, and training traditional midwives. This targeting of midwives coupled with a total disregard for every aspect of traditional midwifery reflected the RF's policy of blaming midwives for infant mortality while ignoring socioeconomic determinants. The policy also exacerbated the differentials of social class by elevated working- and middle-class nurses and denigrating peasant midwives. The article concludes that the RF's faulty and often ineffectual policies in Mexico created the women's health paradigm based on reproduction that was later intensified by population control efforts and that fails to advance health for all as a matter of equity.
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