Skip to main content

Advertisement

Log in

Physically Demanding Labor and Health Among Indigenous Women in the Ecuadorian Highlands

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Physically demanding work carried out during long workdays affects women’s health. In rural and agrarian societies, women perform a variety of domestic and productive tasks, often from dawn to dusk, with little or no leisure time. This paper presents the results of a survey of indigenous women in six rural communities in the Ecuadorian highlands. It was conducted to measure the amount of time women spend on physically demanding work in the context of food security, parity outcomes, and access to prenatal health care. The findings demonstrate that these women work very long workdays and also experience food insecurity and poor access to prenatal health care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Peacock, A. J. (1998). Oxygen at high altitude. BMJ (Clinical Research ed.), 317, 1063–1066.

    Article  CAS  Google Scholar 

  2. Boserup, E. (1970). Women’s role in economic development. London: George Allen & Unwin.

    Google Scholar 

  3. Browner, C. H. (1989). Women, household and health in Latin America. Social Science and Medicine, 28, 461–473.

    Article  PubMed  CAS  Google Scholar 

  4. Deere, C. D., & León de Leal, M. (1981). Peasant production, proletarianization, and the sexual division of labor in the Andes. Signs, 7, 338–360.

    Article  Google Scholar 

  5. Sargent, C. F. & Brettell, C. B. (1996). Gender and health: An international perspective. Upper Saddle River, NJ: Prentice Hall.

    Google Scholar 

  6. Artacoz, L., Cortès, I., Borrell, C., Escribà-Agüir, V., & Cascant, L. (2007). Gender perspective in the analysis of the relationship between long work hours, Health, and Health-related behavior. Scandinavian Journal of Work and Environmental Health, 33, 344–350.

    Article  Google Scholar 

  7. Artacoz, L., Cortès, I., Benavides, F. G., Escribà-Agüir, V., Bartoll, X., Vargas, H., & Borrell, C. (2016). Long working hours and health in Europe: Gender and welfare state differences in a context of economic crisis. Health and Place, 40, 161–168.

    Article  Google Scholar 

  8. Bonde, J. P., Jørgensen, K. T., Bonzini, M., & Palmer, K. T. (2013). Miscarriage and occupational activity: A systematic review and meta-analysis regarding shift work, working hours, lifting, standing, and physical workload. Scandinavian Journal of Work and Environmental Health, 39, 325–334.

    Article  Google Scholar 

  9. Giuffrida, A., Iunes, R. F., & Savedoff, W. D. (2002). Occupational risks in Latin America and the Caribbean: Economic and health dimensions. Health Policy and Planning, 17, 235–246.

    Article  PubMed  Google Scholar 

  10. Singh, S., Sedgh, G., & Hussain, R. (2010). Unintended pregnancy: Worldwide levels, trends, and outcomes. Studies in Family Planning, 41, 241–250.

    Article  PubMed  Google Scholar 

  11. FAO (Food and Agriculture Organization of the United Nations). (2011). The state of food and agriculture: Women in agriculture: Closing the gender gap for development. Rome: FAO.

    Google Scholar 

  12. FAO (Food and Agriculture Organization of the United Nations). (2009). Gender in agriculture sourcebook. Rome: FAO.

    Google Scholar 

  13. Harriss, J. (2014). Gender implications of poor nutrition and health in agricultural households. In A. A. Quisumbing, R. Meinzen-Dick, T. L. Raney, A. Croppenstedt, J. A. Behrman & A. Peterman (Eds.), Gender in agriculture: Closing the knowledge gap (pp. 267–283). Rome: FAO/Springer.

    Chapter  Google Scholar 

  14. Marmot, M., & Bell, R. (2016). Social inequalities in health: A proper concern of epidemiology. Epidemiology, 26, 238–240.

    Google Scholar 

  15. Freire, W. B., Ramirez-Luzuriaga, M. J., Belmont, P., et al. (2014). Tomo I: Encuesta nacional de salud y nutrición de la población ecuatoriana de cero a 59 años. ENSANUT-ECU 2012. Quito: Ministerio de Salud Pública/Instituto Nacional de Estadística y Censos.

    Google Scholar 

  16. Freire, W. B., Silva-Jaramillo, K. M., Ramirez-Luzuriaga, M. J., Belmont, P., & Waters, W. F. (2014). The double burden of undernutrition and excess body weight in Ecuador. American Journal of Clinical Nutrition, 100(Suppl), 1636S–1643S.

    Article  PubMed  CAS  Google Scholar 

  17. Hall, G., & Patrinos, H. A. (Eds.). (2006). Indigenous peoples, poverty, and human development in Latin America 1994–2004. Washington, D.C.: The World Bank.

    Google Scholar 

  18. King, M., Smith, A., & Grace, M. (2009). Indigenous health part 2: The underlying causes of the health gap. Lancet, 374, 76–85.

    Article  PubMed  Google Scholar 

  19. UNDP (United Nations Development Program). (2015). Human development report 2015: Work for human development. New York: UNDP.

    Book  Google Scholar 

  20. INEC (Instituto Ecuatoriano de Estadística y Censo). (2010). Censo de población y vivienda. Retrieved June 20, 2017, from http://www.ecuadorencifras.gob.ec/censo-de-poblacion-y-vivienda/.

  21. Larrea, C., & Montenegro, F. (2006). Ecuador. In G. Hall & H. A. Patrinos (Eds.), Indigenous peoples, poverty, and human development in Latin America 1994–2004 (pp. 67–105). Washington, D.C.: The World Bank.

    Chapter  Google Scholar 

  22. Montenegro, R. A. & Stephens, C. (2006). Indigenous health in Latin America and the Caribbean. Lancet, 367, 1859–1869.

    Article  PubMed  Google Scholar 

  23. Weismantel, M. J. (1988). Food, gender, and poverty in the Ecuadorian Andes. Philadelphia: University of Pennsylvania Press.

    Google Scholar 

  24. World Bank. (2007). Nutritional failure in Ecuador: Causes, consequences, and solutions. Washington, D.C.: The World Bank.

    Book  Google Scholar 

  25. Ministerio de Coordinación de Desarrollo Social & World Food Program. (2010). Mapa de la desnutrición crónica en el Ecuador. Ministerio de Coordinación de Desarrollo Social, Quito: World Food Program.

  26. Camacho, A. V., Castro, M. D., & Kaufman, R. (2006). Cultural aspects related to the health of Andean women in Latin America: A key issue for progress toward the attainment of the Millennium Development Goals. International Journal of Obstetrics and Gynecology, 94, 357–363.

    Article  CAS  Google Scholar 

  27. Alonso-Fradejas, A., Borras, S. M., Holmes, T., Holt-Giménez, E., & Robbins, M. J. (2015). Food sovereignty: Convergence and contradictions, conditions and challenges. Third World Quarterly, 36, 431–448.

    Article  Google Scholar 

  28. Giunta, I. (2014). Food sovereignty in Ecuador: Peasant struggles and the challenge to institutionalization. Journal of Peasant Studies, 41, 1201–1214.

    Article  Google Scholar 

  29. Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., et al. (2008). Maternal and child undernutrition: Global and regional exposures and health consequences. Lancet, 371, 243–260.

    Article  PubMed  Google Scholar 

  30. Mitra, A. K., & Rodriguez-Fernandez, G. (2010). Latin America and the Caribbean: Assessment of the advances in public health for the achievement of the Millennium Development Goals. International Journal of Environmental Research and Public Health, 7, 2238–2255.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Waters, W. F. (2007). Indigenous communities, landlords, and the state: Land and labor in highland Ecuador, 1950–1975. In A. K. Clark & M. Becker. (Eds.), Highland indians and the state in modern Ecuador (pp. 120–136). Pittsburgh, PA: University of Pittsburgh Press.

    Chapter  Google Scholar 

  32. Madsen, M., Jørgensen, T., Jensen, et al. (2007). Leisure time physical exercise during pregnancy and the risk of miscarriage: A study within the Danish National Birth Cohort. BJOG: An International Journal of Obstetrics and Gynaecology, 11, 1419–1426.

    Article  Google Scholar 

  33. Gallegos, C. A., Waters, W. F., & Sebert Kuhlmann, A. (2017). Discourse vs. practice: Are traditional practices and beliefs in pregnancy and childbirth included or excluded in the Ecuadorian health care system? International Health, 9, 105–111.

    PubMed  Google Scholar 

  34. Moore, L. G. (2003). Fetal growth restriction and maternal oxygen transport during high altitude pregnancy. High Altitude Medicine and Biology, 4, 141–156.

    Article  PubMed  Google Scholar 

  35. Moore, L. G., Charles, M., & Julian, C. G. (2011). Humans at high altitude: Hypoxia and fetal growth. Respiratory Physiology and Neurobiology, 178, 181–190.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Moore, L. G., Shriver, M., Bemis, L., Hickler, B., et al. (2004). Maternal adaptation to high-altitude pregnancy: An experiment of nature: A review. Placenta, 25, S60–S71.

    Article  PubMed  CAS  Google Scholar 

  37. Julh, M., Strandberg-Larsen, K., Larsen, P. S., et al. (2013). Occupational lifting during pregnancy and risk of fetal death in a large national cohort study. Scandanavian Journal of Work and Environmental Health, 39, 335–342.

    Article  Google Scholar 

  38. WHO (World Health Organization. (2002). Antenatal care randomized trial: Manual for the implementation of the new model. Geneva: World Health Organization. Retrieved June 20, 2017, from http://apps.who.int/iris/bitstream/10665/42513/1/WHO_RHR_01.30.pdf.

  39. WHO (World Health Organization). (2016). Recommendations on antenatal care for positive pregnancy experience. Geneva: World Health Organization. Retrieved June 20, 2017 from http://who.int/iris/bitstream/10665/250796/1/9789241549912-eng.pdf.

    Google Scholar 

  40. Ferreira, C., Garcia, K., Macías, L., Pérez, A., & Tomisch, C. (nd). Mujeres y hombres del Ecuador en cifras III. Quito: Instituto de Estadistica y Censos & ONUMujeres.

  41. Melby, C. L., Orozco, F., Ochoa, D., Muquinche, M., Padro, M., & Muñoz, F. N. (2017). Nutrition and physical activity in the Ecuadorian Andes: Differences among urban and rural-dwelling women. American Journal of Human Biology. doi:10.1002/ajhb.22986.

    Article  PubMed  Google Scholar 

  42. Deere, C. D. (2009). The feminization of agriculture? The impact of economic restructuring in rural Latin America. In S. Razavi (Ed.), The gendered impacts of liberalization: Towards “embedded liberalism”? (pp. 99–130). London: Routledge.

    Google Scholar 

  43. Momsen, J. H. (2005). Women and development in the third world. New York: Routledge.

    Google Scholar 

  44. Weigel, M., Armijos, R. X., Racines, M., & Cevallos, W. (2016). Food insecurity is associated with undernutrition but not overnutrition in Ecuadorian women from low-income urban neighborhoods. Journal of Environmental Public Health. 10.1155/2016/8149459.

    Article  PubMed  Google Scholar 

  45. UNICEF. (2006). The state of the world’s children 2007: Women and children, The double dividend of gender equality. New York: UNICEF.

    Google Scholar 

  46. Ministerio de Salud Pública. (2012). Manual del modelo de atención integral de salud—MAIS. Quito: Ministerio de Salud Pública.

    Google Scholar 

Download references

Acknowledgements

Funding was provided by Universidad San Francisco de Quito.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to William F. Waters.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

This study was made possible by a Collaboration Grant from the Universidad San Francisco de Quito. The authors are grateful to the women who participated in the study and to two dedicated field workers.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Waters, W.F., Ehlers, J., Ortega, F. et al. Physically Demanding Labor and Health Among Indigenous Women in the Ecuadorian Highlands. J Community Health 43, 220–226 (2018). https://doi.org/10.1007/s10900-017-0407-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-017-0407-7

Keywords

Navigation