i ii iii TABLE OF CONTENTS FOREWORD ......................................................................................................................... i ACKNOWLEDGEMENTS ..................................................................................................... iii CHAPTER 1: OVERVIEW ..................................................................................................... 1 by Bhavya Reddy and Gita Sen Introduction ........................................................................................................................ 1 Methodology ...................................................................................................................... 3 Background......................................................................................................................... 5 Political and economic landscape ...................................................................................... 7 MDG Adoption into policy environment ......................................................................... 11 Nigeria ........................................................................................................................... 11 India ............................................................................................................................... 12 Mexico ........................................................................................................................... 13 Poverty reduction strategies and women’s health and empowerment ......................... 15 Fragmentation of SRHR .................................................................................................... 20 Limited progress on MDGs ............................................................................................... 28 Conclusions ....................................................................................................................... 30 CHAPTER 2: MEXICO CASE STUDY MDGs and SRHR in Mexico’s Social Programs: So near and yet so far ............................ 36 by Erika Troncoso Introduction ...................................................................................................................... 36 Background Information .................................................................................................. 39 Maternal Mortality ........................................................................................................... 43 The voice of women ......................................................................................................... 47 Abortion services: advances and setbacks ....................................................................... 55 Newspaper Content Analysis ........................................................................................... 59 Conclusion ......................................................................................................................... 60 CHAPTER 3: INDIA CASE STUDY Coherence or Disjunction? MDGs, SRHR, Gender Equity and Poverty in Gujarat and Tamil Nadu ........................................................................................................................ 64 by Renu Khanna with Anagha Pradhan and Lakshmi Priya Introduction ...................................................................................................................... 64 National policies and progress on the MDGs, SRHR, gender equity, and poverty: coherence or disjunction? ................................................................................................ 67 Macro-economic profile of India and its poverty, gender equity and SRH access outcomes .......................................................................................................................... 67 Macro economy ............................................................................................................ 67 Poverty .......................................................................................................................... 68 Caste, religion and poverty ........................................................................................... 69 Gender and poverty/ gender equality ......................................................................... 70 Health/ SRHR ................................................................................................................. 72 Summing up: progress on MDGs, gender, poverty and SRHR: .................................... 74 Central government policies on MDGs, poverty, gender and SRHR ............................... 75 National targets ............................................................................................................ 75 Nutrition ........................................................................................................................ 76 Poverty reduction .......................................................................................................... 77 Gender ........................................................................................................................... 80 Health/ SRHR ................................................................................................................. 82 National Policies on poverty, gender and SRHR: Coherence or Disjunction ............... 86 Tamil Nadu policies and progress on the MDGs, poverty, gender equity, and SRHR: coherence and disjunctions .............................................................................................. 89 Profile of poverty, gender inequity and SRHR ................................................................. 89 Attention to MDGs, gender equity, poverty and SRHR in Tamil Nadu ........................... 93 State targets, outlay and borrowings .......................................................................... 93 Poverty reduction policies ............................................................................................. 94 Health ............................................................................................................................ 95 Gender ........................................................................................................................... 97 Perceptions of Tamil Nadu officials on MDGs, gender, poverty and SRHR .................... 98 Community reach of poverty, gender equity and SRHR policies and programs .......... 101 Gujarat policies and progress on MDGs, poverty, gender equity, and SRHR: coherence and disjunctions .............................................................................................................. 107 Profile of poverty, gender equity and SRH access outcomes: Gujarat .......................... 107 Poverty ........................................................................................................................ 107 Gender ......................................................................................................................... 110 Health .......................................................................................................................... 112 Attention to MDGs, poverty, gender equity, and SRHR in Gujarat policies and plans 115 Perceptions of Gujarat officials on MDGs, poverty, gender equity, and SRHR ............ 117 Community reach of SRHR policies and programs ........................................................ 119 Civil Society Action on MDGs, gender equity, poverty and SRHRs ............................... 122 National movements ...................................................................................................... 122 Wada Na Todo Abhiyan (Abhiyan) ............................................................................ 122 Jan Swasthya Abhiyan ................................................................................................ 123 The Right to Food campaign ...................................................................................... 124 The ICPD +15 Review Process ..................................................................................... 125 Legal Action for Maternal Health Rights .................................................................... 127 Voices against 377 ....................................................................................................... 128 Civil society action on MDGs, poverty, gender equity and SRHR in Tamil Nadu .......... 130 Movements ................................................................................................................. 130 Research studies .......................................................................................................... 131 Media monitoring ....................................................................................................... 131 Civil society action on MDGs, poverty, gender equity and SRHR in Gujarat ................ 134 Movements ................................................................................................................. 134 Media Monitoring ....................................................................................................... 135 Conclusion and Ways Forward ....................................................................................... 136 Conclusions .................................................................................................................. 136 Ways forward .............................................................................................................