Abstract
Despite improved national censuses and “micro-demographic” studies, demographic processes and health conditions among indigenous populations in Amazonia and elsewhere in lowland Latin America are not well understood. A new source of demographic and health data has emerged in the past decade, namely meso-scale surveys initiated and administered by indigenous organizations. These surveys offer the potential for filling information gaps, shedding light on culturally specific factors that shape demographic processes and health, and empowering indigenous organizations with data that could inform health initiatives. This article assesses the indigenous-run survey “2005 Health Analysis of the Shuar and Achuar Nations” of eastern Ecuador in which the authors were involved, which reached 1,943 households in 257 communities in Morona-Santiago Province. We present findings on fertility, migration, sanitation, and health, and assess the strengths and weaknesses of the survey. We argue that despite flaws in the survey design and implementation, this survey revealed important linkages among fertility, migration, and health. Such surveys have the potential to provide much needed detail, representativeness, and cultural specificity that macro and micro data sources cannot provide. We conclude with recommendations to improve surveys of this type.
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Notes
We do not consider surveys conducted by academics that included demographic information on indigenous populations within a broader sampling of a multi-ethnic rural population, because they were not intended as comprehensive assessments of specific indigenous groups’ demographic and/or health profiles (e.g., Bilsborrow et al. 2004, Carr et al. 2007). Similarly, the Demographic Survey of Maternal and Infant Health (CEPAR 2004) and the Living Standards Measurement Survey (cited in Larrea and Montenegro Torres 2006) are national samples, but they are distinct from the autonomous indigenous surveys under discussion.
The Independent Federation of Shuar People of Ecuador (FIPSE)—and one Achuar Federation, the Achuar Nation of Ecuador (NAE) also participated, but to a lesser degree. The Survey included Achuar living in Morona-Santiago, but they represent a relatively small percentage of the total Survey (6.0% of households). We aggregate Shuar and Achuar for this report because there were virtually no statistically significant differences between Shuar and Achuar, especially in terms of fertility and health.
Shuar are one of four groups that belong to the Jivaroan language family. The other three groups include Achuar, Huambiza, and Aguaruna. Most Haumbiza and Aguaruna live in Peru and Achuar mostly live in Pastaza Province and in adjoining Peru.
The Sistemas de Educación Radiofónica Bicultural Shuar (Shuar Bicultural Distance Radio Education Systems (SERBISH) is a Shuar-controlled education program.
The Survey found that 42% of Shuar had at least some secondary school training, but only 3% had attended or graduated from a university.
Auxiliary nurses receive 6–12 months of intensive university training and are recognized by the Ecuadorian Ministry of Health. ‘Health promoters’ are trained through periodic courses of 2–5 days and can obtain a certification for their attendance without evaluation of their skills; they are elected by their communities and work voluntarily (pers. comm., J. Pozo, 13 July 2007) (Pozo 2005).
Subsequent contributions of approximately $1,000 went to completing the Survey, paying some of the enumerators, and paying an office worker to input the data. The bulk of the Survey budget was provided by the government of Finland and administered though UNICEF. Further details of the Survey budget were not shared with us.
We also discovered that respondents commonly gave imprecise answers regarding age, showing a marked tendency to ‘round up’ an infant’s age to 1, and to ‘clump’ other ages around common numbers (35, 40, 60, etc.). We therefore used a standard “smoothing” technique to adjust the reported age data and so minimize the effect of clumping on the calculation of vital rates (see UNICEF 2007).
We asked to take a copy of the questionnaires back with us to Ohio. The request was granted, in recognition that previous (uncopied) surveys had been lost by prior Shuar leadership. We therefore paid for all survey questionnaires to be photocopied, and we retain those copies at the Ohio State University. We received some late-coming questionnaire copies upon our return to the U.S., where we continued to clean the data. We do not know where the original set of questionnaires is held in Ecuador.
The range of the estimates reflect differences in the data set we used (household or centro), how we temporally apportioned spurious birth dates, smoothed clumps in women’s reported ages, and other issues. Further, because our ‘groundtruthing’ indicated that the Survey undercounted births to mothers 15–19, and may have been inconsistent in the capture of all births to individual women, we expect that all fertility estimates are conservative.
The ASFR of women 15–19 appears to be surprisingly low for a population with such high overall parity, however this number is likely low in part due to poor sampling and should probably be discounted.
The Survey did not ask the quantity or frequency of remittances, simply if the household receives remittances and how the remittances are spent.
The Survey was designed to include only Shuar or Achuar; the number of mestizos represented in the Survey is likely trivial because the Survey was conducted in recognized rural Shuar centros, where the number of mestizo inhabitants is very small.
For example, the NGO CARE had recently completed a 1,500-household survey of some portion of the study population; the Director of Health intermittently launched small surveys; the National Census had been carried out in 2001, and academics occasionally survey portions of the population.
We are aware that the narrow biomedical understanding of health (emphasized here) only represents a portion of how indigenous people approach their well-being (Izquierdo 2005). While the latter is beyond the scope of this study, we are aware of the ways in which alternative understandings of health could be better integrated into demographic/health surveys generally.
We do know, however, that our interactions with the Shuar Director of Health, while limited to brief discussions of survey design, calculation of basic demographic indicators, database development, and methods for presenting data (population pyramids, age specific fertility rate graphs, and the like)—informed his subsequent design of a similar survey among a separate population of Shuar.
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Acknowledgements
We thank Steve Rubenstein for his advice and support throughout the research process. In Ecuador, we are most grateful to Washington Tiwi, Dr. José Pozo Mosquera, Rosana Posligua, Cecilia Dávila, Dr. Juan Chau, and the leadership and membership of the Shuar Federation (FICSH) for their guidance and willingness to incorporate us into the survey process. We are also grateful for fieldwork support from the National Geographic Society and a Lawrence A. Brown Faculty Fellowship at Ohio State. We thank the anonymous reviewers for their constructive comments.
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Appendix 1. Estimates of parity derived from the Shuar Survey (2005)
Appendix 1. Estimates of parity derived from the Shuar Survey (2005)
FERTILITY | Total |
Total births in past year for all households (household data; BR EST 1) | 750 |
Birth rate (births/total population*1000) ESTIMATE 1 | 62.89 |
Birth rate (births/total population*1000) ESTIMATE 2 | 35.56 |
Birth rate: ESTIMATE 3 | 41.51 |
Age-specific fertility rate (ASFR): | |
15–19 | 88.14 |
20–24 | 269.31 |
25–29 | 358.40 |
30–34 | 328.03 |
35–39 | 295.03 |
40–44 | 110.00 |
45–49 | 70.97 |
Total Fertility Rate (TFR): | 7.60 |
Total women over 50 years | 234 |
All women >50 for whom we have fertility data | 143 |
Total no. births to women >50 for whom we have data | 878 |
Completed fertility rate (all children born to women over 50) | 6.14 |
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Jokisch, B.D., McSweeney, K. Assessing the Potential of Indigenous-Run Demographic/Health Surveys: the 2005 Shuar Survey, Ecuador. Hum Ecol 39, 683–698 (2011). https://doi.org/10.1007/s10745-011-9419-6
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DOI: https://doi.org/10.1007/s10745-011-9419-6