Health development meets the end of state socialism: visions of democratization, women's health, and social well-being for contemporary Russia.
As development organizations undertake the task of improving the public health in former socialist states, their interventions are shaped by a particular cultural logic and predetermined frame of possible action. In the context of local encounters, however, they often confront competing interpretations of a society's prevailing needs. How they manage such differences may not only explain the outcomes of a given project, but may also reveal the capacities and limitations of development agencies to engineer post-socialist change. This article examines a recent WHO project in St. Petersburg, Russia, which defined women's "social well-being" as a local health concern. While the project employed a discourse of "democracy" to promote women's empowerment in the clinic, its parameters of intervention neither incorporated local knowledge nor addressed the structural relations underlying clinic-level conflicts. Two kinds of results ensued: the ideology of democracy was rejected, while WHO's recommendations were partially appropriated as profit-making strategies.
Rivkin-Fish
M
M
Department of Anthropology, University of Kentucky, Lexington 40508, USA. mrivk2@pop.uky.edu
D003466:Cultural Characteristics; D005260:Female; D006291:Health Policy / Q000191:economics* / Q000639:trends*; D006301:Health Services Needs and Demand; D049673:History, 20th Century; D006801:Humans; D007391:International Cooperation; D008427:Maternal Health Services / Q000191:economics / Q000639:trends; D010817:Physician-Patient Relations; D011057:Politics; D011634:Public Health / Q000266:history; D012041:Regional Medical Programs / Q000191:economics*; D012426:Russia; D012959:Socioeconomic Factors; D016387:Women's Health; D014944:World Health Organization