The Joint Programme on Development and Cultural Diversity to Reduce Poverty and Promote Social Inclusion (the Programme) contributed to further the recognition and exercise of the rights of indigenous and Afro-Ecuadorian women. Among other actions, the Programme supported the design and implementation of the Gender and Interculturality Sectoral Policy, where gender and intercultural approaches are addressed together. The Programme also contributed to the development of an innovative intercultural health system that includes the implementation of a culturally appropriate childbirth model. Through the Programme, several culturally and environmentally sustainable productive ventures were launched. These have created 1,500 income-generating enterprises, 800 of which are run by women.
The 2007-2010 National Development Plan, the II Millennium Development Goals Report for Ecuador (2007), the Constitution of the Republic and the 2009-2013 National Plan for Good Living underscore the need to encourage awareness of and respect for cultural diversity as a means to contribute to a more inclusive society.
Objective 8 of the National Development Plan commits “to affirm and strengthen national identity, diverse identities, plurinationalism and interculturalism.” According to the Plan, “inequality and exclusion of the indigenous and Afrio-Ecuadorian peoples, lack of respect for their collective rights and a liberal approach to diversity have borne deep economic and social impact.” The opportunities to access social goods and services are determined by a person’s cultural and racial origin, place of residence and sex.
It is estimated that nine out of the ten persons who self-define as indigenous and seven out of the ten who self-define as Black are poor. Ethnic-racial discrimination further compounds gender-based discrimination. There are gaps between men and women regarding access to productive resources and to social, cultural and economic opportunities. Indigenous women show lower enrolment rates in all school levels than indigenous men, and the highest illiteracy rates. The number of schooling years for indigenous peoples is 3.7 years, compared to a national average of 7.1 years, while the average for indigenous women is 2.7 years.1
The child mortality rate for indigenous children is 59.3 and 32.6 for Afro-Ecuadorian children, while the national average is 25.8. Indigenous women suffer more problems connected with pregnancy, childbirth, postpartum, family planning and access to gender-based violence services. While at the national level 74.2 per cent of births are assisted by professionals, only 30.1 per cent of indigenous women receive professional care. The national rate for use of contraceptives is 61.9 per cent, compared to 26.5 per cent for indigenous women. These indicators are relevant to the high incidence of maternal mortality among indigenous women due to structural factors, such as poverty, malnutrition and low education levels, and to social and cultural factors, such as racism and discrimination, present in health and education systems, which hinder women’s access to reproductive health services.2
In spite of this context marked by a legacy of inequality and discrimination, in recent years the country has taken important steps regarding the acknowledgement of the individual and collective rights of the indigenous and Afro-Ecuadorian peoples, and of the rights of women. Important institutional mechanisms have also been established to foster and guarantee these rights through Equality Councils.
In the same vein, the Joint Programme on Development and Cultural Diversity to Reduce Poverty and Promote Social Inclusion aims “to advance social inclusion by bridging the gaps created by discrimination and strengthening the exercise of the rights of indigenous, Afro-Ecuadorian and Montubio peoples and nationalities, under the mandates of the Constitution and the National Development Plan for Good Living.”
The Programme focused on three lines of action: (i) design of intercultural policies to promote equal opportunities for all peoples and nationalities; (ii) support of productive cultural initiatives to foster cultural revitalization, organizational strengthening of the communities and sustainable livelihood building; and (iii) production of disaggregated statistical information about Ecuadorian cultural diversity to guide public and private decision-making.
In view of the double discrimination suffered by indigenous and Afro-Ecuadorian women (ethnic and gender discrimination), the Programme adopted a gender mainstreaming strategy to counterbalance the causes and consequences of this double discrimination.
The gender mainstreaming strategy of the Programme aimed to “strengthen the exercise of rights to reduce discrimination and promote equal opportunities for groups excluded for reasons of ethnicity or gender through the design of intercultural public policies that take into account the strategic interests of women, particularly indigenous and Afro-Ecuadorian.”
Eight United Nations agencies participated in the Programme: UNFPA, UNESCO, UNDP, UNICEF, UN Women, UNWTO, FAO and OHCHR.
The main Programme partner was the Sectoral Heritage Council, formed by the Ministries for the Coordination of Heritage, of the Environment, of Sports, and of Culture; the Alfaro City Corporation; the National Institute of Cultural Heritage; and the Government Council of the Special Regime of Galápagos. The Ministries of Tourism, Health, and Education, the National Water Secretariat (SENAGUA), the Secretariat of Peoples, Social Movements and Citizen Participation, the Institute for the Eco-development of the Amazon Region (ECORAE), the Ecuadorian Institute of Intellectual Property, the Ecuadorian Railways Company, and the National Secretariat of Planning and Development participated as associated members.
The National Secretariat of Planning and Development (SENPLADES), as the public institution responsible for a participative, inclusive and coordinated national planning, played a key role in the inclusion of a gender perspective in national policies.
The Equality Councils included the Corporation for Afro-Ecuadorian Development (CODAE), Council for the Development of the Indigenous Nationalities and Peoples (CODENPE), Council for the Development of the Coastal Montubio People (CODEPMOC), and the Transition Commission for the National Council for Women and Gender Equality (CDT).
The gender mainstreaming strategy adopted by the Programme focused on five main lines of action:
- Supporting the Ministry for the Coordination of the Natural and Cultural Heritage (MCPNC) to design its gender and interculturality sectoral policy;
- Implementing a culturally appropriate childbirth model;
- Strengthening indigenous and Afro-Ecuadorian women’s organizations;
- Promoting the visibility and dissemination of the works of indigenous and Afro-Ecuadorian writers; and
- Supporting culturally and environmentally sustainable productive ventures.
Gender and Interculturality Sectoral Policy
MCPNC adopted the Sectoral Gender and Interculturality Policy in 2011 to promote equal opportunities for the indigenous, Afro-Ecuadorian and Montubio nationalities and peoples, with a special emphasis on women. A trailblazer in Latin America, this policy resulted from a participatory process involving several institutional and social actors. The Interculturality Committee (Mesa de Interculturalidad) played a key role in this regard, by spreading the issues to other ministries.
One of the most innovative and significant aspects of this policy was the articulated integration of the “Gender” and “Interculturality” approaches, which required all programmes and activities to factor in both dimensions. The policy document begins by providing the rationale for a gender and an interculturality policy, and then presents a conceptual analysis for the combination of the two approaches and a diagnosis of the sector. Finally, the document defines the policy principles, objectives, guidelines, policies, programs and monitoring and evaluation mechanisms, together with the policy budget, the compliance matrix and the evaluation of indicators. The Gender and Interculturality Policy is built upon seven priorities:
- Bridging the exclusion, racism and gender gaps;
- Strengthening intercultural dialogue with a rights and gender-based approach;
- Strengthening the systems and concepts on health and illness used by indigenous, Afro-Ecuadorian and Montubio nationalities and peoples;
- Promoting, safeguarding and preserving the natural and cultural heritage, and the sacred sites located in ancestral territories;
- Strengthening and promoting ancestral sports to preserve cultures and foster interculturality;
- Including nationalities and peoples and their ancestral knowledge in cultural heritage management, sustainable management of biodiversity, food sovereignty and climate change adaptation; and
- Promoting social and political participation in the heritage sector of representatives of the Ecuadorian nationalities and peoples.
The policy discussion process showed the need for a stronger gender and interculturality approach in national planning tools. Accordingly, a Toolbox for the Implementation of Gender and Interculturality Approaches was developed and included in the Guidelines for Sectoral Policymaking, prepared by SENPLADES.
The implementation phase began in 2011 with the participation of the institutions that take part in the Sectoral Heritage Council and the future Equality Councils: CODAE, CODENPE, CODEPMOC and CDT. Several difficulties emerged in the process, due to institutional instability and the permanent change of the staff defined as focal points in the heritage sector entities, and of the representatives of some Equality Councils. Other factors affecting the process were the scarce knowledge of gender and interculturality shown by the heritage sector staff and the public sector at large, the compartmentalization of gender and interculturality knowledge within the future Equality Councils, and the difficulty integrating both variables of analysis. Finally, in the institutional political culture there was some level of resistance to change, to address the problems suffered by large sectors of the population, such as women and “the others.”
Culturally Appropriate Childbirth Models
Indigenous women have traditionally given birth in their homes with the assistance of midwives, their mothers or their mothers-in-law. They have been reluctant to use health facilities, where attention is centreed around the doctor and their ancestral traditions (such as the birthing position, clothing, food and beverage, family participation, placenta handling and traditional medicine) are not respected. In order to counterbalance this reluctance, the Ministry of Public Health designed an innovative intercultural health system that includes a culturally appropriate childbirth model. The implementation of this model involved the following:
- Building or adapting more suitable delivery rooms that replaced the traditional hospital rooms with places where women can choose a birthing position adapted to their traditions and beliefs.
- Training and awareness-raising activities for the administrative and healthcare staff, midwives and community operators. The following training materials were developed to this end: Methodological Guide to Culturally Appropriate Maternal Healthcare, Awareness-raising Modules in Culturally Appropriate Maternal Healthcare for Healthcare Staff and Knowledge Strengthening Modules for Ancestral Midwives (in Spanish). The Taking Care to Live Well (Cuidémonos para vivir bien) flip charts were particularly well received. These were designed for each of the country’s regions (the Coast, the Highlands and the Amazon) and included sexual and reproductive health information with an interculturality and rights-based approach for the peoples and nationalities living in the three regions. They also contained information on prevention of family violence, sharing family chores and implementing emergency family plans, among others.
- Community information and awareness-raising campaign under the motto “Childbirth, just like at home.”
There are currently ten services working under this intercultural reproductive health model (compared with the six services initially planned in the Programme) and progress has been made for its implementation in the rest of the country.
The culturally appropriate childbirth model has motivated a higher number of women from different communities to seek assistance in healthcare facilities, not only for pregnancy checkups, but also for childbirth. According to available information, in Río Verde (Esmeraldas) a monthly average of five women gave birth in a healthcare facility in 2007, while today almost 18 women per month seek this assistance. In 2010, healthcare facilities in Shushufindi, Limoconcha and Cascales (Sucumbíos) dealt with 397, 39 and 35 childbirths, respectively, while in 2011 the number of cases increased to 433, 63 and 40, respectively.
There was some initial resistance to the new model, particularly on the part of the traditional doctors. However, after a process of awareness-raising and training, a significant portion of the healthcare sector supports and is adopting this model. The new staff, and particularly the young professionals completing their intern year working in rural areas, is more open and eager to commit to the change of paradigm that comes with the intercultural health model.
An important challenge is the high level of rotation of the healthcare staff, which requires a permanent awareness-raising and training effort for the new staff. To avoid this constant repetition, the concept of intercultural health should be included in the curricula of the health-related specializations and in the medical schools.
Strengthening Indigenous and Afro-Ecuadorian Women’s Organizations
The Programme supported organizational strengthening and design and implementation of advocacy agendas for provincial, regional and national indigenous and African-Ecuadorian women’s networks and organizations.
One of the projects implemented aimed to strengthen the grassroots organizations of women associated to the Confederation for the Chimborazo Indigenous Movement of the Peoples of the Puruwa Nation (COMICH). The project included a training programme on collective rights and indigenous women’s specific rights that covered the following topics: food sovereignty, the Water Law, Riobamba nationality and interculturality, leadership and organizational management and family violence.
Visibility and Dissemination of the Works of Indigenous and Afro-Ecuadorian Writers
With the aim of recovering memories and knowledge, in 2010 several literary workshops were organized with indigenous women writers from Ecuador and other Latin American nations. The results were compiled in the anthology “It dawns in our lives” (Amanece en nuestras vidas), published in Spanish, Kiwcha and Shuar.
In 2011 the International Meeting of Women Writers and Poets of Indigenous and African Origin of Latin America and Ecuador was organized, with the participation of 22 women writers from Ecuador, Mexico, Colombia, Peru, Brazil, Venezuela, Cuba and Nicaragua. The results are compiled in the document “A Necklace of Stories and Moons. An Anthology of Poetry by Latin American Indigenous Women” (Collar de historias y lunas. Antología de poesía de mujeres indígenas de América Latina).
Supporting Culturally and Environmentally Sustainable Productive Ventures3
The Programme supported 28 productive ventures, selected on account of their viability, cultural revitalization of the indigenous and African-Ecuadorian peoples, environmental sustainability and gender equality. In addition to receiving financial support, the participants took part in a training programme that covered the following topics: organizational strengthening, leadership and participation, the rights of women, peoples and nationalities and project design and management.
Out of a total of 33 activities organized for the 28 participating ventures, 14 dealt with agricultural production, six with craft-making, eight with community tourism and five were culture-related. The available information shows that 1,500 income-generating occupations, 800 of which were managed by women, were created by these initiatives.
For the participating women, the ventures not only represent a source of income: through the ventures they feel useful and committed to the development of the organization and the community, thus improving their self-esteem. Leadership has been strengthened, particularly among the women that lead or coordinate the ventures. Also, the new economic role played by women entrepreneurs has given rise to changes in family and community roles and relationships, not always without tension.
Corporation of Women Artisans of Nízag
Income generated by the Nízag weavers has contributed to their empowerment within the family and community. In Riobamba and in other areas the men, who at first refused to authorize women’s participation in the local meetings, have eventually accepted their participation in the group of weavers. This attitude is stronger among those who have migrated or lived outside of the community.
The potential for empowerment of the income generated by these ventures needs to be assessed in connection with women’s capacity to control this income. Although some women declared that the husbands kept part of the income, most of the women prioritized the family expenses, particularly their children’s, and used the money for books and notebooks, clothes and shoes. It is worth noting that only a few used this income to meet their own needs. Thus, although women have gained more control over their income, the total family income remains in the hands of the heads of the family.
This resistance to change the gender power relations and the tension it creates can also be seen in the community. The income generated by the organization in charge of the venture goes through the community government but is managed by the association on the basis of a mutual agreement. However, this relationship is complex and charged with tension, as the males in power positions are consciously or unconsciously resistant to women’s autonomous resource management
The change in the role of women within the family and their participation in the public sphere of the community and the world outside the community through the group of weavers has called into question the patriarchal system, with its values and traditional mechanisms of family and community income control.
- The combination of gender, interculturality and the new concept of heritage as key elements of a public policy bears great potential for the process of bridging social, cultural and economic gaps in Ecuador.
- The debates arising from the preparation of the Gender and Interculturality Sectoral Policy underscore the need to institutionalize this policy within the Ministry for the Coordination of the Natural and Cultural Heritage and its subsidiary entities, not only at the centralized government level but also in the territories.
- The initial resistance to the intercultural childbirth model shown by most healthcare staff has abated and today many professionals feel engaged with the project and support the process. The constant awareness-raising and training efforts have been key to winning over initial distrust. To consolidate the programme’s achievements and further progress in the implementation of the model, the awareness-raising campaign needs to be continued and expanded to the rest of the country at all levels: healthcare staff, health community operators, women’s groups and the community at large.
- The young doctors currently completing their intern-year working in rural areas where the culturally appropriate childbirth has been implemented have shown greater openness to the new model. This is doubtless a great opportunity to position and disseminate the intercultural reproductive health model in the country.
- It is important that the concept of intercultural health is increasingly introduced in the initial education levels of all healthcare staff and in the curricula of medical schools and health-related specializations.
- The evaluation of the productive ventures supported by the Programme shows that they have contributed to the empowerment of the participating women by increasing their self-esteem, improving their knowledge of women’s rights, affecting decision-making within the families, negotiating participation in meetings, increasing access to markets and forms of political representation and increasing negotiation power with other organizations or state institutions. However, there is a need for a deeper analysis of issues such as the access to and control of assets (home, land, livestock, tools), decision-making at home, representation in local power spaces and forms of negotiation.
Given the positive results achieved by the Programme, the Ecuadorian State has decided to move to a second phase, financed by national public funds. This commitment illustrates the real and potential impact of the Programme, and the need to carry on the work until concrete and permanent changes are achieved in the living conditions of the indigenous and Afro-Ecuadorian population, and particularly of the women.