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Information communication technologies can serve as a crucial missing link toward tacking wicked problems of social welfare policy implementation through collaborative governance. Using a mixed methods approach, a pre- and postanalyses were used to investigate whether and how cell phones can increase awareness of pregnant women about different cash and service benefits of maternal health benefit policies of 82 pregnant women in a remote tribal community in Melghat forest of Maharashtra, India. Pregnant women received customized prerecorded bilingual audio calls on their mobile phones about maternal health benefit policies. The author then traced whether those audio messages increased the claiming of policy benefits and public engagement. The key contribution of this research is that contrary to the optimism about digital governance, findings suggest that cell phones are not a “silver bullet” for increasing receipt of maternal health benefits. This book chapter concludes with the prescription that the impact of mobile phones and other information technologies will be marginal as long as there are administrative deficiencies in policy implementation and a misalignment in state and federal policy designs.

We estimate the parental investment response to the child endowment at birth, by analysing the effect of child birth weight on the hours worked by the mother two years after birth. Mother’s working hours soon after child birth are a measure of investments in their children as a decrease (increase) in hours raises (lowers) her time investment in the child. The child birth endowment is endogenously determined in part by unobserved traits of parents, such as investments during pregnancy. We adopt an instrumental variables estimation. Our instrumental variables are measures of the father’s health endowment at birth, which drive child birth weight through genetic transmission but does not affect directly the mother’s postnatal investments, conditional on maternal and paternal human capital and prenatal investments. We find an inverted U-shape relationship between mothers worked hours and birth weight, suggesting that both low and extremely high child birth weight are associated with child health issues for which mothers compensate by reducing their labour supply. The mother’s compensating response to child birth weight seems slightly attenuated for second and later born children. Our study contributes to the literature on the response of parental investments to child’s health at birth by proposing new and more credible instrumental variables for the child health endowment at birth and allowing for a heterogeneous response of the mother’s investment for first born and later born children.

Purpose – This chapter discusses health disparities among African Americans living in urban spaces within the United States.

Approach – This chapter provides an overview of health disparities in morbidity and mortality related to maternal and child health (maternal mortality rate, infant mortality, and low birth weight).

Practical implications – This chapter describes research and interventions that strive to increase our ability to understand and reduce health disparities. Eliminating health disparities not only is beneficial to these affected groups but also offers the opportunity to improve the health of the entire U.S. population.

Originality/value – This chapter adds to our understanding of the correlates of health disparities for African American women and children as well as successful interventions that have proven effective in ameliorating these disparities.

There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of dignified treatment during birth contributes to a salient, under-examined aspect of women’s childbirth experiences.

We use a two-part conceptualization of dignity, respect and autonomy, to understand how birth experiences and interactions either facilitate or undermine women’s perceived dignity. Data came from the Listening-to-Mothers I survey, the first nationally representative study of postpartum women in the United States (n = 1,406). Through linear regression analysis, we separately modeled women’s perception of respectful treatment and women’s perception of medical autonomy during birth.

Overall women reported high scores for both autonomy and respect. Differences between the models emerged related primarily to the role of interventions and provider support. While women’s perceived dignity is related to elements that she brings in to the delivery room (e.g., birth knowledge, health status), much variation was explained by the medical encounter itself (e.g., type of medical interventions, pain management, nurse support, and number of staff present).

This study is cross-sectional, and required either a telephone or internet access, thus limiting the full generalizability of findings. Two findings have direct practical relevance for promoting women’s dignity in childbirth. First, the number of staff persons present during labor and birth was negatively associated with both respect and autonomy. Second, that women with high levels of knowledge about their legal rights during childbirth were more likely to report high scores on the dignity scale. Limiting staff in the delivery room and including knowledge of legal rights in childbirth education or during prenatal visits may be two mechanisms to promote dignity in birth.

These findings address an important, under-examined aspect of women’s childbirth experiences. This study investigates how different birth experiences and interactions either promote or violate childbearing women’s perception of dignity, and has significant implications for the provision of maternal healthcare. The results reinforce the importance of focusing on the socio-psychological dimensions of childbirth.

This chapter discusses various aspects of family planning initiatives on a global scale, with a specific focus on their influence in Asian contexts, including Bangladesh. This chapter examines the diverse range of family planning programs and policies implemented worldwide, in Asia and Bangladesh considering cultural factors that significantly shape family planning decisions. By highlighting the unique approaches and challenges faced in different regions, it provides valuable insights into the evolving landscape of family planning efforts and their impact on population dynamics.

A country’s performance in health attainment refers to both its achievement (level) and its improvement (evolution) in the health domain. Studies on performance generally measure health attainment using the average health level of the population and quantify health improvement employing the change in attainment over time. However, this approach is flawed because the change in attainment does not satisfy good properties, on the one hand, and because health attainment should not only account for the average health level but also for disparities in health in the population, on the other hand. We propose a solution to the first limitation by following the lead of Kakwani (1993), who uses achievement and improvement measures which are based on attainment measures and which satisfy important properties. For the second limitation, we extend the work of Kakwani and propose new definitions of attainment that account for the average health level but also for health inequalities in the population. Specifically, we focus on overall and social health inequalities and on the health of the poor. By including these new attainment variables into Kakwani’s indices, we generate new classes of achievement and improvement indices. Using data on 11 low- and middle-income Asian countries in the twenty-first century, we highlight that child and maternal health have generally improved in recent decades, due to both an increase in the average health level and a decrease in inequalities.

As maternal mortality increases in the United States, birth providers and policymakers are seeking new solutions to address what scholars have called the “C-section epidemic.” Hospital cesarean rates vary tremendously, from 7 to 70 percent of all births. Based on in-depth, semi-structured interviews with 47 obstetricians and family physicians in the United States, I explore one reason for this variation: differences in how physicians perceive and manage risk in American obstetrics. While the dominant model of risk management encourages high levels of intervention and monitoring, I argue that a significant portion of physicians are concerned about high intervention rates in childbirth and are working to reduce cesarean rates and/or the use of monitoring technologies like continuous fetal heart rate monitors. Unlike prior theories of biomedicalization, which suggest that health risks are managed through increased monitoring and intervention, I find that many physicians are resisting this model of risk management by ordering fewer interventions and collecting less information about their patients. These providers acknowledge that interventions designed to mitigate risks may only provide an illusion of control, rather than an actual mastery of risks. By limiting interventions, providers may lose this illusion of control but also mitigate the iatrogenic effects of intervention and continuous monitoring. This alternative approach to risk management is growing in many medical fields and deserves more attention from medical sociologists.

This chapter provides a comprehensive exploration of the pivotal role of family planning in advancing sustainable development goals (SDGs). It elucidates the intrinsic connection between family planning and sustainable development, scrutinizes the harmonization of family planning initiatives with SDG targets and indicators, gleans insights from global approaches, and identifies formidable challenges, with a particular focus on marginalized communities. This chapter culminates with a set of substantial recommendations aimed at surmounting these challenges and propelling SDG attainment through the prism of family planning.

This chapter explores the significance and implementation of family planning practices, emphasizing their vital role in enhancing reproductive health outcomes. This chapter conducts an in-depth examination of family planning practices within marginalized communities in Bangladesh, shedding light on the unique challenges and opportunities faced by these populations. By uncovering the nuances of family planning practices in marginalized contexts, this chapter underscores the need for tailored and culturally sensitive family planning programs. It advocates for program designs that facilitate the effective adoption of family planning practices among marginalized communities, ultimately promoting better reproductive health outcomes. Furthermore, this chapter highlights the importance of empowerment strategies in reaching and engaging marginalized communities. Through practice enhancement initiatives, it seeks to empower marginalized populations with the knowledge and resources necessary to make informed decisions about family planning, thereby contributing to improved reproductive health and overall well-being.

This mixed-methods study reports on an outreach clinics program designed to deliver genetic services to medically underserved communities in Wisconsin.

We show the geographic distribution, funding patterns, and utilization trends for outreach clinics over a 20-year period. Interviews with program planners and outreach clinic staff show how external and internal constraints limited the program’s capacity. We compare clinic operations to the conceptual models guiding program design.

Our findings show that state health officials had to scale back financial support for outreach clinic activities while healthcare providers faced increasing pressure from administrators to reduce investments in charity care. These external and internal constraints led to a decline in the overall number of patients served. We also find that redistribution of clinics to the Milwaukee area increased utilization among Hispanics but not among African-Americans. Our interviews suggest that these patterns may be a function of shortcomings embedded in the planning models.

Planning models have three shortcomings. First, they do not identify the mitigation of health disparities as a specific goal. Second, they fail to acknowledge that partners face escalating profit-seeking mandates that may limit their capacity to provide charity services. Finally, they underemphasize the importance of seeking trusted partners, especially in working with communities that have been historically marginalized.

There has been little discussion about equitably leveraging genetic advances that improve healthcare quality and efficacy. The role of State Health Agencies in mitigating disparities in access to genetic services has been largely ignored in the sociological literature.