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  • Intimate Interventions in Global Health: Family Planning and HIV Prevention in Sub-Saharan Africa by Rachel Sullivan Robinson
  • Angela Murphy
Robinson, Rachel Sullivan. 2017. INTIMATE INTERVENTIONS IN GLOBAL HEALTH: FAMILY PLANNING AND HIV PREVENTION IN SUB-SAHARAN AFRICA. New York: Cambridge University Press.

Rachel Sullivan Robinson's Intimate Interventions in Global Health: Family Planning and HIV Prevention in Sub-Saharan Africa takes an interdisciplinary approach in discussing historical frameworks and the trajectories of health-programming outcomes on global and local levels.

Rather than relying strictly on statistical data to make sweeping generalizations, Robinson relies on personal interviews with more than 150 participants from a variety of backgrounds to provide detailed, on-the-scene explanations of factors that influence programming, policy, and effectiveness in family planning and HIV prevention. She interviewed experts in global population, and for each case-study country, respondents who worked in NGOs, bilateral organizations, multilateral organizations, federal ministries, and many other organizations related to intimate interventions, defined as, "programs, policies, and organizational actions that aim to change sexual behavior in the name of the individual or collective good" (p. 1).

The first chapter outlines the model for factors that influence intimate interventions. These factors are transnational, political, sociocultural, and economic, and Robinson explains how resources from each set were transferred from family-planning programs to HIV-prevention efforts over the course of four decades. Resources throughout the text are categorized as funding, organizations, and human capital, each with a distinctive effect on the outcomes of HIV prevention.

Situating readers within the global context of reproductive health initiatives, and borrowing from Fligstein and McAdam (2011), Robinson refers to global population and AIDS fields—individuals or collectives operating with shared understanding and goals for particular areas. The proximity of these fields in topics, actors, and target populations rendered the successful emergence of the AIDS field possible, and allowed for strategies and discourses to shift from pregnancy prevention and family planning to HIV prevention. Structurally, the book moves from a discussion of global engagement with reproductive health initiatives, to regional data in sub-Saharan Africa for family planning and HIV prevention, and then makes case studies of three separate nation-states: Malawi, Nigeria, and Senegal.

Over and over, Robinson questions what factors influenced intimate interventions, which resources were most involved, and whether the connections between family planning and HIV-prevention responses in the case-study countries were positive or negative. In Malawi, the socially conservative political legacy of President Banda hampered effective engagement with HIV prevention, demonstrating that "previous health interventions can have negative impacts" (p. 133). Nigeria's political upheaval in the 1990s disrupted the transfer of resources from family planning to HIV prevention. [End Page 112] Contrasting with the previous two cases, Senegal is presented as a model for HIV prevention for several reasons: international ties, strong civil society, and engagement on the part of religious leaders. For each case study, the primary factors in the transfer of resources between family planning and HIV prevention are explained and connected with the strategies and discourses that created positive or negative outcomes.

The argument is clearly presented, without much of the alphabet soup that generally accompanies scholarship on global social issues and policy, but the numerical data overpower the respondents' narratives. Since the case studies are important to demonstrating global and local connections, the chapters on Malawi, Nigeria, and Senegal would be more compelling if they centered on the voices of respondents, more than thirty of them per chapter. Overall, however, Robinson's model provides a rich description of a multilevel, interdisciplinary approach to international health scholarship.

Angela Murphy
People to People International

REFERENCE CITED

Fligstein, N., and Doug McAdam. 2011. A Theory of Fields. New York: Oxford University Press.
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