Laura Sochas , London School of Economics
Health inequalities are a growing concern in LMICs. However reducing inequalities requires better understanding of the processes through which they are produced. This study is based on 42 in-depth interviews conducted in June 2018 with women who gave birth in the previous year, across rural and urban clinic sites in Mansa, Zambia. Inequalities in women’s pregnancy and childbirth experiences were produced and reproduced by health facility rules. These rules, which specify how women should behave during pregnancy and childbirth, can be understood as strategies of social exclusion favouring women with more social and economic resources. The rules also strengthened social exclusion processes beyond the facility by widening power differentials between socially excluded women and others in their social worlds. This study implies that the unequal effects of rules are likely to be structural, and that paying close attention to power relations is particularly important when seeking to reduce health inequalities.
Presented in Session 244. Disparities and Equity in Reproductive Health