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Date of Award

9-2008

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

First Advisor

George Cernada

Second Advisor

Dan S. Gerber

Third Advisor

Julie D. Hemment

Abstract

The international donor community, predominantly the U.S. Government, has invested over $24 million in reproductive health programs in Ukraine, expressly to decrease abortion rates and increase the use of modern contraceptives. Yet, as of 2006, after over 12 years of reproductive health development programming, Ukraine still had one of the highest levels of abortion in the world and the use of modern contraceptives remained very low. In addition, broader international donor goals of building sustainable development programs had not been realized due to Ukrainian policymakers' indifference towards donor supported programs, demonstrated by their lack of financial support for reproductive health development initiatives in Ukraine.

This investigation reveals one significant reason that Ukrainian policymakers have essentially rejected reproductive health development programs over the past decade: distinct differences between international donors' and Ukrainian policymakers' social constructions and cultural meanings of reproductive health. From 2005-2006 this qualitative study surveyed 42 Ukrainian policymakers and interviewed an additional 42, comparing their feedback to 20 international donor participants working on reproductive health policy and programs in Ukraine. The research methodology was guided by the Policy Circle, the Health Belief Model, and the Theory of Planned Behavior, as well as political-economic and socio-cultural paradigms. Study feedback revealed distinct differences in definitions for reproductive health,cultural meanings of health services, and perceptions of gender. The data also revealed some agreement on perspectives of current reproductive health policy and issues in development. Also, research into donor attitudes challenges prevailing scholarly presuppositions that development is a homogenous movement.

This research suggests that both donor respondents and Ukrainian policymaker participants define reproductive health in fundamentally different ways. Essentially their reproductive health values and priorities are not closely aligned. Ukrainian policymakers are concerned with major demographic declines and they situate a woman's role as "mother first" of primary importance in Ukrainian society. These priorities appear to be in conflict with donors' goals of increasing modern contraception use in Ukraine. Unlike internationl donors, Ukrainian policymakers did not conceptualize of abortion within a moral framework; rather, their conceptions of reproductive health were embedded in the political-economic situation at the time.

DOI

https://doi.org/10.7275/3ywg-dz65

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