"This thesis is a critique of the global reproductive health and rights and discourse, which emanated from the 1994 International Conference on Population and Development. The thesis argues that far from being a new population policy paradigm, the reproductive rights and health discourse is a reworking of a neo-Malthusian and neo-liberal policy agenda. The thesis begins with a consideration of the historical and political context in which international population policy has evolved, and questions the extent to which liberal notions of individual rights freedom and choice, enshrined in the reproductive health discourse, bears a relationship to the social, political and economic realities in which poor and socially marginalized people experience their sexual and reproductive health. Through a critical review of the literature the thesis questions the positivist/functionalist paradigms upon which mainstream demographic and reproductive health research is based. In rejecting both the positivism of mainstream demography as well as the relativism of much post-modernism, the thesis draws eclectically upon post-structuralist and practice theory to suggest a framework for "critical social analysis", which understands sexual and reproductive behaviour as both historically grounded and culturally contingent. Central to the framework is an exploration of how constructions of identity and difference shape social and political practice at the national and local level. Drawing upon case study material from Bolivia, the thesis explores how constructions of identity and difference are embedded in historical and structural conditions of inequality and exploitation. Through an ethnographic study the thesis considers how these structural conditions of inequality become embodied in and reproduced through everyday practices, which ultimately shape the experience of health and well being among poor migrant women. The thesis goes on to suggest a methodological approach entitled the "peer ethnographic method" for incorporating such an understanding of identity and difference into programme design and monitoring.
