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International Journal of Health Services. 2010; 40(3):543-67.Most international programs and policies devised to improve women's health in developing countries have been shaped by powerful agencies and development ideologies, including the tendency to view women solely through the lens of instrumentalism (i.e., as a means to an end). In a literature review, the authors followed the trail of instrumentalism by reviewing the different approaches and paradigms that have guided international development initiatives over the past 50 years. The analysis focuses on three key approaches to international development: the economic development, public health, and women-gender approaches. The findings indicate that progressive changes have adopted a more inclusive development perspective that is potentially beneficial to women's health. On the other hand, most paradigms have largely viewed improving women's lives in general, and their health in particular, as an investment or a means to development rather than an end in itself. Public health strategies did not escape the instrumentalism entrenched in the broader development paradigms. Although there was an opportunity for progress in the 1990s with the emergence of the human development and human rights paradigms and critical advances in Cairo and Beijing promoting women's agency, the current Millennium Development Goals project seems to have relapsed into instrumentalism.
Geneva, Switzerland, WHO, 2007. 55 p.The concepts and principles in this document build on the World Health Organization's active ageing policy framework, which calls on policy-makers, practitioners, nongovernmental organizations and civil society to optimize opportunities for health, participation and security in order to enhance quality of life for people as they age. This requires a comprehensive approach that takes into account the gendered nature of the life course. This report endeavors to provide information on ageing women in both developing and developed countries; however, data is often scant in many areas of the developing world. Some implications and directions for policy and practice based on the evidence and known best practices are included in this report. These are intended to stimulate discussion and lead to specific recommendations and action plans. The report provides an overall framework for taking action that is useful in all settings. Specific responses in policy, practice and research is undoubtedly best left to policy-makers, experts and older people in individual countries and regions, since they best understand the political, economic and social context within which decisions must be made. (excerpt)