Contradictory discourses, state ideology and policy interpretation: A feminist evaluation of the Reproductive and Child Health Programme (RCH) in Kerala, India
The Government of India in 1995 introduced the Reproductive and Child Health (RCH) policy, as part of a paradigmatic shift in its ongoing population programme. The shift in policy came in the wake of the International Conference for Population and Development, 1994, which had espoused a rhetoric of reproductive health and empowerment for women in the planning and implementation of population programmes. This thesis explores the process of institutionalization of the ‘gender-sensitive’ discourse of reproductive health within the national population programme in India. This study offers a feminist political analysis of this phenomena; therefore, rather than study reproductive health as demographic or health outcomes, the emphasis is on the analysis of ideological frameworks of the state (and those policy makers who embody its values) that provide particular interpretations of reproductive health. The political analysis of ideology is significant to understanding the translation of global discourses into norms of local practice. The focus on interpretive frameworks opens up a theoretical exploration of the state’s inherent ideologies. Arguing that India, like many other countries in both the developing and developed world, is moving to a broad political, economic and social ethos of neo-liberalism, I explore the implications of this ideological shift for the process of policy interpretation. There are two dimensions of the neo-liberal ideology that are pertinent to this research. First, the assumptions of the role and functions of the state under neo-liberalism is antagonistic to that which is, prima facie, demanded by reproductive health as a gender-empowering discourse. Second, the discourse of neo-liberalism has implications for women’s positioning as citizens within the developmental state, challenging their claims to access the state. The interactions of both these dimensions, that is, contestation of discourses regarding representation of women, and the definition of the state’s obligations under market development, are critical to the outcome of policy design and practice. The empirical analysis in this research is fundamentally qualitative in approach. I primarily undertake an analysis of discourses in the RCH policy documents and interviews with key officials in charge of the programme in Kerala. The analysis seeks to explore the discursive manifestation of the neo-liberal/market ideology, particularly in the way that users of public health care are positioned in the programme, and the state’s broader ideology regarding gender and development. In conclusion, this research seeks to renew a focus on the state as a negotiator of gender discourses in the formulation of development policy. Development policy design and practice cannot be viewed as independent of the ideologies around gender that dominate the state. I argue in this thesis that it is only by addressing issues of political identity that we can develop policies that are more accountable to women, and that are gender-sensitive.
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