Running the Obstacle Course to Sexual and Reproductive Health

These four multi-disciplinary studies focus on sexual and reproductive health advocacy and programs in Latin America. Based on original research and the author's 25 years of experience working in the region, the text illuminates the political, cultural, and organizational dynamics that pose an obstacle course to sexual and reproductive health—dynamics that veterans of the culture wars in many other regions of the world will recognize. One groundbreaking study of advocacy in Colombia and Chile for the legalization of abortion and divorce discusses the double discourse system that keeps repressive laws in place and punishes public opposition to political norms that are based on religious doctrine. Another study of Latin American NGO regional and national advocacy networks examines the roots of difficulties they experience in unified decision making, often resulting in failure to take decisive political action. The book then offers two program case studies—one in Peru and one in Chile—focusing on issues of citizen participation and respect for rights in health systems and in schools. The Peruvian study brings to life a four-city experiment to foster community participation of women's organizations in health services. The Chilean study focuses on a highly participatory and successful sex education program in public schools and The ways in which political controversies affected the program, eventually contributing to its demise. The book's holistic approach, written from the point of view of an outsider/participant, makes a unique contribution to the study of social change in general, and to worldwide efforts to mainstream human rights, social justice, and gender equality in sexual and reproductive health programs and policies.

Bonnie Shepard is a researcher, planner, and program evaluator. Currently she is Senior Planning and Evaluation Specialist for Social Sectors Development Strategies, Inc. in Boston, MA.