Abstract
As development organizations undertake thetask of improving the public health in formersocialist states, their interventions are shaped by aparticular cultural logic and predetermined frame ofpossible action. In the context of local encounters,however, they often confront competing interpretationsof a society's prevailing needs. How they managesuch differences may not only explain the outcomes ofa given project, but may also reveal the capacitiesand limitations of development agencies to engineerpost-socialist change. This article examines a recentWHO project in St. Petersburg, Russia, which definedwomen's ``social well-being'' as a local health concern.While the project employed a discourse of ``democracy''to promote women's empowerment in the clinic, itsparameters of intervention neither incorporated localknowledge nor addressed the structural relationsunderlying clinic-level conflicts. Two kinds ofresults ensued: the ideology of democracy wasrejected, while WHO's recommendations were partiallyappropriated as profit-making strategies.
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REFERENCES
Abbott, Andrew D. 1988 The System of Professions: An Essay on the Division of Expert Labor. Chicago: University of Chicago Press.
Benyoussef, Amor, and Barbara Christian 1977 Health Care in Developing Countries. Social Science and Medicine 11: 399–408.
Brint, Steven 1994 In an Age of Experts. Princeton, NJ: Princeton University Press.
Chesanova, T. 1994 Bolet’ v Peterburge opasno dlia zhizni. Chas Pik October 26: 1.
Davis-Floyd, Robbie 1992 Birth as an American Rite of Passage. Berkeley: University of California Press.
Escobar, Arturo 1995 Encountering Development: The Making and Unmaking of the Third World. Princeton, NJ: Princeton University Press.
Ferguson, James 1994 The Anti-Politics Machine: “Development,” Depoliticization, and Bureaucratic Power in Lesotho. Minneapolis: University of Minnesota Press.
Field, Mark G. 1991 The Hybrid Profession: Soviet Medicine. In Professions and the State: Expertise and Autonomy in the Soviet Union and Eastern Europe, Anthony Jones, ed. pp. 43–62. Philadelphia: Temple University Press.
Field, Mark G. 1995 The Health Crisis in the Former Soviet Union: A Report from the “Post-War” Zone. Social Science and Medicine 41: 1469–1478.
Freidson, Eliot 1994 Professionalism Reborn: Theory, Prophecy, and Policy. Cambridge, UK: Polity Press.
Gridasova, I. 1994 Khochesh’ lechit'sia-ishchi sponsora. Sankt-Peterburgskie vedomosti October 26: 1.
Jones, Anthony, and Elliot A. Krause 1991 Professions, the State, and the Reconstruction of Socialist Societies. In Professions and the State: Expertise and Autonomy in the Soviet Union and Eastern Europe, Anthony Jones, ed. pp. 233–254. Philadelphia: Temple University Press.
Justice, Judith 1986 Policies, Plans and People: Foreign Aid and Health Development Berkeley: University of California Press.
Knaus William A., and Nicholas A. Petroff 1981 Inside Russian Medicine: An American Doctor's First-Hand Report. New York: Everest House Publishers.
Morvant, Penny 1995 Alarm over Falling Life Expectancy. Transition 1: 40–45
Navarro, Vicente 1977 Social Security and Medicine in the USSR: A Marxist Critique. Lexington, MA: Lexington Books.
Public Health Committee of the Mayor's Office of St. Petersburg 1993 The Reform of Medical Health Care, St. Petersburg, Russia.
Rivkin-Fish, Michele 1997 Reproducing Russia: Women's Health and Moral Education in the Construction of a Post-Soviet Society. Ph.D. dissertation, Anthropology Department, Princeton University.
Ryan, Michael 1978 The Organization of Soviet Medical Care. Oxford: Blackwell.
Schecter, Kate 1992a Professionals in Post-Revolutionary Regimes: A Case Study of Soviet Doctors. Ph.D. dissertation, Political Science Department, Columbia University.
Schecter, Kate 1992b Soviet Socialized Medicine and the Right to Health Care in a Changing Soviet Union. Human Rights Quarterly 14: 206–215.
Sheiman, Igor 1995 New Methods of Financing and Managing Health Care in the Russian Federation. Health Policy 32: 167–180.
Solomon, Susan Gross, and John F. Hutchinson, eds. 1990 Health and Society in Revolutionary Russia. Bloomington, IN: Indiana University Press.
Stephenson, Patricia, and Ronald Porter 1994 Preventing Maternal Mortality in St. Petersburg: Safe Motherhood in a Healthy City. St. Petersburg, Russia: WHO Healthy Cities Project.
Wagner, Marsden 1994 Pursuing the Birth Machine: The Search for Appropriate Birth Technology. Camperdown, Australia: ACE Graphics.
World Health Organization 1993a Healthy Cities Project, St. Petersburg Support Project. Copenhagen: WHO, Regional Office for Europe.
World Health Organization 1993b Reforming Services for Mothers and Babies in Eastern Europe: Report on a WHO Consensus Meeting (St. Petersburg 9–11 December 1992). Copenhagen: WHO, Regional Office for Europe.
World Health Organization 1994 St. Petersburg Healthy Cities Action Plan: “Giving Birth to a Healthy Child” Copenhagen: WHO, Regional Office for Europe.
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Rivkin-Fish, M. Health Development Meets the End of State Socialism: Visions of Democratization, Women's Health, and Social Well-Being for Contemporary Russia. Cult Med Psychiatry 24, 75–98 (2000). https://doi.org/10.1023/A:1005587117153
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DOI: https://doi.org/10.1023/A:1005587117153