Women's health in maternal and child health: time for a new tradition?
OBJECTIVE
The status quo in maternal and child health (MCH) focuses on obstetric health. An emerging alternative is to broaden the notion to reproductive health. An inclusive perspective encompasses women's health issues in MCH. The purpose of this paper is to further the debate on the relationship of women's health to MCH. Specific aims are (1) to describe activities promoting women's health in MCH and (2) to examine consequences of alternative perspectives for MCH research, services, and training.


METHODS
To achieve the first objective, I discuss developments in a state health agency and pertinent documents from the MCH Section of the American Public Health Association. To address the second aim, I follow the Bush Policy Analysis Model of weighing the three paradigms against the following evaluative criteria: equity, efficiency, satisfaction, stigma, indirect effects, feasibility, sensitivity to class and race, and social responsibility.


RESULTS
The obstetric approach meets most criteria in a positive fashion; reproductive health satisfies criteria more positively and less equivocally. A women's health perspective bears the most potential for improving reproductive outcomes at this time, since no area of women's general health has been definitively shown to be irrelevant to reproduction (or vice versa).


CONCLUSIONS
This analysis suggests that women's health should be incorporated more fully into the MCH field, as well as other areas of public health and medicine. Once research deficits have been addressed and the scope of reproductive health delineated more clearly, the alignment of women's health with MCH may be reevaluated.
Bennett
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Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill 27599-7400, USA. trude_bennett@unc.edu
D002648:Child; D002675:Child, Preschool; D005260:Female; D005544:Forecasting; D019538:Health Care Surveys; D006266:Health Education / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008430:Maternal-Child Health Centers / Q000458:organization & administration* / Q000639:trends; D009313:National Health Programs / Q000458:organization & administration* / Q000639:trends; D009657:North Carolina; D011050:Policy Making; D011247:Pregnancy; D015397:Program Evaluation; D011634:Public Health / Q000639:trends; D012955:Societies, Medical; D016387:Women's Health