The second lesson is that gender has a lot to do with it. Awareness of gender as a health determinant is relatively recent. He cites evidence that as the environment deteriorates the percentage of small women increases. The third lesson we have learnt is that improvement in perinatal health needs more than improvement in socioeconomic conditions. Women need to have access to essential obstetric care.
Infant mortality is a sensitive indicator of socioeconomic development.
Perinatal mortality, on the other hand, is an indicator of the level of care which women receive in pregnancy and childbirth. The record is mixed. The cult of high technology still attracts fervent followers. While most health professionals are willing to concede that a major proportion of ill-health results from socioeconomic factors and that there is a limit to what modern medicine can achieve without social interventions, there is no consensus on the implication of these facts for the health profession. It can rightly be argued that the health community has limited capacity and limited credibility for taking direct action outside the health sector.