Schedule:
Sunday, January 15, 2012: 11:45 AM
Constitution E (Grand Hyatt Washington)
* noted as presenting author
Dheeshana Jayasundara, PhD, Student, University of North Dakota, Plano, TX
Ruby Bouie, LMSW, PhD Student, University of Texas at Arlington, Arlington, TX
Cándida Madrigal, Phd, Assistanr Professor, San Francisco State University, Walnut Creek, CA
Background and Purpose: This paper tests the applicability of Amartya Sen's theory on capability and development (Sen, 1992; 1993a; 1993b; 1999a; 1999b; 2007) to the identified empirical models of maternal mortality and infant mortality. Each year more than 500,000 women die of pregnancy-related complications and the death of a mother with children less than 5 years of age increases the chances of the death of those children by almost 50% (Ashford, 2001). In addition, on average, in less developed countries, 61 infants die for every 1000 live births (Population Reference Bureau, 2007). Since the 1990s, the United Nations Development Program (UNDP), separate from the reproductive movement, has adopted Sen's human development paradigm in their developmental efforts (Fakuda-Parr, 2005). But to date no research has been conducted testing the efficacy of Sen's theoretical perspectives to reproductive health of women in developing countries. In the past, empirical studies have focused on a limited number of possible structural influences, centering on individual rights and gender-based perspectives with structural variables as their backdrop constructs (Clark, 2006; Pillai & Gupta, 2006; Pillai & Wang, 1999; Swatzyna, 2004; Wang, 2004, 2007). Yet, these empirical models lacked the backing of a clear theory; instead they used an eclectic theoretical approach. The proposed model hypothesizes that social development and reproductive capabilities negatively influence maternal mortality and infant mortality in the developing countries when controlling for economic growth and political development.
Methods: This analysis was conducted using secondary data. The sample for this study came from 142 developing countries out of 144 identified by the World Bank (World Bank, 2009). Data were collected from several international bodies such as World Health Organization, United Nations, World Bank, and several of their affiliated institutions. The path analysis method was used to determine if the theoretically proposed paths and the models were empirically validated. Factor based scales were developed to measure the latent constructs: reproductive capability and social development.
Results: The path model provided is an excellent fit model for the observed variance-covariance matrix for both maternal mortality and infant mortality. Infant mortality was indicated by very low chi square value of 2.07 (df = 4), and fitness of CFI (1.00), TLI (1.01) and RMSEA (.00). Maternal mortality was also indicated by very low chi square value of 2.08 (df = 4), and fitness of CFI (1.08), TLI (1.03) and RMSEA (.04). All hypothesized paths and the two theoretical models were empirically validated.
Conclusion and Implications: The paper argued that capability and social development based approaches are more congruent to alleviate maternal and infant mortality in developing countries. The study findings urge social workers to promote social development efforts, especially focusing on adult literacy, reallocation of resources, and improvement in basic amenities. These efforts must also be followed by improvements in reproductive capabilities, such as health care policies, better access to services, and advancements in female empowerment to improve maternal health.
