Intimate Interventions in Global Health: Family Planning and HIV Prevention in Sub-Saharan Africa

294 Pages·2017·2.796 MB·English

by  Rachel Sullivan Robinson

Intimate Interventions
in Global Health
When addressing the factors shaping HIV prevention programs in sub-
Saharan Africa, it is important to consider the role of family planning
programs that preceded the epidemic. In this book, Rachel Robinson
argues that both globally and locally, those working to prevent HIV
borrowed and adapted resources, discourses, and strategies used for
family planning. By combining statistical analysis of all sub-Saharan
AfricancountrieswithcomparativecasestudiesofMalawi,Nigeria,and
Senegal, Robinson also shows that the nature of countries’ interactions
with the international community, the strength and composition of civil
society, and the existence of technocratic leaders influenced variation in
responses to HIV. Specifically, historical and existing relationships with
outside actors, the nature of nongovernmental organizations, and
perceptions of previous interventions strongly structured later health
interventionsthroughprocessesofpathdependenceandpolicyfeedback.
This book will be of great use to scholars and practitioners interested in
global health, international development, African studies and political
science.
Rachel Sullivan Robinson is an associate professor in the School of
International Service at American University. She holds a PhD in
sociology and demography from the University of California, Berkeley
and has conducted field research in Nigeria, Senegal, Malawi, and
Namibia. She teaches courses on statistics, global health, population
studies,development,andnongovernmentalorganizations.

Intimate Interventions
in Global Health
Family Planning and HIV Prevention
in Sub-Saharan Africa
rachel sullivan robinson
AmericanUniversity
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Firstpublished2017
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LibraryofCongressCataloging-in-PublicationData
Names:Robinson,RachelSullivan,author.
Title:Intimateinterventionsinglobalhealth:familyplanningandHIVprevention
insub-SaharanAfrica/RachelSullivanRobinson.
Description:Cambridge,UnitedKingdom;NewYork,NY:CambridgeUniversity
Press,[2017]|Includesbibliographicalreferences.
Identifiers:LCCN2016056470|ISBN9781107090729(hardback)
Subjects:|MESH:HIVInfections–prevention&control|FamilyPlanning
Services–methods|SexualBehavior|BehaviorControl–methods|PublicPolicy|
GlobalHealth|AfricaSouthoftheSahara
Classification:LCCRA643.86.A357|NLMWC503.6|
DDC614.5/9939200967–dc23
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pregnancywantedandHIVobsolete

Contents
ListofTablesandFigures pageviii
Acknowledgments ix
1 Introduction:UnderstandingtheLinksbetweenFamily
PlanningandHIVPrevention 1
2 TheIntersectionoftheGlobalPopulationandAIDSFields 37
3 FromFamilyPlanningtoHIVPreventioninSub-Saharan
Africa 70
4 Malawi:NegativePolicyFeedbackandPoliticalLegacy 102
5 Nigeria:TransnationalPressureandPoliticalDisruption 134
6 Senegal:TransnationalTiesandTechnocraticLeadership 168
7 Conclusion:TheImplicationsofIntimateInterventions
forGlobalHealth 206
References 221
Index 273
vii
Tables and Figures
Tables
1.1 Sub-SaharanAfricanCountriesbyTimingofPopulation
PolicyandFoundingDateofMajorFamilyPlanning
NGO page27
3.1 ResultsfromLinearRegressionsPredictingLogofTotal
GlobalFundDisbursementsforHIV/AIDS,Sub-Saharan
AfricanCountries,2002–2010 96
3.2 ResultsfromLinearRegressionsPredictingDifferentHIV
Outcomes,Sub-SaharanAfricanCountries,2001–09 97
Figures
2.1 DistributionofDonorExpendituresforPopulation
Assistance,1995–2011 46
3.1 TotalFertilityRates,Sub-SaharanAfrica,2014 74
3.2 HIVPrevalence,Sub-SaharanAfrica,2013 80
3.3 PrevalenceofMaleCircumcision,Sub-SaharanAfrica,
2007 81
3.4 AntiretroviralCoverageRates,Sub-SaharanAfrica,2012 88
3.5 DistributionofLocalHIV/AIDSNGOs,Sub-Saharan
Africa,2003 93
4.1 MalawiCondomPackaging 103
5.1 NigeriaNationalFamilyPlanningLogo 142
6.1 NationalAIDSCommission,Dakar 169
viii