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dissertation entitled

INTERNAL MIGRATION AND THE NUTRITIONAL STATUS
OF SCH0.0L-‘-AGED CHILDREN IN COTOCOLLAO ALTO,
VQUITO, ECUADOR

presented by

Bethann Sandlin Witcher

has been accepted towards fulfillment
of the requirements for

Ph.D. degree in Nutrition

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(athryn M. Kolasa

Date 7/31/85

 

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INTERNAL MIGRATION AND THE NUTRITIONAL STATUS OF
SCHOOL-AGED CHILDREN IN COTOCOLLAO ALTO,
QUITO, ECUADOR

BY

Bethann Sandlin Witcher

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Food Science and Human Nutrition

1985

ABSTRACT
INTERNAL MIGRATION AND THE NUTRITIONAL STATUS OF

SCHOOL-AGED CHILDREN IN COTOCOLLAO ALTO,
QUITO, ECUADOR

BY
Bethann Sandlin Witcher

Anthropometric measurements and 24-hour dietary recalls
were collected from eighty-five school-aged migrant children
8 to 10 years of age in Cotocollao Alto, Quito, Ecuador.
Socioeconomic, food frequency and dietary history data were
collected from the food system gatekeeper of each child's
family. The relationship between the nutritional status of
these children and their families' length of residence in
Quito was assessed.

No relationship was found between length of family
residence and the children's dietary adequacy as determined
by their intake of energy, protein. iron, calcium. thiamine,
riboflavin and vitamin A. Mean percents of the 1974 FAG/WHO
Recommended Nutrient Intakes adjusted for sex and age were
50% or greater although 30 or more percent of the children
were found to consume less than 66% of their dietary recom-
mendation for energy, calcium, vitamin A, riboflavin and

thiamin.

Bethann Sandlin Witcher

Chiers weight was found to increase as the length of
family residence in Quito increased. Number of parents
migrating (one or both) was found to interact with length of
family residence in Quito as it affected child's weight.
When the sample was stratified by number of parents migrat-
ing to examine the interaction of length of family residence
and number of parents migrating, length of residence had no
effect on child's weight. Age was the only variable linear-
ly related to height. Sex was found to be a predictor
variable for weight/height ratio. The weight/height ratio
was linearly related to income, showing an increase in
weight/height ratio of approximately .04 for every 1000
sucre increase in income.

The reported rural and urban food consumption patterns
for the same gatekeeper were significantly different.
Migration from rural to urban Equador resulted in changes in
the dietary patterns of migrating families and the eventual
complete adaptation to the dietary pattern of their urban
counterparts. Further interpretive analysis of these data
revealed patterns of change which could affect the
nutritional status of migrant children. These patterns of
change were examined for potentially positive. negative or
neutral effects on the nutritional status of migrant
children. The relationship between migration related
dietary pattern changes and gatekeeper reported satisfaction

with life was demonstrated.

DEDICATION
To my daughter,
Marisa Iara Pruitt,
who lit the fire
and
To my mother,

MaryHelen Witcher,
who never let the fire burn out

ii

ACKNOWLEDGEMENTS

The author wishes to express her appreciation and
thanks to the following persons and institutions for the
support which made this project possible:

To Dr. Kathryn M. Kolasa for the opportunities which
she provided and for consistently demanding that the highest
standards be met.

To Dr. Jenny 13 Bond, Dr. Ann Millard, Dr. Robert
Thomas and Dr. John Gill for the support, guidance and
encouragement which each of them so willingly and generously
provided me.

To Lisa Lewis and Sharon Tiemann for shared moments of
panic and anxiety and many hours of work in the preparation
of this manuscript.

To Mercedes Solano, for her insights and for the time
and energy she devoted to being a research assistant.

To the directors and teachers of the elementary schools
Galo Molina, Galo Plazo Lasso, Junta Nacional de La Vivienda
and Diario 'El Comercio' for their unquestioning participa-
tion and facilitation of this project.

To the families of Cotocollao Alto for welcoming me
into their homes and lives and for their cheerful participa-

tion in this project.

iii

To the Instituto Nacional de Investigaciones Nutri-
cionales y Medico Sociales staff in Quito, Ecuador for their
assistance in the implementation of the data collection,
with special thanks to Dr. Mario Paredes, Dr. Jose Suarez,
Dr. Guillermo Troya, Lic. Mariana Oleas and Fernando
Briones.

To Dr. Kenn Farr and Dr. Carlos Luzuriaga, USAID Mis-
sion, Quito, Ecuador, for their advice, support and words of
encouragements throughout my stay in Ecuador.

To my co-workers at MAP-ECUADOR for their continual
loving support and caring reinforcement.

To my brothers and their families for lending a helping
hand.

To Carrie Heeter, for sharing her knowledge, her love
and her home.

To Alejandro, for being there.

To those organizations and institutions without whose
financial support this project could not have been com-
pleted; United States Agency for International Development,
Title XII Strengthening Grant, Ford Foundation, Women-In-
Development Research Grant, Council on International Educa-
tional Exchange, Sigma Xi and the Department of Food Sci-

ence and Human Nutrition, Michigan State University.

iv

TABLE or CONTENTS
Page
LI ST OF TABLES O O C C O O O O O O O O O O O O O O O 0 v 1

LIST OF FIGURES O O O O O O O O O O O O O O O O O O O Vii].-

CHAPTER
I. Introduction . . . . . . . . . . . . . . . . . 1
II. Review of Literature . . . . . . . . . . . . . 7
III. Methods and Procedures . . . . . . . . . . . . 32
IV. The Research Site . . . . . . . . . . . . . . . 45
V. Results . . . . . . . . . . . . . . . . . . . . 54
VI. Discussion . . . . . . . . . . . . . . . . . . 98
VII. Summary, Implications & Research

Recommendations . . . . . . . . . . . . . . . . 134

APPENDICES
A Three—day Dietary Record Form, Twenty-four
Hour Dietary Recall Form and Anthr0pometric
Data Record Sheet . . . . . . . . . . . . . . . 141
B Socioeconomic Interview Schedule . . . . . . . 157
C Food Frequency Instrument and Dietary Change
Instrument O O O O O O O O O O O O O O O O O O 164

BIBLIOGRAPHY O O O O O O O O O O O O I O O O O O O O O 173

Table

1.

10.

11.

12.

LIST OF TABLES

Prevalence of Undernutrition in Ecuadorian
SChOOl Children 0 O O O O O I I O O O O O O I 0

Profile of children (8-11 years) in Cotocollao
Alto, Quito, ecuador, June, 1983 (n=85) . . . .

Profile of families in Cotacollao Alto, Quito,
Equador, June, 1983 (n=85) . . . . . . . . . . .

Age and education of children's parents in
Cotocollao Alto, Quito, Ecuador, June, 1983

(n=85) o o o o o o e o o o o o o o o o o o o o 0

Occupation of children's mothers in Cotocollao
Alto, Quito, Ecuador, June, 1983 (n=81) . . . .

Occupation of the children's fathers in
Cotocollao Alto, Quito, Ecuador, June, 1983

(n=85) O O I O O O O O O O O O O O O O O O O O 0

Housing in Cotocollao Alto, Quito, Ecuador,
June, 1983 (n=85) o o I o o o o o o I o o o o 0

Family migration data, Cotocollao Alto, Quito,
Ecuador, June, 1983 (n=85) . . . . . . . . . . .

Motivation for and satisfaction with migration
of migrants in Cotocollao Alto, Quito, Equador,
June'1983(n=45)00000000000000.

Table of Candidate list of explanatory variables
used with each dependent variable . . . . . . .

Male and female childrenfls mean percent FAD/WHO
Recommended Nutrient Intakes for one total day
for energy and six nutrients, Cotocollao Alto,
Quito, Ecuador, June, 1983 (N=85) . . . . . . .

Number of children meeting and thos meeting more
than 100% of FAQ/WHO Recommended Nutrient
Intakes for energy and six nutrients, Cotocollao
Alto, Quito, Ecuador, June, 1983 (n=85) . . . .

vi

Page

11

56

58

61

62

63

66

70

73

75

77

78

Table
13.

14.

15.

16.

17.

18.

Summary of regression results examining the
interaction of selected independent variables
and those dependent variables reflecting
nutritional status . . . . . . . . . . . . . . .

Distribution of weight-for-age, height-for-age
and weight-for-height for male and female
children 8 to 11 years of age in Cotocollao
Alto, Quito, Ecuador as compared to the 1976
NCHS standards, June, 1983 (n=85) . . . . . . .

Migrated homemakers reported food frequencies in
a dual time framework of post- and pre-
mitration, Cotocollao Alto, Quito, Ecuador,
June, 1983 (n=85) o o o o o o o o o o o o o o 0

Reported urban food frequencies for migrants and
non-migrants living in Cotocollao Alto, Quito,
Ecuador, June, 1983 (n=85) o o o e o o o o o o o

1983 Reported length of residence of Quito
migrants (n=722) compared to length of residence
of Cotocollao migrants (n=63) Quito, Ecuador,
June, 1983 O O O O O O O O O O O O O O O O O O 0

Migration related dietary changes and their

potential affect on nutritional status of
Children 0 O I O O O I O I O O O O O O O O O O 0

vii

Page

81

83

90

93

108

130

LIST OF FIGURES

Figure

1.
2.

5.

Equador O O O O O O O O O O I O I O O O O O O O

Weight-for-age distribution of Cotocollao Alto
sample children in percentiles as compared to
1976 NCHS growth charts. Quito, Ecuador, June,
1983(n385)cocoa-000000000000

Sex and age specific z-scores for weight of
sample children in Cotocollao Alto, Quito,
Ecuador ’ June] 1983 (“385) o o o o o o o o o o e

Height-for-age distribution of Cotocollao Alto
sample children in percentiles as compared to
1976 NCHS growth charts. Quito, Ecuador, June,
1983 (n=85) I O O O O I O O I O O I I O O O O 0

Sex and age specific z-scores for height of
sample children in Cotocollao Alto, Quito,
Ecuador, June, 1983 (n=85) . . . . . . . . . . .

Weight-for-height distribution of Cotocollao
Alto sample children in percentiles as compared
to 1976 NCHS growth charts. Quito, Ecuador,
June, 1983 (n=85) O O O O O O O O O O O I O I O

The relationship between migration related die-

tary pattern changes and gatekeeper satisfaction
With life 0 O O O O I O O O O O O I O O O O O 0

viii

Page
46

85

85

87

87

88

133

I . INTRODUCTION

Research results have indicated that nutritional defi-
ciencies can be considered a major health problem in Ecua-
dor. In 1980, Handleman compared health statistics of Latin
American countries and concluded that Ecuador was one of the
three or four most malnourished nations in the Western
Hemisphere. In 1982, W, Ecuador's largest daily
newspaper, printed a series of articles declaring malnutri-
tion Ecuador's most serious public health problem and a
major cause of infant mortality (Torres, l982L. A.preva-
lence of protein—calorie malnutrition and endemic goiter
have been observed in the rural areas and the marginal zones
of the city, especially within the vulnerable mother and
child population (Murgueytio, 1980).

Between 1970 and 1975, 73 million people living in
rural areas of develOping countries moved to the city
(Caliendo, 1979). In Ecuador, the urban pOpulation in-
creased from 28.5 percent in the 1950 census to 41.4 percent
in the 1974 census: a trend towards urbanization that
continues today. A contributing factor to this increase in
urban population has been rural-urban migration. Rural;
urban migration in Ecuador has decreased the agricultural
workforce and accelerated growth of urban slums

(Rivadeneira, 1980).

2

Migration of a family from a rural area to an urban
city can be considered among those factors known as determi-
nants of nutritional status (Jelliffe, 1976). Families
migrating from rural environments to large urban centers in
developing countries undergo changes that can cause both
psychological and physical stress (Caliendo, 1979). Changes
in the environment related to the acquisition, preparation,
storage and intake of food can cause a disturbance in the
equilibrium of the family ecosystem resulting in stress.
When this disturbance of equilibrium affects the nutritional
status of family members it can then be defined as nutri-
tional stress.

Migrant families must adapt in order to cope with all
forms of stress. Adaptation is the process of establishing
and maintaining a stable, reciprocal relationship with the
environment (Melson, 1980). Nutrition adaptation is the
process of establishing the portion of this adaptive rela-
tionship with the environment involving the acquisition,
preparation, storage and intake of food.

There are number of variables which, together, affect
the outcome of migrant adaptation to the urban area. Among
these are the ethnic and cultural background of the migrant,
the place of origin and the destination, the reasons for
migration, the political structure of the urban site, the
availability of employment and the time factor or length of
residence in the city. The time factor is the least re-

searched and least understood of all the determinants

3
affecting migrant adaptation to the city (Butterworth and
Chance, 1981). Few studies have adequately tested this
variable and the resulting data has been contradictory.

Researchers studying school-aged children in Equador
have identified both undernutrition and malnutrition as a
health problem among this population (Interdepartmental
Committee on Nutrition for National Defense, 1960: Ortiz-
Calvache and Borsotti, 1978: Murgueytio, 1980: Instituto
National de Investigaciones Nutricionales y Medico Sociales
(ININMS) 1980). Nutrition during childhood is important and
undernutrition can have serious consequences for the school-
aged child (McWilliams, 1966). Migration, interacting with
the socioeconomic and demographic characteristics of a
child's family, can be a determinant of the nutritional
status of the child.

This research project focused on the relationship
between the time in residence and the nutritional adaptation
of migrant families in Quito, Ecuador. The effect of this
relationshipton the nutritional status of new, recent and
settled migrant children was studied. A socioeconomic
interview schedule was used to collect demographic,
socioeconomic and migration data of the childrenfis families.
Data on the nutritional status of the child was obtained by
height and weight measurements and one 24-hour dietary
recall. These data were used to answer the following

questions:

4
- Does the nutritional adequacy of the diet of the
school-aged migrant child, 8, 9 and 10 years of age,
change with the time in residence in the city of
Quito, Ecuador?
- Does the nutritional status of the school-aged mi-
grant child, 8, 9 and 10 years of age, change with

the time in residence in the city of Quito, Ecuador?

A food frequency instrument was administered to each
family food system gatekeeper and a dietary change instru-
ment was administered to the subsample of migrated gate-
keepers. Data from these instruments provided a more
profound understanding of the effect of the rural-urban
transition on the gatekeepers ability to adequately feed

their families.

QREBATIQNAL_DEEINITIQNS

Migration: Leaving the place of origin or the place of
residence in rural Ecuador and moving to Quito with the
intent of establishing long term residence in the city.
Migrants: Those persons who have changed their place of
residence from a rural Sierra area to the city of Quito for
a substantial period of time or who intend to remain for a
substantial period of time. Based on Jerome's (1980) work
on Southern black migrants to Milwaukee, migrants will be
divided into three categories of length of time in residence

in the city:

5
Nen_migrants: people who have established their place
of residence to Quito within the last five year period.
Regent_migrants: people who have changed their place
of residence to Quito more than five years ago and up
to and including ten years ago.

Settled_migrants: people who have changed their place

of residence to Quito more than ten years ago.
WW: Nutritional adequacy of
the diet is determined by computing each child's intake of
energy, protein, calcium, iron, riboflavin, thiamin and
vitamin A from a.24-hour dietary recall and comparing in-
takes to the Recommended Nutrient Intakes of the Food and
Agriculture Association (Passmore et al., 1974).
W: Dietary and anthrOpometric parameters
are indicators of nutritional status of migrant children in
Quito, Ecuador. Dietary intake has been explained above.
Anthropometric measures are weight-for-age, height-for-age
and weight-for-height.
Nutritional_fitress: Stress, or a disturbance of equilibrium
in the system, (Melson, 1980) involving changes in the
environment related to the acquisition, preparation, storage
and intake of food which can affect nutritional status.
Nutritional_AdantatiQn: The establishment of a stable,
reciprocal relationship with the environment involving the
acquisition, preparation, storage and intake of food. Nu-

tritional adaptation may result in food habits that can

6
positively or negatively affect the nutritional status of
individuals or can have a neutral effect.
Urban: of, relating to, characteristic of or constituting
the city of Quito, Ecuador, (Area = 16,561 km2; population =
800,000).
Rural: The area of the Sierra region of Ecuador which is
agricultural or countryside.
Family: A semi—closed system of individuals characterized
by long—term, intimate relationships of blood, marriage or
adaption of food and an interacting unit with regard to the
preparation, storage and intake of food.
Wm: The person responsible for
the acquisition, preparation and storage of food and the
provision of nutrients for the family who controls the flow
of food into the family system and its distribution within

the system (Lewin, 1943).

II. REVIEW OF LITERATURE

During 1953 and 1954, the United Nation's Food and
Agriculture Organization (FAO) and the Ecuadorian National
Institute of Nutritional Research (INNE) collaborated to
conduct a food consumption survey in various geographic
areas of the country. Findings indicated that the Ecuador-
ian family had low intakes of kilocalories, calcium and
animal protein (Thomason at al., 1957).

The only national nutrition survey for Ecuador was
conducted in 1960 by the Interdepartmental Committee on
Nutrition for National Defense (ICCND). This study assessed
the nutritional status of samples of both military and
civilian families to identify major nutrition.and feeding
problems in Ecuador. The civilian papulation consisted of
4,876 persons in 15 distinct geographic areas. The most
notable clinical abnormality was the high incidence of
goiter, as high as 40% in the Sierra. While caloric intake
was found to be 95% adequate, intakes of thiamin, ribo-
flavin, calcium and vitamin A were found to be low (ICNND,
1960). Dietary adequacy for this study was reported as
percent intake of the 1954 Recommended Dietary Allowances of

the United States.

8

INNE conducted surveys to assess the prevalence of
malnutrition. One study, conducted in 1968, sampled 9,000
preschool children in five provinces. The sampled consisted
of 7,000 urban children and 2,000 rural children. The
results were a 39% pmevalence of generalized malnutrition
with a 10% higher incidence of malnutrition reported for
rural areas (ININMS, 1980). INNE evaluated morbididy data
for a sample of 5,913 children under five years of age and
again demonstrated a 39% prevalence of malnutrition (ININMS,
1980). These data are reported as Grade I, II or III malnu-
trition but no explanation of the classification system is
given.

A 1973 study by the American Technical Assistance Cor-
poration documented the incidence of malnutrition among
preganant and lactating mothers, infants and children, 1-5
years of age. Malnutrition was demonstrated to potentially
exist in 1.2 million persons, representing about 10 percent
of the population of pregnant and lactating mothers and
children under five years of age. Geographic region, income
and dietary habits were taken into consideration. .Again,
the incidence of malnutrition was found to be higher in the
rural than in the urban areas (Junta Nacional de Plantifica-
tion y Coordinacion Economica, 1979).

Ortiz-Calvache and Borsotti (1978) evaluated the rela-
tionship between selected socioeconomic factors and the
nutritional status of rural and urban children in the Sier-

ran province of Tungurahua. A correlation was found between

9
the families socioeconomic status and the nutritional status
of their children. Cultural variables were found to have a
greater impact in the urban area while economic factors had
a greater impact in the rural area. A higher percent of
GradetIimalnutrition was identified among rural children.
Once again, no explanation is provided for the classifica-

tion of malnutrition.

EN! . ilk 1 E Ei i . . E i

Inadequate intakes of calcium, riboflavin, thiamin and
vitamin.A have been reported identified by researchers in
the last 25 years (Thomason at al., 1957: Paredes de
Martinez, 1962). A 1979 study by Oleas, G. at al. reported
inadequate iron intake but did not report either assessment
method or prevalence. Paredes Vasconez (1979) reported
insufficient absorption of iron based on biochemical assess-
ment but did not report prevalence. Freire (1982) identi-
fied an 80% prevalence of anemia deficiency among school-
aged girls, 7-10 years of age, in the costal town of
Esmeralds. Cause of anemia was believed to be iron defi-
ciency resulting from low dietary iron.

The most prevalent mineral deficiency found among Ecua-
dorians has been iodine deficiency. Goiter and endemic
cretenism have been prevalent in the Andean or Sierran
region of Ecuador. Studies prior to the 1968 iodized salt
law recorded 3 to 73 percent goiter and 8% cretenism
(Fierro-Benitez et al., 1969: Greene, 1973: Varea Teran,

1976 and Murgueytio, 1980). The prevalence of goiter

10
appears to have declined since the iodization of salt but

still remains a public health problem in Ecuador.

H l 'l' E 1 ]_ i 1.]:
Infants and preschool children or adolescents whose
rapid growth makes observable growth rates easy to detect
are most frequently studied. However, those researchers who
have studied school-aged children in Ecuador have identified
undernutrition as a health problem among this population
(ICNND, 1960: Ortiz-Calvache and Borsotti, 1978; ININMS,
1980; Murgueytio, 1980L. Table 1 summarizes research re-
porting the prevalence of undernutrition in Ecuadorian
school-aged children (Pigott, 1981). The lack of the use of
a consistent standard or the lack of reporting a standard
results in an inability to make definitive statements about
the nutritional status of school-aged children in Ecuador.
Although not a dramatic time of growth, nutrition in
the childhood years is important and undernutrition can have
serious consequences for the school-aged child (McWilliams,
1966). Undernourished children become easily fatigued and
are unable to sustain prolonged physical and mental effort.
They are at great risk of infection. The child with limited
nutrient reserves can have frequent absences from school
(Pipes, 1977). H0pwood and Van Iden (1965) studied the
relationship between physical growth and school performance
of North American children for a 10 year period and found
unacceptable patterns of growth were accompanied by scholas-

tic underacheivement.

11

 

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14
WW

Corn, wheat, barley, potatoes, rice and vegetables have
been reported to be the staples of the Ecuadorian Sierra by
authors researching food habits and dietary intake in Ecua-
dor (ICNND, 1960; Manoff International, 1976; Munoz and
Gallegos, 1977; Murgueytio, 1980; Rivadeneira, 1980). Milk
was used in cooking and to make cheese rather than for
drinking (American Public Health Association, 1974). Foods
containing animal protein were not eaten frequently due to
their cost (Torres.S. and Narvaez, 1980). Onions and cab-
bage were reported to be the most frequently consumed vege-
tables (Weil at al., 1973; Chauvin, 1983). Fruits were
found to be consumed in season, economic conditions of the
family permitting (Chauvin, 1983).

Chauvin (1983) reported potatoes, rice, corn, wheat,
milk and meats as principle foods of the Sierran diet. Of
secondary importance were beans and broad beans, barley,
cabbage and onions and bananas and oranges. Barley, broad
beans and corn, which were traditionally principle food
items, have lost their place due to increased urbanization
in Ecuador and decreased production of these items.
Most Sierran families follow a three meal a day pattern of
breakfast, lunch and dinner. Breakfast is usually coffee
made with water or milk and plain bread. Lunch consists of
two main courses: a soup and a 'dry" course. The soup may
be very simple or very complex, depending upon the economic

resources of the family. Generally, the soup contains

 

15
potatoes and other grains, cereals or vegetables. The
second or 'dry' course, also called the rice course, con-
sists of a plate of rice and an accompaniment of meat, fish,
beans, potatoes or spaghetti. A salad may be added, usually
lettuce, tomato, avocado, carrots, beets or cabbage. Car-
bonated beverages, natural fruit juices or gruels are drunk
at the meal. The evening meal consists of one dish, either
the soup or the dry course left over from or similar to
lunch. .A hot gruel or chocolate, coffee or tea and bread is
added to the main dish (Chauvin, 1983). This pattern, as
described by cited authors, if followed, would provide a
nutritionally adequate diet. In reality, meat, milk, mild
products and vegetables are frequently eliminated from this
traditional dietary pattern for economic reasons resulting
in potential nutritional defficiencies of protein, iron,

calcium and vitamin A.

C Ell] | 'I'

Lack of adequate production of nutritious foods, lack
of food storage and distribution facilities, lack of eco-
nomic resources to purchase adequate nutrients, lack of
nutrition education were considered causes of malnutrition
Ecuador by the American Public Health Association (1974).
Rivadeneira (1980) stated that Ecuadorians knew which foods
were most nutritious but were not consuming them due to
limited income.

The National Institute of Nutrition and Medical Soci-

ology Research (ININMS, 1980) reported a multifactorial

l6

origin of malnutrition based on deficiencies in distribution
and production of foods and economic, social and cultural
factors of the Ecuadorian people. Specifically, for the
poor, malnutrition appeared to be due to limited access to
profits from production, lack of education and lack of food
because of inequitable distribution. Among the more
affluent malnutrition was attributed to lack of knowledge
about basic nutrition and food composition.

Ecuador has not had problems of famine or endemic
starvation such as have been found in Southeast Asia, but a
large portion of the Ecuadorian population has suffered from
chronic malnutrition, a condition which can interfere with

both physical and mental development (Rivadeneira, 1980).

Migration in Latin America

Migration may be defined as a mechanism for the adjust-
ment of a population of regional disparaties in economic
development. Internal migration is a fundamental variable
of spatial redistribution of the population and of change in
the demographic structure of a country (Elizaga, 1972).
Migration movements are also an important factor in the
socioeconomic development of the country (Kemper, 1971).

Migrations within Latin America have occurred for many
reasons. A common interpretation of the causes of interna-
tional migration is the "push-pull" theory -- a rational
process in which individuals weigh and balance positive and
negative aspects involved in migration (Elizaga, 1972:

Butterworth and Chance, 1981L. The push elements involve

17

rural poverty and a scarcity of rural opportunities. The
pull relates to an individual or family's expectations of
improving their lot or the "bright lights' of the city.
Environmental changes in Latin America that must be consi-
dered relevant.to migration are movements to sites of new
economic develOpment, out-movements from areas of overly
dense occupation. out-movements caused by agricultural revo-
lutions, migrations associated with expectations in health,
education and recreation and trial-and-error wanderings of
surplus pOpulations resulting from the population explosion
(Whiteford, 1976; Butterworth and Chance, 1981L. The most
common explanations for migration given by migrants are
those of an economic nature. Sociocultural reasons such as
education and family are the second most common reasons for
migration. Other reasons are a dissatisfaction with rural
life and the attraction of city life (Elizaga, 1972;8utter-
worth and Chance, 1981).

According to Kemper (1971) Latin America exhibits three
distinct patterns of internal migration. The first pattern
is that of the migrant moving directly from the countryside
to a large metropolis. Most common is a migration in
stages, whereby a family moves first to a medium sized city
and then to a metrOpolis. Often, in stage migration, the
final stage is completed by the children of the original
migrant family. The third pattern is a movement in response

to available work. Additional research has continued to

18
document the existence of these patterns (Perlman, 1975:
Lomnitz, 1977; Butterworth and Chance, 1981).

Migrants most commonly relocate in the old-decaying
city center, newly developed suburban areas or squatter
settlements at the urban fringe. Whatever the choice, the
most important determinant of residence is the location of
previously arrived family or friends from the migrant's
*village or region.(Perlman, 1975; Lomnitz, 1977; Butterworth
and Chance, 1981).

H' Ii . E i

Quito, as the political—administrative capital of Ecua-
dor, and Guayaquil, as the economic capital, have been major
recipients of incoming migrants.

Quito has received mass movements of people from the
rural areas. Migrants have come from both the Coast and the
Sierra, with the majority being from the Sierra.

Migration to Quito has been a result of both push and
pull factors. Agrarian Reform was instituted in Ecuador in
1964, 1973 and 1976 with the goal of attain more equitable
land distribution. Results have been negligible and land
distribution has remained as it was prior to the reforms.
The latifundio-minifundio system (Large land area farms-
small land area farms) has prevailed. Hence, many rural
families have had small plots of poor quality soil upon
which agricultural production has been low. This situation

coupled with limited additional opportunities for income in

19
the rural areas has driven many rural residents to become
urban residents (Peek, 1979).

An additional important push factor in Ecuador has been
the lack of services in the rural areas. Basics, such as
sewage, light and water, have not been available to many
communities. Education services have often been nonexistent
or of low caliber. Health services have been more
frequently non-existent (Calvache Ulloa, at al., 1980).

The pull factors of Quito have been those of any
growing industrial city in the developing world. Quito has
offered more job opportunities than any other urban center
in Equador, with the exception of Guayaquil. A high
percentage of these opportunities have been in the informal
sector. Hence, non-skilled migrants have come to Quito and
found occasional daily work in such jobs as carriers, car
watchers, street vendors, washer women, messagers and
construction workers (Luzuriaga, 1979).

The provision of services in Quito has traditionally'
been better than anywhere in the country. The best
education is obtained in Quito. Health services, while
still inadequate in marginal areas, have been the best
available. Transportation, communication and recreational
services are readily available (Luzuriaga, 1979).

Quito receives migrants who have migrated in stages and
those who have come directly from the countryside. Most
migrants are in their early working years of 15-20 years.

Kinship and family ties play an important role in the

20

migration process. Chain migration has been common and
marginal neighborhoods are often characterized by a predomi-
nance of only a few surnames. Circular migration has
existed among those migrants who live closer to Quito.
These migrants have stayed in Quito during the week, return-
ing their labor and their earnings to the rural area on the
weekends. Circular migrants have been found to make defini-
tive moves to Quito after a few years (Calvache at_al.,
1980).

The Municipal Planning Division of the city of Quito
found 31% of Quito's migrants had migrated within the last 3
years, 37% within the last 4 to 13 years and 32% had mi-
grated more than 14 years ago. A ratio of 65% native resi-
dents to 34% migrated residents was reported. Seventy per-
cent of the migrants originated from the Sierran provinces
of Cot0paxi, Tungurahua, Chimborazo and Bolivar. Eighty-one
percent of these migrations reported moving to Quito in

search of work and better incomes. (Anonymous, 1983).

H | 'I' lit Ii

In developing countries, the population of the cities
has grown more than four percent per year and the larger
urban centers have grown twice as fast (Caliendo, 1979).
This population influx has been too rapid for the people's
needs in terms of housing, employment, food and other serv-
ices to be met (Jelliffe and Jelliffe, 1970: Perlman, 1975;
Griffin and Williams, 1980). Basta (1977) cited estimates

of 200 million people living in urban areas around the world

21
under conditions of “absolute poverty." defined as the lack
of access to potable water, sewage and adequate nutrition.
Twenty-four percent of these peOple were located in South
America.

Ghettos and slums have often provided an environment
worse than the areas from which peeple have ndgrated
(Caliendo, 1979). Migrants have usually been among those at
the lower socioeconomic levels, living in overcrowded hous-
ing with unsanitary conditions. Population density has
favored the transmission of diseases such as tuberculosis,
infectious diarrheas, measles, whooping cough, venereal
disease, worm infestations and pneumonia. The need for
potable water has put a demand on the cities to provide this
service (Costa, 1975).

Migrants face new problems related to the change from a
subsistent, food-growing economy of a rural environment with
the support of a closely knit pattern of relatives and
family to a cash economy and the sense of alienation and
individual impotency of the city (Caliendo, 1979). They
must purchase rather than produce their own food. This can
mean a substantial decrease in their ability to acquire food
despite equivalent or increased monetary incomes.(Jerome,
1980). They may be thrust into a situation where they can
no longer rely on traditional food habits, and where they
buy food based only on their ability to pay. Food purchased
is usually the cheapest, most easily transported and not

necessarily the most nutritious. A lack of adequate home

22
cooking and storage facilities can cause further feeding
difficulties (Caliendo, 1979).

Chassy at al. (1967) supported the hypothesis that in
the process of industrialization or urbanization, food
habits and food patterns change progressively, becoming
increasingly more complex or varied, and that such changes
are related to other similar changes in the social and
economic environment. Family food patterns were fitted into
a Guttman scale, indicating a sequence of changes in food
patterns and a trend toward increasing complexity of the
diet. The scale correlated with other indices of urbaniza-
tion.in Mexico, in particular, education and occupational
history.

Few researchers have look at the effect of migration on
the nutritional status of the migrant. Costa (1971) stated
that there appeared to be a tendency for malnutrition to
increase for individuals who migrated from rural zones into
the city. Basta (1977) used existing data from food con-
sumption surveys in develOping countries to examine nutri-
tion and health statistics in low income urban areas of the
Third World. City health statistics indicated higher health
status for urban residents than for rural residents either
because squatters and slum inhabitants were not included in
the statistics or because their inclusion was obscured by
the enormous difference between their status and the few
middle to high income inhabitants of the city. When these

data were disaggregated, disease was found to be about fifty

23

percent higher in squatter settlements than in the city as a
whole. Food energy intakes of those in squatter settlements
and slums were usually half to two—thirds lower than those
persons in other areas of the city. Access to health care
was sometimes two to ten times worse. When urban data were
compared to rural data, the nutrient availability for the
low or very low socioeconomic groups was lower in the urban
groups than for corresponding rural groups. Ward and
Sanders (1980) compared the diets of rural and urban popula-
tions in Ceara, Brazil and concluded that rural—urban migra-
tion appeared to aggravate nutrition problems for low-income
groups.

Not all researchers, however, agree that migrants suf-
fer nutritionally'as they move to the city. One study of
anthropometric and dietary differences between rural and
urban children in Costa Rica found dietary intakes to be
lower in the rural areas. The height-for-age data showed
only 16% of the rural children classified as normal
(Valverde and Rawson, 1976). These data did not include
information on the socioeconomic status of the families of
the sampled children. Rivadeneira (1980) referred to Ecua-
dorian studies that compared the nutritional status of rural
and urban children. The rural children consistently showed
higher incidenceeof:malnutrition. Careful examination of
some of these data showed that the comparison was between
low-income farm families and middle to upper class urban

residents.

24
The gravity of the migrant's nutritional dilemma was
summarized by Dr. Egbert deVries in a discussion at the
International Conference on Nutrition, National Development
and Planning (Nour, 1973):

. . . there are a few hundred cities absorbing
millions and millions of people. I have a feeling
that even worse than the famine conditions and the
crop failures of the seasonal undernutrition in
the rural areas is the plight of the hundreds and
hundreds of millions of people living in the shad—
owland between rural areas and the urbanized,
industrialized society, where the nutritional
standards are deplorable and where it is most
difficult to do anything because their productivi-
ty is almost nil and the old resources of the
countryside and even the forest are gone for these
people. They have no productive income. How do
we deal with perhaps 300 million people. They
have no productive income. How do we deal with
perhaps 300 million people in the world who are in
that status? From the point of view of human
welfare perhaps that is the greatest nutrition
problem.

WWW

Many socioeconomic, cultural and«demographic factors
have been identified as determinants of the nutritional
status of children. These factors interact with migration
for those families who have recently urbanized by rural to
urban migration. Variables examined as interacting with
migration were sex of the child, size and economic level of
the family, education and occupation of the child's mother
and the presence or absence of the child's father. All of
these variables have been listed as 'risk factors in protein
calorie malnutrition“ (Jelliffe, 1976).

W151. Research findings have shown that

girls have a lower nutritional status than boys (DeChavez at

25

al., 1974; Levinson, 1974; Greiner and Latham, 1981).
Cassidy (1980) cited research results that indicated pref-
erential treatment of male infants by providing themmwith
earlier supplementation and later weaning. Luzuriaga (1979)
stated that, within the Ecuadorian nuclear family, boys were
given preferential treatment because the man, as the pro-
vider, deserved certain privilages. Scrimshaw (1978) felt
that neglect of female children in highland Ecuador went
beyond malnutrition, possibly leading to female infanticide.

£amily_§izen A relationship between the size of the
child's family and the nutritional status of the child has
been shown to exist. Rao and Goplan (1969) found that 61
percent of all cases which they identified as having
protein-calorie malnutrition were children with 3 or more
siblings. In the Philippines, Florencio (1980) found that
the intake of energy, protein and vitamin A decreased as
family size, both rural and urban, increased. Greiner and
Latham (1981) found that the more live siblings the child
had the lower the child's weight-for-age.

Emnngmig_La1al. Numerous studies have shown that nu-
tritional status is lower among families at a lower economic
level of living (Wray and Aguirre, 1969: Kanawati and
McLaren, 1974; Levinson, 1974: Marchione, 1978). Greiner
and Latham (1981) found that the index of economic living
had the greatest average magnitude of effect on the nutri-
tional status of St. Vincent children. Smith at al. (1983)

found that food money available had the greatest impact on

26
preschool Haitian childrenhs current nutritional status as
measured by weight-for-age. Rivadeneira (1980) stated that
income was the single most important determinant of nutri-
tional status in Ecuador.

Wan. The level of formal education of
the homemaker has been positively associated with improve-
ment in family food consumption patterns. Moench (1983)
reported that nutritional studies in Colombia had found
mother's educational level to be an important indicator of
nutritional status. In Mosley's study in Kenya (1983),
mother's education was shown to be the single most important
variable in determining the child survival. Dietary data
collected from a sample of Bolivian boys showed that in-
creased dietary diversity and quality were positively cor-
related with mother's education (Moreno-Black, 1983).

Wat. Data resulting from the examina—
tion of the relationship of mother's employment and nutri-
tional status are variable. Lees (1966) found maternal
employment in St. Lucia to be associated with lower nutri-
tional status of infants. Wray and Aquirre (1969) in Colom-
bia found a trend toward higher levels of malnutrition among
children of mothers who worked part time and lower levels
when the mother worked full time. JPopkin and Solon.(l976)
suggested that the higher malnutrition associated with ma-
ternal employment in the Philippines and elsewhere may
result from the mother's poverty rather than from their

working status. Florencio (1980) found that mother's

27

participation in the labor force in rural Philippines had a
positive effect while urban mother‘s;participation in the
labor force negatively affected nutrient intake of her chil-
dren. Greiner and Latham (1981) found no significant asso-
ciation between nutritional status and motherks employment.
Moreno-Black (1983) found a negative relationship between
dietary diversity and dietary quality of Bolivian boys and
the mother's employment outside the home.

Wage. While female headed households have
been shown to have lower incomes than male headed house—
holds, the effect of the father's absence on the nutritional
status of the children is unclear. In New York state
(Sanjur at_al,, 1979) urban female-headed households were
found to have purchased more adequate diets than their male-
headed counterparts. In St. Vincent, the child's nutri-
tional status was found to be slightly lower, at a marginal
level of statistical significance, if the father was present
in the home (Greiner and Latham, 1981). In Haiti, no rela-
tionship was found between the presence or absence of the
father in the home and the nutritional status of the chil-

dren (Smith £131., 1983).

W

Nutritional status is an operational term relating the
condition of health to the intake of foods and the utiliza-
tion of nutrients. Two basic methods utilized for assessing
nutritional status are anthropometric measurements and die-

tary data (Christakis, 1973). Dietary intake data provide

28
information on low, excessive or unbalanced nutrient intake
whereas anthropometric measures show the effect of nutrition
on physical growth (McLaren, 1976).

AnthLopgmatrig_fleasuramanta. Measurements of the body
are quantitative, practical techniques to aid in evaluating
nutritional status. Measurements must be made correctly
with inter-rater reliability and findings must be consist-
ently reported (Krick, 1982).

Weight is a measure which is subject to great variation
both within and between individuals. ‘Weight-for-age informs
you if a child is over or under his expected weight. This
parameter does not allow the researcher to determine if this
measurement reflects current dietary intake or past nutri-
tional history (Seone and Latham, 1971). When serial deter-
minations are used, weight-for-age is a useful guide to a
child's growth progress (Griffiths, 1982).

Height is essentially the measure of linear growth of
the skeleton. The tissue between the vertebrae and long
bones do not make significant contributions to this measure
(Beal, 1980). Height-for-age measures chronic nutritional
status but does not provide any indication of present die-
tary intake or the status of the child (McLaren, 1976).

Height-for-weight looks at the ideal weight for the
child's height, independent of age. This measure provides
an index of acute current nutritional status of the child.
Low weight-for-height is an indicator of current or recently

past malnutrition or chronic malnutrition (Seone and Latham,

29
1971). Current recommendations are that weight-for-height
and height-for-age be used jointly as primary anthropometric
indicators for child growth (Waterlow at al., 1977).

Anthropometric data are then compared to reference data
as a means of selecting those children who are outside a
predetermined level of growth. The use of reference data
also allows international comparisons of health and
nutritional status (Neumann, 1979). The World Health
Organization expert committee on nutritional surveillance
currently recommends the use of the 1976 United States
National Center for Health Statistics reference data as an
international standard (Waterlow at al., 1977).

'Dietary data. Four methods are generally used to
determine individual food consumption: estimation by
recall, dietary history, the weighed intake and the food
record. Each method has both strengths and limitations
(Young and Trulson, 1960).

The recall procedure is usually used for a twenty-four
hour period. All food consumed the previous day is recalled
and quantities are estimated in ordinary household measures
or serving (Marr, 1971). Researchers have found the 24-hour
dietary recall a valid and reliable method for estimating
mean nutrient intake for population groups (Lechtig at al.,
1976 and Carter at al., 1981). The limitations of using the
24-hour dietary are in ranking individuals or in estimating
individual nutrient intake. Each 24-hour dietary recall can

only be considered as good as the subject's memory. Current

30
recommendations are that a minimum of four 24-hour dietary
recalls must be collected from each person for the dietary
intake information to represent usual intake and account for
daily variation (Food and Nutrition Board, 1982).

The diet history is designed to discover usual food
intake patterns over a relatively long period of time and is
most often obtained by interview. A diet history is uti-
lized to gather information on dietary customs over an
extended period of time, to obtain data on changes inidie-
tary patterns and to examine food habit trends (Burke, 1952:
Marr, 1971). This method includes the recording of the
frequency with which various foods are consumed. The food
frequency is best utilized to measure the cultural aspects
of the diet rather than to assess dimensions of nutrient
intake (Campbell at al,, 1982).

The most accurate record of food consumption is ob-
tained by having the subject weigh all food consumed during
a specific period of time. This method is costly, time
consuming and intrusive but useful for metabolic studies
(Marr,l971).

The food record method has the subject keep a record of
food eaten for a given period of time. Quantities of food
are estimated in common household measures. This method is
less dependent on subject memory but demands a high level of
subject cooperation (Caliendo, 1979).

Dietary data can be used to calculate specific quanti-

ties of nutrients. Quantitative evaluations.are based on

31
the calculation of nutrients as derived from food composi-
tion tables. The use of food composition tables only gives
approximate results due to the limitations of variations in
nutrient content of foods, number of sample analyzed and
methods of analysis (Pike and Brown, 1975).

Standards of adequacy of nutrients have been formulated
to assure that essential nutrients are included in the diet
and are consumed in sufficient amounts for good nutrition
(Goodhart, 1980). The general aim of these standards is to
prescribe a level of nutrition that will maintain good
health for substantial numbers of the population. These
standards are a recommendation for the amount of nutrients
that should be included in the daily diet (Hegsted, 1975).
Dietary standards are determined from experimental data on
human nutrient requirements. The United States and many
other countries, as well as the Food Agriculture Organiza-
tion of the United Nations have formulated dietary standards
which can be used for making quantitative estimates and for

measuring the adequacy of the diet (Caliendo, 1979).

III. METHODS AND PROCEDURES

Introduction to Methods and Procedures

The relationship of time in residence in Quito, Ecuador

 

 

and the nutritional status of school-aged children of mi-
grant families was the focus of this study. Other factors
studied in relationship to nutritional status were childks
sex, family size, family income, age, education and occupa-
tion of the child's parents and whether either parent was
absent.

In the prefield portion of this study, bibliographic
research was conducted and preliminary instruments were
developed in English. ‘These instruments were translated
into Spanish, refined and pretested in Ecuador. Spanish
versions of all six instruments are in Appendices A, B a C,
accompanied by English translations. All forms were sub-
mitted and approved by the University Committee on Research
Involving Human Subjects (UCRIHS). Subjects rights of re-
fusal to participate, privacy and anonymity were maintained
throughout the study by using coded numbers on all written
material and retaining information collected in confidential
files at Michigan State University.

Upon arrival in Ecuador, the researcher selected the
research community with the guidance of staff of the Ecua-
dorian National Institute for Nutrition and Medical

32

33

Sociology Research (ININMS). Initially. four areas of Quito
were identified as receiving areas for inrcoming migrants.
Further investigation of each area led to the elimination of
three areas on the basis of not meeting the design criteria,
not being safe for the researcher and not being easily
accessible by public transportation and resulted in the
selection of Cotocollao Alto as the research community.
Initial visits to this community enabled the researcher to
determine that the community was open and willing to partic—
ipate in the study.

The field work portion of this study, which was com-
pleted over fourteen months, was divided into three phases:
participant observation, sampling and interviews and meas-
urements. Participant observation was conducted by the
researcher for a three month period in Cotocollao Alto (CA),
the research community. Sampling of the children to partic-
ipate in the study was completed in four public elementary
schools serving the research community. Instruments admin-
istered to the sampled children were a three day dietary
record and a 24-hour dietary recall. Anthropometric meas-
urements taken of the sampled child were weight and height.
A socioeconomic interview schedule, a food frequency and a
dietary change form were the three instruments administered
to the mother of the sampled child on two home visits.

These data were collected by the author, hereafter
called the researcher, with a paraprofessional assistant

from the research community, hereafter called the RA.

34
2 li . l DI l'

The initial participant observation phase (Wilson,
1978) lasted three months in CA. Informal interviews were
conducted with local clergy, school personnel, community
leaders, health personnel and homemakers to investigate the
following: number of families in the community, their
length of residence and places of origin, elementary schools
attended by community children and potential problems in-
herent to working in the community.

When acceptable to the interviewee, observations were
recorded in a field notebook during the informal interviews.
All contacts and interviews, as well as objective and sub-
jective observations, were recorded in the field notebook
(Bass at al., 1979). A research assistant (Spradley and
McCurdy, 1972) was identified and selected during this

period.

W

The research assistant (RA) was identified with the
guidance of the clergy and school personnel. Mrs. Mercedes
Solano, a CA resident was employed as the RA from May, 1982
to May, 1983. The criteria established for selection of the
RA were that this person be well acquainted with the com-
munity, be respected in the community and be impartial in
community politics. A female was preferred as those being

interviewed were mothers of the sampled children.

35

ResearehJssistantJraining

The project was explained in detail to the RA before
she was asked to participate. Training for the home visits
and instrument administration to the mothers involved de-
tailed explanation by the researcher of the home visit's
purpose. .All instruments were reviewed with the RA as they
would be administered. The RA was asked each question, gave
her own personal response and discussed the intent of each
question with the researcher. The RA was also trained to

measure childrenls heights and weight under supervision.

WW

In the first phase of the field work portion of this
project, the RA's role was to select key community persons
and arrange interviews for the researcher. 131the second
phase, the RA made the initial contacts with the public
schools from which the sample was drawn, explained the
project and set up appointments for the researcher with each
school principal.

In the final part, the RA conducted the two home visits
and assisted in the administration of the socioeconomic
interview schedule, the food frequency and dietary change
instruments and the anthropometric measurements of children.

The RA's time commitment to the project varied from
five to twenty hours per week, depending upon the demand of
the particular project phase. These hours were worked at

her convenience so as not to interfere with her own work.

36
Sampling

The universe was defined as all children 8, 9 and 10
years of age residing in CA and attending schools. Gladhart
(1981) reported a 78 percent school enrollment of boys and
girls six to eleven years old in Ecuador. Luzuriaga (1979)
stated that 100 percent of the six to eleven year olds in
urban areas of Ecuador were enrolled in school. Sampling
from the schools was also done because of the availability
of school records for each child which included birthplace
and birth data (Gladhart & Gladhart, 1981).

During participant observation, those public schools
attended by children in CA were identified. Class lists
obtained of the second, third and fourth grades in the four
public schools totaled 838 students. From this original
number of 838, all children not residing in CA or not 8, 9
or 10 years of age were eliminated, leaving 225 eligible
children. A sample of 100 was drawn using a random numbers
table (Johnson, 1976). i

The mothers of the sampled children or the family's
food system gatekeeper became a second sample to whom the
socioeconomic interview schedule and the food frequency
instrument were administered. Of this second sample, those
who had migrated formed a further subsample who were asked
to respond to the food frequency instrument in a dual time
framework. The dietary change instrument was administered

only to this subsample.

37
Participant observation in CA was done from April to
June, 1982. Drawing the sample of children took place in
July'and August, 1982. Initial contacts with the child's
family were made from September to December, 1982. Inter-
views with the mothers were held from January, 1983 to May,
1983. The children were measured and 24-hour dietary re-

calls were taken in April and May, 1983.

D' l D I C J] l'

Dietary data from the children were preposed to be
collected via a series of 24-hour dietary recalls as recom-
mended by the Food and Nutrition Board (1982). That plan
was changed after discussions with school personnel. A
three-day dietary record administered to school children as
a homework assignment was thought to be the best way to
collect dietary data.

The form used for the three-day dietary record was
developed by the researcher in Ecuador in consultation with
public school personnel and the staff of ININMS. Two, 45-
minute class periods were used by the researcher to adminis-
ter the three-day dietary record. The first class period
was used to present second, third and fourth graders basic
food group concepts utilizing a 24-hour dietary recall as a
teaching tool and to prepare them for the forthcoming home-
work assignment. The second class period was used to give
students the three-day dietary record forms, to verbally

review, in detail, all instructions and to answer questions.

 

38
Instructions for estimating quantities of food eaten using
cups and spoons were also given. The assistance of the
teachers was solicited to collect the assignments upon com-
pletion. The researcher returned to each school to pick up
the completed assignments.

The three-day dietary records were returned incomplete
and directions for reporting food quantities had not been
followed. For these reasons the data collected with the
three-day dietary record were unsatisfactory for useful data
analysis. Subsequently, a 24-hour dietary recall was ver-
bally administered to each child individually (Marr, 1971).
The form was developed in East Lansing, Michigan and modi—
fied in Ecuador in consultation with the ININMS staff and
the RA. The 24-hour dietary recalls were conducted at the
schools in the principal's office. The method of starting
with the most recent food eaten and working backwards for
the 24-hour period were utilized. Food models were used for
estimation of serving sizes (Christakis, 1973). Food models
were constructed at Michigan State University and consisted
of plain rounded foam shapes painted in appropriate colors

to represent a wide variety of foods.

Wham
Anthropometric data collected were height and weight of

the children. Weighing and measuring of the children was
done in the school principal's office to provide maximum

privacy so children could remove all outer clothing. The

39
children weighed in pounds on a Hanson spring-type floor
model bathroom scale, Model Number W503-62. Height was
measured with a centimeter tape measure leveled with the
floor and taped to the wall. WHO guidelines for the meas-
urement of height and weight were utilized (Jelliffee,
1966). National Center for Health Statistics (NCHS, 1976)
growth charts were used as the standard recommended by WHO
for use as an international standard and recognized by

ININMS as an acceptable standard for Ecuador.

5 i . I I . S] i]

The preliminary socioeconomic interview schedule was
further developed in Spanish in Ecuador in consultation with
the staff of ININMS, the staff of the Ecuadorian AID mission
and the RA. The socioeconomic interview schedule had 33
forced choice questions to obtain information on income,
housing, occupation and migration. The interview schedule
included two open-ended questions dealing with migration. A
family data sheet was utilized to record the composition of
the childfls family including relationship to the child, age,
educational level and birthplace of each family member.

The demographic questions yielded information for a
profile of the families in which the sample children re-
sided. ‘The socioeconomic variables were examined as pos-
sible indicators of nutritional status (Jelliffe, 1966).
Housing information was collected to create a housing pro-

file. Place of origin, length of residence in Quito, length

 

1

t _ ..._u1

40
of residence in the community and residence with kin upon
arrival in Quito were examined as they related to the nutri-
tional status of the migrant children, 8-10 years of age

(Butterworth and Chance, 1981).

EII'HS' .
InterlieLSQhedule

Pretesting of the socioeconomic interview schedule was
conducted in CA with four homemakers not related to the
sampled children who were selected by the RA. Minor revi—

sions were made of some questions for clarity.

Ei'ill' EIISi .
1W

The socioeconomic interview schedule was administered
to each mother of the sampled children. When the child's
mother was not present in the home, the family‘s food system
gatekeeper (gatekeeper) was interviewed. All interviews
were conducted in their homes on the second visit and re-
quired about one hour to complete. All interviews were

conducted by either the researcher or the RA.

Wisteria
W

A Food Frequency Instrument (Young, 1982) was developed
by the researcher for use by ININMS in a health status study
conducted in Cayambe, Pichincha, Ecuador. This instrument
was adapted by the researcher for this project by adding

food items, reducing the response scale from seven to four

 

41
choices and using the instrument in a dual time framework of
pre- and post-migrat ion.

The Dietary Change Instrument (Burke, 1952; Marr, 1971)
consisted of six Open-ended questions developed by the re-
searcher to describe changes in food acquisition, prepara-
tion, storage and intake that might have resulted from
rural-urban migration. This instrument was administered in
conjunction with the food frequency instrument to provide
more descriptive and in-depth dietary change data from the

subsample of those mothers who had migrated.

W
W

Pretesting of the food frequency and dietary change
instruments was conducted in CA with four homemakers not
related to the sampled children who were selected by the RA.
These interviews were conducted jointly by the researcher
and the RA. .Minor revisions were made after pretesting to

clarify instructions.

MW
AW

On the second visit, the food frequency and dietary
change instruments were administered to the gatekeeper,
usually the mother, in which the sampled child resided.
These interviews were completed within an hour. These in-
struments were administered after the completion of the

socioeconomic interview schedule. All gatekeepers were

 

42
asked the frequency of consumption for each food item within
the last month. If the gatekeeper had migrated, she was
asked the frequency of consumption for each food item at the
present time and before migration. Only those mothers who
had migrated were asked to respond to the dietary change
instrument. All interviews were conducted by either the

researcher or the RA.

Data Analysis

The 24—hour dietary recall data were used to calculate
intake»of the following: energy, protein, calcium, iron,
vitamin A, thiamine, riboflavin and vitamin C. Energy and
the seven nutrients were calculated utilizing the Latin

American Food Composition Table (Lueng and Flores, 1961) and
Food Values of ngtions Commonly Used (Pennington and

 

Church, 1980). The nutrient values were calculated utiliz-
ing standard recipes from a popular Ecuadorian cookbook
(Juanita, 1983). A total daily intake was tabulated for
energy and each nutrient and percents of the FAO/WHO Recom-
mended Intakes of Nutrients (1974) adjusted for age and sex
were computed. The percents of the FAO/WHO standards were
used as dependent variables.

Weight-for-age, height-for-age and weight-for-height
for each child was plotted on separate NCHS growth charts
(1976) for boys and girls, as a means of comparing this

sample to an internationally accepted standard.

 

43

It is possible to express the distance between an
observed value and the mean of the curve in standard devia-
tions from the mean. The result is the Z-score (Snedecor
and Cochran, 1980). Individual Z scores for weight and
height were calculated for each child based on age and sex
specific means for weight and height calculated from the
research pepulation. A weight-for-height ratio was also
calculated for each child (weight/height) (Cole at al.,
1981). The raw weight expressed in kilograms, raw height
expressed in centimeters and weight-for-height ratio for
each case were used as dependent variables.

Frequencies were calculated for all foods on the food
frequency instrument. Responses on the food frequency in-
strument referred to a one month period and, therefore, were
coded as follows: Never = 0; Sometimes = 1; Weekly = 4;
Daily = 30. Frequencies were reported in both the present
urban time framework and the pre-migration rural time frame-
work. A paired t-test was used to determine significant
differences in food consumption between the urban present
and the rural past for each migrated gatekeeper. A stu-
dentus t-test was used to determine significant differences
in present food consumption between those gatekeepers who
had never migrated and those gatekeepers who had migrated.

Computer analysis was done utilizing the Statistigal,

W (Nie at al., 1975) and the Mich-
igan State University Computer Cyber 750 CDC. Sub-programs

 

L:

44
utilized were Frequencies, Pearson Correlation and Regres-
sion.

Pearson Correlation Coefficients were calculated for
each of the 11 dependent variables and per capita food
expense (estimated family food expenditure divided by family
size), per capita income (estimated family income divided by
family size), family size, mother's age and father's age.
Multiple regression was done for each dependent variable to
determine the best combination of variables to predict that
dependent variable. Variables included in the original
regression equation were length of residence in Quito,
length of residence in the community, the existence of
migration, home ownership, gatekeeper's education, gate-
keeper's occupation, presence or absence of the father in
the home, per capita income, per capita food expenditure,
urban agricultural production, family size, and the sex, age
and migration of the child.

The open-ended questions on the socioeconomic interview
schedule about migration and the dietary change instrument
were analyzed descriptively. Field notes from the partici—
pant observation phase were analyzed descriptively and

interpretively.

IV. THE RESEARCH SITE

Ecuador, one of the smallest countries in South Ameri-
ca, is approximately the size of the state of Colorado. It
is crossed by the Equator and is bounded by Peru, Colombia
and the Pacific Ocean. Its territory included the Galapagos
Islands, some 600 miles west of the mainland (Weil at al.,
1973).

The country is divided into three regions: The 'Costa'
or lowlands along the Pacific Ocean; the highlands or
'Sierra’, a mountainous area over 4,000 feet in altitude;
and the eastern region or 'Oriente', a sparsely populated
tropical forest (Figure l).

Quito, the capital city, is located in the Sierra at an
altitude of over 9,000 feet. The temperature in the Sierra
varies more during the 24-hour day than from season to
season. The rainy season is from November to May: the dry
season is from June to October (Weil at al,, 1973).

Ecuador has approximately eight million inhabitants
with an annual population increase of 3.1 percent (Papula-
tion Reference Bureau, 1980).

The white, the Indian and the mestizo (Indian and white
mixed) make up the ethnic composition of Ecuador. Spanish

is the national language but Quechua is the common language

45

 

 

46

 

 

.m
m 3.56
... .o. r
0 ...-co-
6 m «MI:
II * In."
'fiit'tm‘dnhu.~”
~QQOO c I'll
E m
Q P
Q
0
no
0\\\OQQ
m
m
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3 r
.m
s. m
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mm m. L
m...“ o. .
m. C e w.
e o ...
o .L F

 

47
of most of the Indian groups. The predominant religion is
Roman Catholic (Weil a; al., 1973).
This description of the research site is based on field
notes taken during participant observation. This informa-
tion is based on researcher observation only. No attempt is

made to quantify these data.

W

The research site, Cotocollao Alto (CA), is located at
the extreme north of Quito, capital city of Ecuador. Coto-
collao Alto is bordered by the Avenida Occidental on the
east and rises.up the Pichincha volcano on the west. This
community was selected because the area has developed in the
last fifteen years and contains settled sections, recently
developed sections and sections under construction. Initial
visits by the researcher involved informal interviews with
local personnel who confirmed that the area received many
incoming migrants from rural areas of the Sierra.

At the extreme north of Quito, CA was once rural, a few
hours ride from the city. During this period, the area was
a large, privately owned farm. During the Agricultural
Reforms of 1964 and 1973, the hacienda was taken from its
private owners and partitioned among those laborers working
the land. Therefore, many current residents are descendants
of families who had lived on that land for many generations.
The remainder of the residents are persons who have migrated
from the rural areas of Ecuador to find work in the capital

city.

 

48
The entire community is divided into small neighbor—
hoods which have their own leaders and neighborhood commit-
tees. These committees work together to solicit better
services for the area, to handle problems and to plan social
events. Parent committees exist for each school and are an

important part of community life.

Mannie

The residents are primarily Indians or meztizos. A
small number of black families also reside in CA. It is not
possible to distinguish between the Indians and the meztizos
because indigenous dress is no longer worn and there is no
other visible means of differentiation. All residents
dressed in a manner typical to Sierran city residents of a

lower socioeconomic status.

W

The roads in CA are all unpaved resulting in dangerous
mud during the rainy season and dust in the dry season.
Electricity was installed in the area in 1976 and most homes
are served. There is no sewage system in CA. Most families
have latrines, although some families use the open areas in
the community. There is no source of potable water. The
water supply for CA is piped water distributed through hand
pumps located at various points in the neighborhood. CA is
divided by a large ravine. The ravine creek provides a

water source for some families and is where most families

 

 

i.._i _

49

wash their clothing. Garbage collection is erratic and not
utilized by most residents.

Housing construction is varied. Many houses have been
constructed until the money ran out, at which point the
family moved into the house. Many of these homes are never
finished. Most families live in one or two rooms with a

separate room for cooking and a latrine.

Transportation

Small bus cooperatives provided public transportation
to CA. The bus line ran from CA to a major bus stOp in the
central section of Quito. This bus service was initiated in
1981 and connected CA to the rest of Quito. The bus service
is erratic and when road conditions become extremely bad,
the buses cannot go up into CA. While a few families own
vehicles for business purposes, they do not own cars for
personal use. Hence, the bus system is vital to the resi-
dents of CA. The fare is five sucres ($1 = S. 95) which is

the standard small bus fare in Quito.

Religion
The majority of the families in CA are Catholic. There

is a chapel in CA where many families attend mass on Sunday
morning. Those families who consider themselves to be up-
wardly mobile attend mass in a church in San Carlos, the
neighboring community. Saint days are causes for much
festivity which traditionally involves church services,

parades and a great deal of food and drink.

50
W

CA is officially serviced by the Ministry of Health
Center #8 which is down the mountain and across the Avenida
Occidental in Cotocollao, approximately 45 minutes to an
hour away by public transportation. The distance to the
health center is such that it provides minimal services to
the residents of CA. CA has a small drug store whose pro-
prietor sells medications. An Ecuadorian doctor has a pri-
vate office behind the botica where she sees patients every
afternoon between 4:00-7:00 PM, charging 100 sucres per
visit (approximately one dollar). The woman who runs the
botica is a self-appointed health care worker who attends to
most of the medical problems of the community. People come
to her with health problems and she prescribes both treat-
ment and medications. Nutrition advise is often included in
her prescribed treatments. When she cannot treat a particu-
lar health problem, she requests that the patient consult
the doctor.

In the spring, 1983, four cases of typhoid fever were
reported in CA. In the spring, 1983, two cases of rabid
dogs were reported. The most frequently reported health
problems in the community are parasites and respiratory

ailments.

Families
Families are large, cohesive units which are the center

of social life. Young men and women live with their parents

 

II-

51
until they marry and set up their own homes. Many young
adults in their twenties are still living at home. Some of
them are studying, in which case the family provides total
support. Some of them are working, in which case the youth
contributes some of his/her earnings to the family. Young
women tend to marry in their mid-teens, therefore are less
frequently found residing with their parents. Young men
marry anywhere from their late teens to late twenties and,
therefore, are more frequently found residing with their
parents. Parents play a primary role in the lives of their

children until they leave home.

SQhQQlinE

Education is valued by the residents of CA and most
children attend school. Most children attend public school:
however, a few families send their children to private
schools. Private schools abound in Quito and there is
status associated with sending your children to private
school. There is one elementary school in the community and
others in nearby communities. Children residing in CA at-
tend the elementary school in the community and three others
located within the two nearest neighborhoods, San Carlos and
Cotocollao. Secondary school students attend public and
private schools throughout the city. The number of eligible
youths attending secondary school was 50% less than those
attending primary school. Boys go to work as soon as they
can and many girls marry shortly after finishing primary

school or stay home to care for younger children.

 

52

Marketing

Like all of Quito, CA has many small neighborhood
stores which sell the most frequently purchased dry goods,
vegetables, canned goods and alcoholic beverages. The mar-
ket utilized by CA residents is located in the neighboring
community of San Carlos and is a Saturday market. Those
buses which go to CA stOp directly in front of the market,

making it easily accessible to CA residents.

Hark

Because Quito is on the equator, the sun rises at 6:00
AM and sets at 6:00 PM. The life of the city follows a
similar pattern. PeOple rise at 5:00 AM and the work day
begins by 7:00 AM ending at 6:00 PM when the sun sets.

Male residents work in construction, service~occupa-
tions or skilled trades. These men spend their entire day
away from home. Women workers are housewives, domestic
servants, market women or owners and Operators of small
stores. Most of the women are housewives who spend their
time tending children, preparing food and washing clothes.
Many of them deliver the mid-day meal to their husbands at
their work site. Teenage boys frequently work as day labor-
ers in construction. Teenage girls may work as domestic
servants. Young children make a contribution by caring for
very young children, helping with food preparation and col-

lecting wood in the wooded areas of the volcano.

 

‘Lhn' .‘

53

AlQQthifim

Alcoholism is defined by CA residents as a major prob-
lem in the community. Drinking is a major weekend activity,
continuing until the drinkers are no longer conscious. Ac-
cording to CA residents, the main street itself has 14 bars.
Problems reported resulting from alcoholism were fighting
between cantina patrons, beating of wives and children,
abandoned children and money drained from the family budget.
Drug use and drug sales were also reported to be a problem

among the young adult population of CA.

 

V. RESULTS

Demographic and socioeconomic data were obtained from
the socioeconomic interview schedule. Dietary data were
obtained form 24-hour dietary recalls of the children, from
food frequency instruments administered to all family food
system gatekeepers and from a dietary change instrument
administered to the subsample of migrated gatekeepers. The
childrenfis weight and height were measured.

Descriptive results for all variables will be reported.
The relationship between migration and nutritional adapta-
tion of migrants from the rural Sierra to Quito specifically
will be examined. The effect of migration on the nutri-
tional status of school-aged migrant children will be

analyzed.

Sample
From the originally sampled 100 cases, 88 children and

their gatekeepers participated in the study. Twelve chil-
dren did not participate for the following reasons: two
were black and did not fit criteria for selection, two
refused and eight had moved away from the neighborhood and
could no longer be located. Three additional cases were
omitted after data collection due to incomplete data and 85
cases were used for analysis.

54

 

r! m—m “L1
..

55

A randomly selected sample was utilized to examine the
relationship of length of time in residence and the nutri—
tional status of school-aged migrant children. Because the
sampling was random, the distribution of new, recent and
settled migrants was uneven with only a small number of both
new and recent migrants (10% each). Future examination of
length of time in residence as an independent variable
should utilize samples stratified by length of residence to
provide comparable groups.

Eighty—eight socioeconomic interview schedules and food
frequency instruments were completed. Eighty-two of these
were completed by the child's mother, one by the child's
father, two by the child's aunt and three by the child's
grandmother. Forty-one dietary change instruments were
completed by those homemakers who had migrated. Height and
weight were measured for 88 children. A 24-hour dietary

recall was taken from 86 children.

Demographic data of the Children

Data describing the sampled children are found in
Table22. Demographics collected for each child were age,
sex, and birthplace.

Children's age was recorded twice: once during samp-
ling and once during measurement. At the time of sampling,
the children ranged from 8 years to 10 years and 7 months.
At the time of measurement, the children ranged from 8 years

10 months to 11 years 5 months.

Table 2. Profile of children (8-11 years) in Cotocollao

56

Alto, Quito Ecuador, June, 1983 (n = 85)

 

 

Characteristic Number Percent
ChildLS_A§£

8.5 - 9.5 years 22 26
9.6 - 10.5 years 29 34
10.6 - 11.5 years 34 40
W

Males 46 54
Females 39 46
W

Quito 70 82
Pichincha 8 9
CotOpaxi 3 4
Chimborazo 2 2
Imbabura l l
Carchi 1 l

 

Due to rounding, some totals may not equal 100%

 

_“_J

57

Families of the sampled children ranged in size from 2
to 11 members. The average family size in CA was 6.9 com-
pared with 6.1 for the Ecuadorian Sierra (Junta Nacional de
Planificacion, 1974b). Those families in this sample which
were small were either grandparents living with a child or a
family with younger parents. Families which were extended
were primarily families where the father was absent. In two
families the child of the mother's sister was taken into the
family. One child was an orphan and the other child's
mother was a cretin still living with her parents.

Fifty-four percent of the sample were male and 46% were
female. Seventy'(82%) of the children were born in Quito.
The remaining 15 (18%) were born in the provinces. The
reported childrenks birthplaces provided information indi-
cating that 18% of the children themselves had migrated in
their lifetime.

Fourteen of the children were kin to another child in
the sample. There were two sets of siblings, four sets of
cousins and one uncle-nephew pair, involving seven families.
This subsample of related children was not analyzed further
because it was so small. Indepth family data would need to
be collected via interviews and observations to examine

kinship relationships and nutritional status.

We
Data describing the families are in Tables 3, 4, 5 a 6.

Demographics collected about each family were family size,

 

...—j

58

Table 3. Profile of Families in Cotocollao Alto, Quito,
Ecuador, June, 1983 (n=85)

 

 

Family Characteristics Number Percent
Eamiluize

2 - 4 members 8 9
5 - 7 members 45 53
6 - 11 members 31 32
Not reported 1 l
W

Father 74 87
Mother 4 5
Grandmother 4 5
Grandfather 1 1
Uncles 2 2
W

Father present 74 87
Father absent ll 13
MaternalJresense

Mother present 81 95
Mother absent 4 5
Neighborhoodjesidense

Santa Anita 38 44
Bellavista l4 16
E1 Bosque 14 16
El Triunfo 8 9
San Jose 6 7
San Rafael 4 5
Santa Ana 1 1

 

Due to rounding, some totals may not equal 100%

59
family head and presence or absence of either parent and
local family residency (Table 2). Descriptive characteris-
tics of the mother and father are age, education and occupa-
tion (Tables 4, 5, 6).

Seventy-four gatekeepers reported that the father of
the child was the head of the family. In the 11 remaining
families where the father was absent from the home, the
head-of-family was reported as follows: four mothers (5%),
four grandmothers (5%), two uncles (2%) and one grandfather
(1%). In these 11 families, the father was dead in two
cases, unknown mates of cretin mothers in two cases and
known but not residing with the mother in seven cases. The
childks mother was found to be present in 81 families (96%)
and absent in four families (4%). In those families where
the mother was absent, she had abandoned the child in two
cases, died in one case and was a cretin living separately
in one case.

The community of CA was divided into distinct small
neighborhoods. Based on observation, these small neighbor-
hoods had different characteristics which.could haveemade
neighborhood residency a predictor variable for the nutri-
tional status of the children. Some of the small neighbor-
hoods were settled longer than others, others were located
closer to the main road, others were on better (more level)
land. .After data collection, it was found that neighborhood
divisions left numbers too small for analysis. Because

there was not logical way to group these small

 

60
neighborhoods, this variable was not further analyzed. To
examine the relationship>of spatial distribution within a
neighborhood and the nutritional status of children, a rep-
resentative sample from each distinct area would have to
have been collected.

Age distribution of the mothers and fathers of the
sampled child appears in Table 4. The age range of the
childrenfis mothers was from early twenties to early fifties.
The mean mother's age was 33 years. The age range of the
childrenfis fathers was from late twenties to early sixties.
The mean father's age was 36 years.

Twenty-two mothers reported that they could not read or
write. One mother reported that she had no formal education
but that she could read and write. Thirty-nine mothers
(46%) had some primary education while 14 mothers (11%) had
completed primary school. Four mothers (5%) had some sec-
ondary education. The mean years of education for the
childrenls mothers was 2.8 years. Three fathers (4%) could
not read or write and two (2%) had no formal education but
could read and write. Twenty-six fathers (31%) had some
primary education and 33 fathers (39%) had completed primary
school. Four fathers (5%) had some secondary education
while 3 fathers (4%) had completed secondary education. One
father had university training. The mean years of education
for the childrenls fathers was 5 years.

Occupational data of the childrenls:mothers are sum—

marized in Table 5. Fifty-four mothers (64%) reported that

“'fiJ‘II {—

61

Table 4. Age and Education of Children's Parents in Coto-
collao Alto, Quito, Ecuador, June, 1983 (n=85)

 

 

MOTHERS FATHERS
Characteristics Number Percent Number Percent
Age
20-29 years of age 9 ll 4 5
30-39 39 46 26 31
40-41 29 34 36 42
50-51 2 2 5 6
60-69 0 0 1 1
Not reported 6 7 13 15
Edmtian
Illiterate 21 25 3 4
Literate-no formal education 1 l 2 2
Some primary 39 46 26 31
Completed secondary 14 16 33 39
Some secondary 4 5 4 5
Completed secondary 0 0 3 4
University 0 0 l 1
Not reported 6 7 13 15

 

Due to rounding, some totals may not equal 100%

62

Table 5. Occupation of children's mothers in Cotocollao
Alto, Quito, Ecuador, June, 1983 (n = 81)

 

 

Occupation Number Percent
Housewife 54 64
Washer woman 10 12

Market woman
Small store owner
Domestic servant

Brick maker

HNNUIQ
HNNO‘m

Private Business

 

Due to rounding, some totals may not equal 100%

they were housewives with no outside of the home employment.
Of those women who worked outside the home, 10 (11%) were
washer women, seven (8%) were women who sold food at local
markets, five (6%) owned small neighborhood grocery stores
and two each (2% each) were domestic servants or brickmakers
and one was involved in a food transportation business with
her husband. Noidifference in per capita income or in per
capita food expenditure based on whether or not the woman
worked outside the home (t-test, p>.05l. For further analy-
sis, mother's occupation was collapsed into two groups:
mothers who were home during the day and mothers who were
away from home during the day.

Occupational data of the children's fathers are sum-

marized in Table 6. Father's occupation is frequently used

 

63

Table 6. Occupation of the childrenfis fathers in Cotocollao
Alto, Quito, Ecuador, June, 1983 (n=85)

 

 

Occupation Number Percent
Managers and administrators 9 ll
Professionals & technical workers 4 5
Employees in offices 7 8
Craftsman and artisans 10 12
Drivers 6 7
Personal service 4 5
Workmen and day workers 31 36
No work 3 4
Not reported ll 13

 

Due to rounding, some totals may not equal 100%

as a socioeconomic indicator with income data. The fathers
of the sampled children were employed in 24 distinct jobs.
These jobs were divided into categories based on those
categories utilized by the Ecuadorian Census Institute
(INEC) in the 1974 census. Occupation of the father distri-
buted as follows: nine managers and administrators (10%),
five professionals and technical workers (6%), seven office
employees (8%), ten craftsmen and artisans (11%), six
drivers (7%), four personal servants (5%) and 31 (36%)

workmen and dayworkers. Three fathers were unemployed.

 

64
W

Income data were collected from CA homemakers. These
data were used to compute a per capita income by dividing
income by family size. Estimated monthly food expenditure
was also collected and a per capita food expenditure was
computed by dividing estimated food expenditure by family
size. Information on additional sources of economic activi-
ty of the family was also collected.

Per capita monthly income ranged from (J to 6,000
sources (UALA. 1$=95 sucres: June, 1983). The mean per
capita income was 1,039 sucres and the reported mode was
1,000 sucres. In 1976, the average family income based on
an average family of 5.4 for urban areas of Ecuador was
$139.00 (Luzuriaga, 1979). At that time, $139.00 was equal
to 3,475 sucres. lJiJUne, 1983, the same $139.00 was worth
13,205 sucres and the minimum wage was still 4,000 sucres
per month.

Per capita food expenditure ranged from 150 to 1,500
sucres per month. The mean monthly per capita food expendi-
ture was 614 sucres.

Families were asked what other sources besides their
principle economic activity contributed to the family in—
come. Nine families (10%) received income from the rental
of a house which they owned. Twenty-six families (30%) used
agricultural products from their own land. Families who had
small plots of land beside their homes usually grew corn,

potatoes, and onions. A few families also grew lupine

65
beans. Three families (3%) received money from other family
members. Twenty families (23%) received gifts of goods and
food from friends and other family members. These were
mainly families from nearby rural areas who relatives

brought them food grown on their land.

flaming

Housing characteristics are described in Table 7. Home
ownership data were reported. Housing characteristics re-
ported were wall materials, floor materials, roof materials
and the number of rooms. Data were also collected on fuel
sources, food storage facilities and refrigeration. Infor—
mation on water source, garbage disposal and human waste
disposal was collected.

Sixty-three families (74%) owned their own homes. Of
those who did not own their homes, 18 families (21%) rented
their homes and three families (3%) were non-paying care-
takers in their homes. The houses ranged from one to six
rooms. This room count excluded the kitchen and the latrine
which were both usually separate from the house. Construc-
tion materials for walls, floors and roofs varied and this
distribution is summarized in Table 6.

The peOple in CA secured electricity for the community
in 1976 and all homes in the sample had electricity. Al-
though water was not potable, most families (97%) obtained
their water from hand pumps located throughout the neighbor-

hood. Erratic garbage collection was available and was

I' '

 

66

Table 7. Housing in Cotocollao Alto, Quito, Ecuador, June,
1983 (n=85)

 

 

Housing characteristic Number Percent
Hammnarship

Homeowners 63 74
Home renters 18 21
Home caretakers 3 4
MW

1 room 18 21
2 rooms 32 38
3 rooms l6 l9
4 rooms 9 ll
5 rooms 6 7
6 rooms 4 5
Hall_£9n5t£n£t12n

Cement block 34 40
Adobe 21 25
Brick 21 25
Mixed construction 8 9
Wood 2 2
W

Eternit 28 33
Tiles 21 25
Cement 22 26

Zinc 13 15

67

Table 7. (Cont.)

 

 

Housing characteristic Number Percent
W

Wood planks 51 60
Dirt 12 14
Cement 13 15
Brick 4 5
Parquet 3 4
Mixed construction 1 1
W

Hand pumps 82 97
Ravine creek 2 2
Water tank truck 1 l
Garbagooisoosal

Garbage collection service 26 31
Burned garbage 21 25
Garbage thrown in ravine 19 22
Garbage thrown in own yard 12 14
Garbage buried 7 8
WW

Latrines 73 86

Open countryside 12 14

Table 7. (Cont.)

68

 

 

Housing characteristic Number Percent
Eualjouroes

Gas 50 59
Wood 14 16
Both gas and wood 10 12
Gasoline 4 5
Kerex 4 5
Electricity 3 3
E 3 SI E 'J'l'

Open shelves 47 55
Closed shelves ll 13
Boxes 20 24
Closed containers 5 6
Barrels 3 3
B E . I.

Refrigeration present 24 28
Refrigeration absent 61 72

 

69

utilized by 26 (31%) of the families. Garbage scattered
throughout the neighborhood was viewed as a sanitation prob-
lem. Seventy-three families (86%) had latrines for despos-
ing of human waste.

The most frequent source of fuel was tanked gas used in
50 homes (59%). Twenty-six homes had and used refrigera—
tion. Food storage facilities were varied and ranged from
boxes and barrels to closed shelves.

Those data which describe the research population have
been reported. Selected variables will be further analyzed
as they effect or interact with the relationship between

migration and the nutritional status of migrant children.

H' I.
Information on place of origin, the length of residence
in Quito, the length of residence in CA and the existence of
migration within the family was collected and is summarized
in Table 8. Place of origin and residence with kin upon
arrival were reported by those families who had migrated.
Responses to Open-ended questions on the reasons for migra-
tion and the satisfaction with life in Quito were recorded.
Migration of these families all took place from the
Ecuadorian Sierra, some from rural areas and some from
secondary urban centers. Because place of origin was de-
fined as province of origin, a distinction between these two
groups was not possible, resulting in all migrants being

treated as one group for analysis. Those rural areas

70

Table 8. .Family migration data, Cotocollao Alto, Quito,
Ecuador, June, 1983 (n=85)

 

 

Migration characteristic Number Percent
E] E Q . .

Quito 31 36
Pichincha 19 22
Cotopaxi 9 ll
Chimborazo 8 9
Imbabura 5 6
Carchi 5 6
Bolivar 3 4
Azuay 3 4
Tungurahua l 1
Loja l l
I I] E E .3 . 0 '|

0-5 years 9 11
6-10 years 9 11
11-15 years 10 12
16-20 years 7 8
more than 20 years 50 59

I I] E .3 I] C W

0-5 years 29 34
6-10 years 30 35
11-15 years 6 7
16-20 years 1 l

more than 20 years 19 22

71
Table 8. (Cont.)

 

 

Migration characteristic Number Percent
E i l E M' I.

No Migration '21 25
Both parent migration 35 42
Mother only migrated 13 15
Father only migrated 13 15
He-of—family (not parent) migrated 2 2

E .3 'll 8' E . 1

Not applicable 31 36
No one 28 33
Grandparents of the child 6 7
Aunts and uncles of the child 7 8
Aunts and uncles of the parents 5 6
Friends 6 7
Cousins 2 2

 

Due to rounding, some totals may not equal 100%

closest to Quito attracted the most migrants and CotOpaxi,
the neighboring province, attracted the second largest
group. After that, proximity no longer explains migration
to Quito. The third largest number of migrants came from
Chimborazo, one of the furthest provinces.

Length of residence in Quito ranged from 2 to 52 years.
The mean length of residence on Quito was 25.5;years. The

reported mode was 42 years and the median was 25 years.

72
Length of residence in CA ranged from 1 to 49 years. The
mean length of residence in CA was 14.8 years. The reported
mode was 5 years and the median was 9 years.

In 21 families (25%) there was no migration at all
during the generation of the child's parents. In 35 fami-
lies each (15% each) only the mother or only the father had
migrated. Migration in two families took place by the head-
of-family where that person was neither mother nor father of
the child. This variable was collapsed as no parent migra-
tion, one parent migration and two parent migration for
further analysis.

Twenty-eight families (33%) reported that they had not
stayed with a relative or friend upon their arrival in
Quito. Fifty percent of those families who migrated stayed
with a friend or family member upon arriving in the city.
Because most of the families who had migrated were settled
migrants residing in Quito for more than 10 years, kinship
ties at the time of arrival were not examined in relation-
ship to nutritional status.

Responses to open-ended questions related to reasons
for migration and satisfaction with life in Quito were
answered by 45 mothers or gatekeepers. These results are
presented in Table 9.

Eighty percent of those respondents who had migrated
reported coming to Quito for reasons related to work. Ten
respondents that gave work as the reason for migration were

women who had migrated to Quito at an early age to work as

73

Table 9. Motive for and satisfaction with migration of
migrants in Cotocollao Alto, Quito, Ecuador, June,
1983 (n=45)

 

 

Migration Characteristic Number Percent
ReasoanorJioration

Work 36 80
To live with relatives 8 18
Health 1 2

S I. E I. ill MI I'

Satisfied with life in Quito 43 96
Unsatisfied with life in Quito 2 4

 

domestic servants. Most of these respondents simply an-
swered 'work' as their motive for migrating. Three respond—
ents specified already secured work for the father of the
family in Quito.

Of 45 respondents answering the question on how they
felt about migrating to quito, only two felt unhappy in
Quito. One stated that life was too much of a battle and
the other had been abandoned by her husband. Most of the
respondents felt that their life had improved by moving to
Quito and expressed either satisfaction or happiness with
their lives. Among those who gave more specific answers for
their satisfaction, 11 respondents mentioned the availabil-
ity of work, 6 mentioned the education of their children and

5 were pleased at being able to own their own home.

74
Nutrition and Migration

Nutritional status is an operational term relating the
condition of health to the intake of foods and the utiliza-
tion of nutrients. The four basic methods utilized for
assessing nutritional status are anthropometric, biochemical
or laboratory studies, clinical evaluation and dietary data
(Christakis, 1973). In this study, dietary intake and an-
thropometric measurements were utilized to assess the nutri-
tional status of school-aged migrant children.

Multiple regression analysis was used to examine the
relationship of migration and the nutritional status of
migrant children. A candidate list of variables considered
in the initial regression equation appears in Table 10.
From this initial list utilized for all dependent variables,
individual regression equations were determined. Regression
results for each dependent variable used to assess nutri—
tional status will be presented.

Dietary Data. Dietary data for this study was col-
lected via a 3-day food record and a 24-hour dietary recall.
Calculations for energy and six nutrients were done from the
24-hour dietary recalls» Those nutrients calculated were
protein, calcium, iron, thiamin, riboflavin and vitamin A.
Mean percents for males and females of the FAO/WHO Recom-
mended intake of Nutrients and the percent standard devia-
tion are reported for energy and each of the six nutrients
(Table 11). The distribution of males and females not

meeting and those meeting more than 100 percent of the

Table 10. Table of candidate list of explanatory variables
used for each dependent variable.

 

Variable

Explanation

 

Quito time

Community time

Migration

Sex
Age
Family

Per capita Income

Per capita food expenditure

Father

Education

Occupation

Home

Farming

81
82
S3
S4

Length of residence in Quito

Length of residence in the
community

No parent, one parent or two
parent migration

Sex of the sampled child
Age of the sampled child
Family Size

Income divided by family
size

Food expenditure divided by
family size

Presence or absence of the
father in the home

Education of the child's
mother or gatekeeper

Occupation of the child's
mother based on whether or
not the mother was home
during the day

Ownership or not of the
family's home

The use or not of agri-
cultural products from the
family‘s own source of land
Quito time squared
Community time squared

Migration squared

Family squared

76

Table 10. (Cont.)

 

 

Variable Explanation

SS Per capita income squared

S6 Per capita food expenditure
squared

11 Interaction of Quito time
and migration

12 Interaction of migration and
family size

13 Interaction of migration and
per capita income

14 Interaction of migration and
mother's education

15 Interaction of family size
and per capita income

16 Interaction of family size
and per capita food
expenditure

17 Interaction of farming and

per capita food expenditure

 

77

Table 11. Male and female children's mean percent FAO/WHO
Recommended Nutrient Intakes for one total day
for energy and six nutrients, Cotocollao Alto,
Quito, Ecuador, June, 1983 (n=85)

 

 

NUTRIENT MEAN % FAO/WHO i so
MALES EEMALES
ENERGY 78 i 31 89 i 33
PROTEIN 140 i 53 175 1 89*
CALCIUM 77 1 49 92 i 64
IRON 84 i 31 112 i 62*
THIAMIN 74 i 34 107 1 54*
RIBOFLAVIN 63 :t 32 95 3; 54*
VITAMIN A 50 i 47 59 i 58

 

*Significant difference in intake between male and female
children (P S .01).

FAO/WHO standards for energy and six nutrients is reported
in Table 12.

Energy. The children in CA consumed from 30 percent to
182 percent of their recommended energy intake. The mean
percent intake of energy was 83 percent and the mode was 61
percent. Mean energy intake for females was higher than for
males: however this difference was not significant.
Mother's education showed a weak correlation with the
child's energy intake (r=.31, p$.01). There was a signifi-
cant difference in energy intake between those children
whose mothers had had no formal education and those mothers

who had formal education (p$.05L. Mean percent energy

78

 

 

 

 

o m o m mH mu Hm cH cH>mHuonHm
o q a H «H an em m cHemHns
H o m m m «H on an a cHemuH>
o m m b mH mm mH H couH
o m m HH «H EH 4H mm asHoHoo
m OH NH em mH «H v o :Hmuoum
o o m m mH em mu N mmumcm
«com wommuHom oomust mmmHneMH ammHuHOH «OOHupm wewaem wmmno ucmHuusz
moxmucH ucmHuusz namEEoomm o=s\o¢m mcHummz :muoHHno

Ammucv mmmH wage «boomsom .ouHso .ouH< oMHHooouoo

.mucofiuusc me can mmuoco uom moxmucu ucmfiuusz noccmesooom om3\o<m
mo mooa can» oboe mcHuomE omonu can wcfluooe no: concafino mo ambasz .NH manna

79
intake was higher for those children whose mothers had
attended school. When mother's education was examined in
conjunction with other variables possibly impacting energy
intake, this effect was eliminated. No relationship was
found between the energy intake of the children and length
of residence in Quito or the migration of the parents.

Braggin. The children consumed from 47 percent to 424
percent of their recommended protein intake. The mean per-
cent of intake for protein was 156 percent and the mode was
96 percent. Mean percent protein intake was significantly
higher for females than for males (ngnJ. Mean percent
protein intake was higher for those children whose mothers
attended school than for those children of mothers who had
never attended school (p=_<..Ol). No relationship was found
between length of residence in Quito or the migration of the
parents and the protein intake of the children.

Iran. The children consumed from 24 percent to 282
percent of their recommended iron intake. The mean percent
intake of iron was 97 percent and the mode was 68 percent.
The mean percent iron intake was higher for females than for
males (p$.05). Mean percent iron intake was significantly
higher for those children whose mothers had attended school
than for those children whose mothers had never attended
school (p$.05). Length of residence in Quito and the exist-
ence of migration within the family was not found to be
related to the iron intake of the child. The relationship

of the sex of the child and iron intake was confirmed by

80

regression analysis. Home ownership was also found to be
related to the iron intake of the child. Per capita food
expenditure was significantly related to iron intake but, in
a non-linear manner. Sex of the child, home ownership and
per capita food expenditure explained 20 percent of the
variation in the children's iron intake. The linear and
quadratic terms for food expenditure accounted for 93 per-
cent of the explained variance (Table 13).

Calcium. The children consumed from 8 percent to 266
percent of their recommended calcium intake. The mean per-
cent calcium intake was 84 percent and the mode was 23
percent. Mean percent calcium intake for females was higher
than for males, however, this difference was not signifi-
cant. No relationship was found between calcium intake and
those variables included in the regression analysis.

Thiamin. The children consumed from 24 percent to 263
percent of their recommended thiamin intake. The mean per-
cent thiamin intake was 89 percent and the mode was 82
percent. The mean percent thiamin intake was higher for
females than for males when other variables were ignored
(p$,01). However, no relationship was found between thiamin
intake and those variables included in the regression
analysis.

Riboflavin. The children consumed from 9 percent to
288 percent of their recommended thiamin intake» The mean
percent riboflavin intake was 78 percent and the mode was 48

percent. The mean percent riboflavin intake was higher for

81

coaumgmHa unonuq H no aconmq 0: Lou acmoquacman ooze

 

mmwp. + momaoo+
thomw.l
mp. Hmlmom. + hmowumx

w». «Fm.m + ommum

a: hm.—m I zwm.=mm +
mm. www.m— + awm.hm + corn:

NmmINN. + moN.I

ma. Hmmo. + mm.N= + P.moum
mums. + mmcw.l
Hm. www.mm mom.>m + mPHuH

oHHso no Nahum
mafia hadammum
escoca madame soauH

OMMM<

a can 2 no :ofiuomsoucHuH:
coaumsmaa Haucosmauz

cuHso 2H oocovamon no sandman;
eHHno co ommua

oncoqxo coon mafiqmo Loaum
oaoocH «guano LoauH

oHHso co xomum

oncooxo coon muaqmo Lmaum
aanmnoczo oaonum

oHHso co ammum

NWQZH Hmchm\HmuHm3

mo<lmomlamonm

mo<lm0hlhmon3

ucofiumcwaa ucoan neon
2H><A>omHm

zomH

 

ma cosmsnuc

couumscm conmoLmom

oHQMHLm> uaoocoqoocH

oHAMHLm> acoocoqon

 

magnum HmcoHuHLusc mcwuooHu L aoHnmasa> acovcoqov moon»

new noanmanm> unovcoaoocu oouoonm uo :oHuomsoucH on» mcwcfiamxo muasnon coaumonwon ho anaaasm um? Tapas

82

females than for males (p$,Ol). Intake of riboflavin had an
inverse and linear relationship with the number of parents
migrating and with per capita income and there was an inter-
action between these two variables. Per capita food expend-
iture was found to have an inverse and non-linear relation-
ship with riboflavin intake. When the data were divided
into three groups according to the number of parents migrat-
ing (none, one or both), sex of the child, per capita income
and per capita food expenditure were significantly related
to riboflavin intake only for children with two parents
migrating. In that case, 45 percent of the variation in
riboflavin intake was explained, with most of that related
to the linear and quadratic terms for food expenditure
(Table 13).

yitamin_A, The children consumed from 0 percent to 330
percent of their recommended intake of Vitamin A. The mean
percent intake of vitamin A was 54 percent and the mode was
32 percent. Mean percent vitamin A intake was higher for
children in homes where the father was present (p$.05) when
other variables were ignored. No relationship was found
between vitamin A intake and those variables included in the
regression analysis.

Anthropometri§_data. Height and weight were collected.
Weight-for-age, height-for-age and weight-for-height ratio
were used as indicators of growth. Comparisons of these
anthr0pometric measurements for the sampled children are in

Table 14.

83

moor Anzac go: has uaauo» anon .wcavanon 0» 05a

 

 

m m o o o o ooplom
m m H H o o manpm
mp PP o o o o cane»
mm Pm N N a m mblpm
pm am > o p o omlom
mp mH N. or NH 0. mmlp—
m 3 2H NH mm HN epic

p m Fe «m Hm m: m to

amoucoonom popes: ommucoonom Lopes: ammusoosom Longs: economy» mmoz
usmuosugoulunmaoz ommnnouuaanom ammunohnasmaoz no omcmp oHHucoouom

 

Hm» u as mam. .oase .moraecmsa mmoz
3.3 on... o... vonmaaoo no .Hovwsom .9390 5.2% omaaoooHoo 5" 0mm .3 930.». 3 o» m .3252?
mamaou new case Lou unmaonlnouluano: new .ommnnouluzmao: .ofimtnouaunmwoz no coausnfinanaa nap mange

84

Hfiighizfinizagg. Weight-for-age of the CA children
distributed between the 0-5 percentile range to the 50-75
percentile range of the NCHS growth charts (1976) (Figure
2). The 10 percentile point was the mean percentile weight-
for-age for these children. Most children (51%) fell into
the 0-5 percentile range. Because this resulted in a dis-
tribution that placed most of the sample in the same range,
individual z—scores were computed for each childfls weight-
for-age. 'This method produced a positively skewed distribu-
tion ranging from -2.39 to +2.58 with a mean z-score for

+ .98 (Figure 3).

weight of +.86 and a standard deviation of
A significant difference was found in weight-for-age z-
scores between those children living in a home where the
father was present and those children living in a home where
the father was absent (p$,05). Children living in homes
where the father was absent had a higher mean z-score for
weight than the children living in homes where the fathers
were present.

Weight was linearly related to age as would be expected
showing an increase in weight corresponding to an increase
in the child's age. Overall, a linear relationship was
found between length of residence in Quito and the weight of
the child. The interaction of length of residence in Quito
and the number of parents migrating was also related to the
childfls weight. To examine this interaction, the data were

divided into three groups according to the number of parents

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

51$
. 651
504
45¢
a
g 401
C
o as.
8.
0 30¢
.-
5 25¢
0
:1 201
$
$51 ‘41:
I 125
10‘
1s
51
&
5 10 25 60 75 90 95 100
praccutur RANGE
Figure 2: Weight-for-age distribution
of Cotocollao Alto sample
children in percentiles as
compared to 1976 NCHS growth
charts. Quito, Ecuador, June,
1983 (N=85).
ass
as,
r
'21s
a 20’ I:.34
: 30:1.96
3
y
t ‘5 131 ...‘L‘.
o
Q.
:1. 10 > P2,”. 9 54
2
I!
t
5 >
as .
n n n E:
-zs-¢m «Ls-1m ‘n5 0 .5 an ‘L5 24>:L5 an
z-sconrs
Figure 3: Sex and Age specific Z-scores for

wei
col

1

ht of sample children in Coto-
ao Alto, Quito, Ecuador, June,

1983 (NBBS).

86
migrating (none, one or both) and no effect of length of
residence was found.

Height;for;age. Height-for-age of the CA children
distributed from the 0-5 percentile range to the 90-95
percentile range of the NCHS growth charts (Figure 4). The
12 percentile point was the mean percentile height-for-age
ofr these children. Most children (61%) fell into the 0-5
percentile range of the NCHS growth charts. Because this
resulted in a distribution that placed most of the children
iJnthe same range, z-scores were computed for each child's
height-for-age (Figure 5L. This method produced a normal
distribution ranging from -2.26 to a +2.59 z-score for
height with a mean z-score for height of +334 and a standard
deviation of 1;.96. Age was the only variable linearly
related to height. This is an expected result as a childk:
height should normally increase with increased age. Never-
theless, based on the regression analysis, age explained
only 18% of the variation in the height of this sample.

W. Weight-for-height of the CA chil-
dren distributed from the 0-5 percentile range to the 95-100
percentile range on the NCHS growth charts (Figure 6). The
46 percentile point was the mean percentile point of these
children. The greatest number of children (27%) were in the
25-50 percentile range. Fewer children fell below the 50
percentile point for weight-for-height than for weight-for-
age or height-for-age. For further analysis, a weight/
height ratio was calculated dividing weight by height. When

87
55
51‘
50'
45-
40-
35"
30'

25‘ 1h

20:

peace»? or cases

15d

12%
10'

7‘

4S

 

 

 

 

5 10 25 50 75 00 05 100
PERCEN‘I’ILE RANGE

Figure 4: Height-for-age distribution of
Cotocollao Alto sample children
in percentiles as compared to
1976 NCPS growth charts. Quito,
Ecuador, June, 1983 (N=85).

 

 

 

 

 

 

 

 

 

35 a 348
‘—

30 .
a 32.86
W 25 b
a -
c 00.. 1.00
o
g 20»
O
p.
z 15r 1.5—:
" 13$
0 1
c 111.
w 10 >
a 11, ‘ 7s

5‘ ‘35s ass

as as 1s
'2.5 ’2.0 -1.5 -.1 -.5 0 .5 1.0 1.5 2.0 2.5 3.0
2 - SCORES

Figure 5: Sex and age specific Z-scores for
height of sample children in Coto-
collao Alto, Quito, Ecuador, June,
1983 (N885).

88

 

 

 

 

 

 

 

 

 

 

 

35-
m 30"
Ill 27%
2 25¢ ‘ 25%
0
u C
O 20
'2- 15. 7 ‘59“
In 13%
0
El 10‘
7%
°' —-l 5%
54
3% 3%
f l l
5 10 25 5O 75 90 95 100

PERCENTILE RANGE

Figure 6: Weight-for-height distribution of Cotocollao
Alto sample children in percentiles as com-
pared to 1976 NCHS growth charts. Quito,
Ecuador, June, 1983 (N=85).

89
one family with unusually high income was removed from the
sample, the index was linearly related to income, showing an
increase in the weight/height ratio of approximately .04 for
every 1000 sucre increase in income. Sex was also found to
be a predictor variable for weight/height ratio with females

having a higher mean than males (Table 13).

W

Food frequency data were collected in a dual time
framework from the homemakers who migrated. Frequency of
food consumption was reported for ”within the last month' in
Quito and for 'a one month period" during rural residency.
Forty-one homemakers responded to the food frequency instru-
ment in both the rural and urban time framework. Four
homemakers had migrated at too young an age to recall rural
food patterns.

The food frequency instrument was utilized to examine
dietary changes related to migration. A correlated t-test
was done to look for differences between rural and urban
food consumption for the same person. These results are
reported in Table 15. A student's t-test was done to look
for a difference in urban food consumption between those
persons who had only urban food frequency scores and between
those persons who had both an urban and a rural food fre-
quency score. This looked at the difference in present
consumption between those who had always lived in the urban
area and those who had migrated to the urban area. These

results are reported in Table 16.

90

Table 15. Migrated homemakers reported food frequencies in a dual time
framework of post- and pre-migration. Cotocollao Alto,
Quito, Ecuador, June, 1983 (n = 85)

 

 

Urban Mean Rural Mean Significance

Frequency Frequency
We
chulpi .70 3.25 .040'
corn 2.28 5.18 .031' ?
popcorn 4.03 2.66 .055 g
toasted corn 5.40 10.35 .010. i
hominy 3.08 8.00 .003' l
morocho corn 2.97 10.00 .0001.
barley 2.80 9.05 .001'
wheat .53 1.35 .289
quinoa 1.23 2.33 .141
chuchuca 1.45 2.43 .154
barley flour 5.28 14.10 .0001.
wheat flour 3.58 7.00 .024.
morocho flour .25 .05 .118.
corn flour 5.10 8.78 .039.
semola .03 1.02 .006.
oats 4.80 4.23 .194
noodles 4.53 2.78 .016'
spaghetti 5.30 2.43 .015.
rice 28.05 13.65 .0001.
bread 29.28 15.95 .0001'
WW2:
peas 4.28 4.78 .475
lentils 1.18 1.40 .238
fava beans 6.25 6.58 .558
beans 4.15 5.60 .147
garbanzos .08 .05 .323
lupin 3.40 2.38 .180
pea flour 2.08 3.56 .121
fava bean flour 3.77 5.40 .183
.Issetablss.
cabbage 13.38 11.23 .163
purple cabbage 1.25 .15 .152
turnip greens 3.90 3.25 .645
swiss chard 3.45 .95 .014.
spinach 1.23 1.10 .861
onion 20.65 13.93 .002.
white onion 27.33 22.95 .024.
tomato 18.08 10.58 .0001.

91

Table 15. (Cont.)

 

 

Urban Mean Rural Mean Significance

Frequency Frequency
Iflzslahl£§.(cont.)
lettuce 9.13 5.33 .012.
hot pepper 16.28 16.55 .876.
green beans 1.45 .78 .001.
green peppers 2.83 2.18 .548
cucumbers 1.00 .55 .002.
avacado 3.32 3.15 .899
squash 1.30 3.85 .046.
squash seeds 1.18 3.15 .063.
pumpkin 1.10 3.03 .070
carrots 23.43 18.88 .008.
white carrots .80 1.18 .075
radish 1.50 .70 .0001!
beets 2.25 2.17 .917
ullucus tuber 2.30 3.48 .267
oka .80 3.65 .027.
potato 30.00 29.35 .323
Emits
pears 2.58 .75 .018.
apples 1.93 .75 .0001*
figs .70 .68 .918
tree tomato 1.75 1.38 .117
andean cherry 1.40 .83 .003.
papaya 2.80 1.93 .426
pineapple 2.80 2.05 .485
passion fruit 2.13 .58 .028.
orange 4.02 3.43 .440
lime 15.55 15.03 .651
green plantain 6.20 6.68 .734
red plantain 6.55 5.40 .345
ripe plantain 9.03 9.58 .719
banana 22.55 19.15 .165
babaco .33 .08 .031.
chamburo .18 .13 1.000
taxo .85 .50 .085
naranjilla 1.70 2.23 .489
blackberry 1.48 2.33 .396
strawberry 1.13 .85 .396
grape .67 .35 .202
mango .83 .63 .031'
cantelope .58 .25 .186
sour sop .50 1.23 .336
cherimoya .93 1.10 .432
tangerine 1.13 1.70 .448

 

Table 15. (Cont.)

92

 

 

Urban Mean Rural Mean Significance
Frequency Frequency
W
rabbit .50 1.13 .012.
guinea pig .63 2.38 .027.
chicken 2.95 3.05 .658
pork 2.53 4.67 .0445 r
lamb .93 2.23 .100 I
beef 21.10 15.30 .003' ‘
fish 1.35 .40 .0001 t.
shellfish . 28 . 03 .0311| ‘
eggs 22.40 24.73 .263
W
milk 15.80 26.75 .0001.
yogurt 1.70 .03 .116
cheese 4.93 7.10 .170
ice cream 14.20 8.98 .0001.
Miscellanea:
sugar 30.00 25.65 .012
crude brown sugar 1.73 8.40 .006.
regular salt 1.53 10.63 .001.
iodized salt 28.50 19.10 .0001.
cookies 7.10 1.25 .002.
candy 8.48 2.00 .001'
coffee 27.10 22.78 .061
tea 1.95 1.98 .987
colas 16.60 7.48 .002.
mineral water 11.73 5.03 .004.
food supplement .38 .03 .046.

 

' p 5,.05

93

Table 16. Reported urban food frequencies for migrants and non-migrants
living in Cotocolloa, Quito, Ecuador, June, 1983 (n = 85)

 

Urban mean

 

Frequency Urban Mean

for Non- Frequency

Migrants for Migrants Significance
W19.
chulpi .46 .70 .140
corn 1.66 2.28 .047.
popcorn 5.44 4.02 .374
toasted corn 6.35 5.400 .628
hominy 4.29 3.08 .429
morocho corn 5.62 2.98 .039.
barley 4.66 2.80 .07
wheat .58 .53 .806
quinoa 1.75 1.22 .436
chuchuca 1.48 1.45 .934
barley flour 6.32 5.28 .621
wheat flour 5.38 3.58 .263
morocho flour .48 .25 .318
corn flour 6.50 5.10 .480
corn starch 11.02 8.58 .369
semola .02 .025 .898
oats 11.19 4.80 .002.
noodles 4.56 4.53 .978
spaghetti 6.87 5.30 .362
rice 25.46 29.28 .116
bread 29.45 29.28 .840
Wanna
peas 3.06 4.28 .231
lentils 1.31 1.18 .662
fava beans 3.38 6.25 .074
beans 3.13 4.15 .310
garbanzos .15 .08 .290
lupin 2.04 3.40 .258
pea flour 1.04 2.07 .198
fava bean flour 5.73 3.78 .172
.Iassiahlsa.
cabbage 14.15 13.38 .787
purple cabbage .17 1.25 .161
turnip greens 6.48 3.90 .143
swiss chard 2.79 3.45 .583
spinach 1.00 1.23 .514

r—F-F—“1

94

Table 16. (Cont.)

 

Urban mean

 

Frequency Urban Mean

for NOn- Frequency

Migrants for Migrants Significance
.Ifisfiiahl§§.(0ont.)
onion 18.65 20.65 .482
white onion 27.70 27.40 .854
tomato 11.48 18.08 .021.
lettuce 5.94 9.13 .148
hot pepper 14.42 16.28 .554
green beans 1.17 1.45 .376
green peppers 1.17 2.83 .119
cucumbers 1.06 1.0 .831
avocado 1.92 3.33 .177
squash 1.63 1.30 .207
squash seeds .98 1.18 .370
pumpkin .90 1.10 .358
carrots 16.60 23.43 .150
white carrots .66 .80 .637
radish 1.29 1.50 .518
beets 2.69 2.25 .520
ullucus tuber 2.08 2.30 .514
ok§a .71 .80 .736
potato 28.16 30.00 .083
Emits
pears 1.60 2.57 .322
apples 2.29 1.92 .684
figs .39 .70 .128
tree tomato 3.81 1.75 .055
andean cherry 1.06 1.40 .188
papaya 3.14 2.80 .719
pineapple 3.06 2.80 .785
passion fruit 2.00 2.13 .900
orange 5.44 4.02 .374
lime 14.66 15.55 .767
green plantain 6.60 6.20 .516
red plantain 5.85 6.66 .740
ripe plantain 11.40 9.03 .362
banana 24.33 22.55 .482
babaco .13 .33 .116
chamburo .10 .13 .764
taxo .81 .85 .875
naranJilla 1.81 1.70 .868
blackberry 2.19 1.48 .023
strawberry 1.19 1.13 .826
grape .52 .68 .389

 

95

Table 16. (Cont.)

 

Urban mean

 

Frequency Urban Mean

for Non- Frequency

Migrants for Migrants Significance
E£n1&§.(Cont.)
mango .69 .83 .402
cantelope .66 .58 .691
sour sop .46 .50 .811
cherimoya .71 .93 .231
tangerine 2.15 1.13 .246
W
rabbit .46 .50 .766
guinea pig .63 .63 1.000
chicken 2.93 2.95 .968
pork 1.58 2.53 .378
lamb 1.33 .93 .143
beef 24.33 21.10 .220
fish 1.33 1.35 .955
shellfish .06 .28 .079
eggs 22.77 22.04 .888
Wm:
milk 16.48 15.80 .818
yogurt .90 1.70 .511
cheese 6.65 4.93 .353
ice cream 6.50 14.52 .123
Miscellanea:
sugar 30.00 30.00 1.000
crude brown sugar 2.60 3.73 .456
regular salt .63 1.53 .463
iodized salt 29.38 28.50 .456
cookies 3.16 7.10 .078
candy 3.88 8.48 .058
coffee 22.70 27.10 .061
tea 2.15 1.95 .895
colas 15.62 16.60 .749
mineral water 10.66 11.73 .722
food supplement .17 .38 .263

 

'1

96

Dietary change data were collected from those home-
makers who had migrated. Changes in food intake, food
acquisition, food preparation and food storage were
reported.

Thirty-one said that there were no foods which had been
eaten in the rural area which they did not eat in Quito.
Three women said that their families consumed more milk in
the rural area. Two women mentioned the use of crude brown
sugar in the rural area which they no longer used in Quito.
One respondent each stated that they no longer consumed
corn, hominy, morocho corn, ullucus tubers or ocas. Twenty—
nine homemakers reported that there were no new foods which
they were eating in Quito which they had not eaten in the
rural area. Spaghetti, sugar, rice and vegetables were
reported to be new foods in three households. Three women
said that their families now ate more beef. Two women
reported consuming bread which they had not consumed in the
rural area and one woman said that her family now ate fruits
which were previously unavailable to them.

When asked about changes in food marketing, 14 women
said that they had experienced no change in their marketing
practices while~19‘women stated that they had changed from
growing food to feed their families to purchasing food to
feed their families. Two women reported that they used to
buy on a weekly basis and that in Quito they purchased food

items in bulk and that now they purchased food by the pound.

W

‘ifi‘ I M 01:.

97

Twenty-eight women changed their source of cooking fuel
when they moved to the city. Twenty-four changed from wood
to gas, three from kerex to gas, one from gasoline to gas
and one from wood to kerex. Eight women reported that
cooking time was reduced in the city. Ten women reported a
change in cooking utensils. In the rural area they had used
clay pots and wooden spoons, whereas in Quito they were not
using aluminum pans and spoons. One woman also reported
that her family used to eat on clay dishes with wooden
spoons, a custom which is no longer practiced. One woman
said that she now'had a pressure cooker and one woman said
that she had changed her seasoning.

Twenty-one women reported no change in the manner in
which they stored food. Five women said that they used to
store food for longer periods of time in the rural area.
Three women reported that they now had refrigerators to
store food. Seven women reported that they had used boxes,
baskets and barrels to store food in the rural area and that
they now used shelves to store food. One woman reported
that she had had more space for storage in the rural area
and another reported that she had more space for food
storage in Quito.

The importance of these changes in dietary customs
based on migration will be discussed in the next chapter.

The implication of these changes will be considered.

VI . DI SCUSS ION

MW

Sampling from the public schools serving the community
proved to be a strength of this study. This approach played
a role in the high degree of cooperation of CA homemakers.
First, the school personnel's support of the project facili—
tated entry into the children's homes (Lomnitz, 1977;
Gladhart, 1981). Secondly, the fact that the children al-
ready knew the researcher and were familiar with the project
also facilitated entry into their homes.

The advantage of random sampling is that the sample is
obtained in such a way that each element of the population
has an equal chance for selection, hence the sample will not
be biased (Johnson, 1976). For a study, in which the main
objective is to compare specific groups, random sampling of
a whole p0pulation can be a weakness resulting in insuffi-
cient cases in each group to make the comparison. The
objective of this study was to examine the relationship of
length of residence in Quito and nutritional status by
comparing children of new, recent and settled migrant fami-
lies. Small sample size, however, proved to be a weakness
resulting in an uneven distribution of new, recent and

settled migrants with only a small number of new and recent

98

A;

A!
n

99
migrants (10% each). Future research to examine this rela-
tionship should stratify the population by length of resi-
dence, drawing the sample from each stratum. Random sam-
pling could be employed to draw equal numbers from each
stratum.

The sample consisted of children 8, 9 and 10 year of
age. Studying children in this age group was important due
to a void in the literature regarding causes of their nutri-
tional problems. This age group was selected as an age
group that could be considered a reliable source of their
own dietary data. The physiological stability of these
children, however, caused a limitation. Their slowed growth
rates made differences in nutritional status more difficult
to detect by methods employed here.

Dietary data were originally collected via a 3-day
dietary record administered to the children as a homework
assignment. As has been previously stated, these data were
not useful for analysis due to lack of quantification and
incompleteness of recording by the children. Although this
methology was not useful for this study, it is believed that
this method has potential for collection of dietary data
from large numbers of children over a short period of time.
Recommendations for the improvement of this methodology are
the administration of the food record daily for three con-
secutive days as an in-class rather than a homework assign-
ment. The failure of this method to provide data useful for

nutrient analysis resulted in the use of one 24-hour dietary

 

100

recall to assess dietary intake and from which to calculate
nutrient intake. The use of one 24-hour dietary recall is a
major limitation of this study. Current recommendations are
that a minimum of four 24-hour dietary recalls must be
collected from each person for the dietary intake informa-
tion to represent usual intake and account for daily varia-
tion (Food and Nutrition Board, 1982). Although the recalls
were taken on different days of the week, it is possible
that the day reported was non-representative of the child's
usual intake.

During participant observation, food patterns and
amounts of foods usually consumed were recorded in the field
notebook. The training of the researcher in the administra-
tion of the 24-hour dietary recall and the use of food
models for estimating quantities yielded information which
was consistent with the recorded observations. However, the
inability of children to recall their complete food intake
with accurate quantities limits the interpretation of these
dietary data (Sanjur, 1982).

Calculations of nutrient content of composite foods
were based on recipes in a pepular Ecuadorian cookbook
generally accepted to be representative (Juanita, 1933).
All soups and other mixed dishes contained meat. This was
consistent with the mean monthly frequency of beef reported
CA homemakers (x = 22.3 times per month; maxiumum = 30).

Seventy-four percent of the sample reported daily beef

101
consumption. This is consistent with the fact whenever the
researcher ate in CA, all soups contained meat.

Protein consumption for middle and upper class
Ecuadorians exceeding that which is recommended has been re-
ported (Murgueytio, 1980) and was observed by the research-
er. The researcher noted that Ecuadorians of all socio—
economic classes have the concept that good nutrition means
a high consumption of animal rrotein, particularly beef.
Homemakers who did not include meat in their meal prepara-
tion may have been ashamed to admit it. Possibly, daily
beef consumption reported by CA homemakers was actually no
more than a bone proving bone broth for the soup rather than
meat in the soup. The presence of meat in those meals in
which the researcher participated can be attributed to the
homemaker's anticipation of her participation.

The recipe method of nutrient calculations may be con-
tributing to the high percent FAQ/WHO recommended nutrient
intake found for protein, iron and thiamin. If these com-
posite dishes were prepared without meat, the protein, iron
and thiamin content of these dishes would be.neduced by 30
percent. Growth data for these children do not reflect a
long term high level of protein intake. Had the CA children
been consistently consuming a high level of protein, it
should have been reflected in their height data with the
sample distributing for more normally rather than with 61%
falling into the 0-5 percentile range of height-for-age on

the NCHS growth charts.

1m -m¥m’£fi¥

102

The Food Frequency Instrument assessed the use, non-use
or the frequency with which various foods were usually
consumed. Food frequency data have been found to provide
meaningful descriptive information on food intake patterns.
The food frequency is best utilized to measure the cultural
aspects of the diet rather than to assess dimensions of
nutrient intake (Campbell, gt_a1,, 1982). In this study,
the food frequency instrument provided information on die-
tary patterns before and after moving to Quito. The dietary
change instrument provided a partial food history to augment
the information secured via the food frequency.

The use of forced-choice questions in the socioeconomic
interview schedule were found to be appropriate for this
population. Open-ended questions requiring conceptualiza-
tion and abstract thinking were limited. The demographic
data sheet was useful in yielding a profile of families in
which the sample children resided.

Anthropometric data were collected via a spring-type
bathroom scale and a tape measure. .Although these simple
instruments can sometimes be less accurate than more sophis-
ticated ones, they were useful in this study because of
their low cost, ease of transporting and simplicity. The
limitations of the instruments were dealt with by calibrat-'
ing the scale with a commercial weight, taring the scale
after each measurement and utilizing a triangularly shaped
wooden block along side the tape measure for height determi-

nations.

 

103

Family Profile

The average family size for this simple was larger than
either the 5.4 average family size reported to urban centers
in Ecuador (Luzuriaga, 1979) or the 6.1 average family size
reported for the Sierra region of Ecuador (Anonymous, 1983).
As is true in Ecuador, most of these families were nuclear
families (Weil g; §_1_., 1973). In 80 percent of these fami-
lies the child's father was present and in 96 percent of
these families the child's mother was present. Luzuraiga
(1979) has reported high percentage of incomplete families
among the poor people in the cities of Ecuador. Most of the
families in CA, however, were families in which both the
mother and father were present and in which both contributed
to the functioning of the family unit. Most of these fami-
lies, whether migrant or life-long Quito residents, were
observed to be struggling for a better quality of life for
themselves and their children. The family unit made an
important contribution to this struggle by providing these
families with identity, structure and a value system. Pity
was expressed towards disrupted families who were viewed as
less than ideal. The existence of strong nuclear families
has been identified in other marginal urban communities in
Latin America (Perlman, 1975; Lomnitz, 1977).

Most of the mothers of the sampled children where
homemakers who spent the majority of their time involved in
those tasks related to home and child care. Many mothers

spent the morning preparing the major meal of the day,

104

taking this meal to their husband's work site and returning
home to feed the children. The remainder of their days were
spent washing, cleaning, marketing and going into town on
errands related to family issues, husband's work or chil-
dren's schooling. Of those mothers who worked, store owners
usually had their stores connected to their homes and di-
vided their time between the store and the home. Washer
women, domestic servants, market women and brickmakers all
worked on a daily basis, being away from home when the work
situation demanded it. The rate of illiteracy of these
women in CA was higher than the 7.6 percent illiteracy rate
reported for urban women in Ecuador (Luzuriaga, 1979). This
literacy rate, however, takes in all socioeconomic classes
while the CA women were all members of the lower socioeco-
nomic strata of Quito. Moench (1983) reported that nutri-
tional studies in Colombia had found mother's educational
level to be an important indicator of nutritional status.
In Kenya which, like Ecuador, is a developing country,
motherfls education was shown to be the single most important
variable in determining child survival (Mosley, 1983).

The fathers of these children were usually older than
their wives and usually more educated. The majority of the
CA fathers were away from home during the day, leaving the
house before sunrise and returning after sunset. Most of
the fathers were workmen or day workers working in construc-
tion or in textile factories. The artisans and craftsmen

among them were tailors, carpenters and painters with small

105
businesses of their own. Those who worked in offices were
lower level clerks or messengers. The role of the father
was clearly imprinted in the minds of the children. Even
though the actual contact time was limited, the father was

regarded as the ultimate authority figure in the home.

Housing

Luzuriaga (1979) reported that housing units in the
Sierra were more frequently rented than owned because of the
high cost of construction materials. Seventy-four percent
of the families in CA had purchased small plots of land in
the neighborhood and built or were building their own homes.
These findings are more consistent with recent findings that
67 percent of Quito migrants own their own homes (Anonymous,
1983). Housing data from studies conducted in marginal
neighborhoods in Quito have shown that the construction
materials are more permanent than those materials used in
marginal neighborhoods in other areas (Luzuriaga, 1979). A
cold climate is the main reason for this difference in
housing construction materials between Quito and other large
urban centers in South America. Although more costly and
sturdier construction materials are used, much construction
in CA was never finished and many homes remained partially
constructed. 'The number of rooms was more related to the
family income than family size. Overcrowded living quarters
was as much a reality in CA as in other urban centers in

Ecuador.

106

The urban poor initially livetin marginal neighborhoods
that lack all basic services but, with time, the population
will secure these services (Luzuraiga, 1979). 'The people in
CA secured electricity for the community in 1976. Through
the demands of the community, water was piped into the
community. There is no sewage system in CA and the neigh-
borhood committees constantly work towards trying to secure
one. Garbage was seen scattered throughout the community,
along the streets, in the yards and, particularly, in the
ravines. Many people complained about the garbage as an eye
sore and a sanitation problem.

Gas was the fuel source most commonly used in Quito and
was found to be the most common fuel source in CA. A 10
kilo gas tank cost about $2.00 to fill after a one time
$10.00 cost to purchase the tank and hook-up. How often a
family filled the tank depended upon the amount of cooking
done. The tank fill-up ranged from once a month to once
every 2-1/2 months.

Food storage facilities were varied. Regardless of the
form of food storage, food storage was a problem. In both
private homes and small grocery stores food was unwrapped
and left out. Even those foods stored in cupboards or
refrigerators were improperly prepared for storage. Flies
and fruit flies frequently surrounded food items and home-
makers reported cockroach infestations. Food spoilage in
the Sierra is not rapid due to the cool climate, however,

improper storage and lack of hygiene resulting in food

 

107

spoilage and food contamination was observed.

Migration

A limitation of this study was the distribution of
migrants which resulted from a small sample size. Based on
Jerome's criteria (see definitions), only 10 percent of
these families were new migrants and 10 percent were recent
migrants. The remaining sample was composed of settled
migrants who, by definition, were assumed to be fully
adapted to their new environment. This uneven distribution
of new, recent and settled migrant families limited the
between group comparisons of nutritional adequacy and nutri-
tional status of school-aged migrant children.

A 1968 study of CA (Breihl, 1968) stated that the
population of CA as 250 families. Both the local priest
(Bruel, 1982) and the neighborhood president (Rundo, 1982)
estimated the population of CA to be 500 families, which
appeared to be a realistic estimate. If their estimates
were correct, CA had developed and approximately doubled its
population in the last 14 years. Sixty-eight percent of the
sample were new or recent residents of Quito. 'Therefore,
although CA had a population of incoming migrants and was
estimated to have doubled in the last 14 years, it does not
appear to be an original point of arrival for in-coming
migrants. CA appears to be a neighborhood to which migrants
moved after they had become partially adapted to the city,
saved some money and were able to select a place where they

wanted to live and build a home.

108

Although interviews with community leaders, school and
health personnel and local clergy verified that CA had a
large population of incoming migrants, these interviews did
not reveal the secondary residence characteristic of CA. A
sample survey yielding more precise information on the
length of residencebof CA migrants would have resulted in
the elimination of this neighborhood as the research site
and the subsequent selection of another neighborhood.

A recent study of marginal neighborhoods in Quito re-
ported the length of residence for in-coming migrants in
Quito (Anonymous, 1983). Table 1? compares the distribution
found by these researchers and the length of residence found
in CA. This comparison is further support that CA may be a
secondary residence location for in-coming migrants.

Table 17: 1983 Reported Length of Residence for Quito
Migrants (n = 722) Compared to Length of

Residence of Cotocollao Alto Migrants, (n =63)
Quito, Ecuador, June, 1983.

 

 

Length of Residence 1983 Report Cotocolao Alto
0- 3 years 31% 5%
4-13 years 32% 29%
greater than 14 years 37% 66%

 

In this sample, 50 percent of those families who had
migrated stayed with a friend or family member upon arrival.
Kinship ties are reported to be an important adaptation

factor for new migrants arriving in the city (Butterworth

“Ti" ' : “..wa

109
and Chance, 1981). .Again, the limitation of a small sample
size in this study affected further examination of this
variable. Because most of the families who had migrated
were settled migrants residing in Quito more than 10 years,
kinship ties at the time of arrival were not examined in
relation to nutritional status.

Rivadeneira (1980) stated that two of the strongest
motivators for rural to urban migration in Ecuador were
better work opportunities in the city and better educational
opportunities for their children. CA migrants also gave
work as their major motive for migrating to Quito. A 1983
Ecuadorian study (Anonymous, 1983) on migration found that
80 percent of the migrants came to Quito to find work; the
same percentage of CA migrants reported work as their motive
for migration in this study.

Most of the migrant families in CA reported that they
were satisfied with their lives in Quito. The questions
about satisfaction with life in Quito did not ascertain if
life was better in the rural or urban areas. It did, how-
ever, ask migrants to give their perception of their life in
Quito relative to their perception of their life in the
rural area. Ninety-six percent of the migrant gatekeepers
in CA perceived the lives in Quito as being either satisfac-
tory or happy. Even though the literature reports deplor-
able conditions of the urban slums (Perlman, 1975; Caliendo,
1979) and implies that health and nutrition status decline

for migrants moving into the urban areas (Costa, 1971;

110

Basta, 1977; Ward and Sanders, 1980) migrants perception of
their reality is different. Electricity in the home, water
piped into the community and the availability of public
transportation within the community are all amenities which
are not available in many parts of rural Ecuador. There are
more schools and more teachers in the urban education sys-
tem, making public education more readily available to the
children. A government health center over an hour away by
public transportation may be shocking to city residents but
is a luxury to someone from a rural area who may have had to
walk 3 to 4 hours down a mountainside to the closest avail-
able health care.

It must be considered that not only is life in the city
perceived to be better but that, in fact, life in the city
may actually be better. In 1978, the number of land parcels
in Ecuador with less than five hectares totaled 78 percent
(Junta Nacional de Planificacion, 1974a). .A 1975 employment
study (Prealc, 1975) stated that 25 percent of the rural
labor force were landless and potential migrants. If these
migrants are from among those who were landless in the rural
area or had insufficient land holdings for subsistence then,
indeed, these people are better off in a marginal urban area

where they are underemployed and live with minimal services.

WA
The limitations of the 24-hour dietary recall and the

cookbook method of nutrient calculation restrict the

lll

interpretation of the results. The one 24-hour dietary
recall is possibly non-representative of the child's intake.
The calculations of nutrients for mixed dishes utilizing a
popular cookbook may have introduced an error in the estima-
tion of meat consumption. If there is a systematically
biased error introduced by this method of nutrient calcula-
tion, then the relationships of nutrient intakes of one
child to another child would be true even though intakes
would be high. If indeed, these dietary recalls reflect
actual usual intake, then these children are consuming high
quantities of protein, iron and thiamin. Such high intakes
of protein, iron and thiamin, however, were not reflected in
the children'slgrowth measurements. A recent study of 7-
year-old boys from low income families in La Paz, Bolivia
found equally high means percent intakes of protein when
comparing the nutrient intakes to FAG/WHO. For recommended
Nutrient Intakes (Moreno-Black, 1983), however, no explana—
tion was presented.

If CA is a secondary residence for in-coming migrants
and the majority are home owners, then this population can
be considered upwardly mobile» meaning that they would be
making a concerted effort to emulate dietary patterns consi-
dered typical among middle and upper class Ecuadorians, ie,
high beef consumption. Among those 24-hour dietary recalls
with exceptionally’high (more than 166%) reported protein
intakes, meat and beans had been consumed in the same day.

Beans and meat at the same meal is a common dietary pattern

 

112

among middle and upper class Ecuadorians. Beans and meat at
the same meal would be a new dietary pattern for this popu-
lation and, hence, is not yet reflected in the growth of
their children. Sixty-one percent of these children fell
below the 5th percentile of the NCHS height-for-age standard
and 51 percent fell below the 5th percentile of NCHS weight-
for-age standard.

Energy. Major carbohydrate sources of energy for these
CA children were potatoes, rice, spaghetti, bread and bana-
nas. Protein sources of energy were meat, eggs, milk and
beans“ Fats in their diets were limited, came mainly from
use in food preparation and were either vegetable oil or
lard. Energy requirements were mainly satisfied by the
consumption of large quantities of carbohydrate rich foods.
Based on data from the 24 hour dietary recall, a child in
this sample consumed l to 1-1/2 cups of rice at a meal.
Mixed soups would also be consumed in l-l/2 to 3 cup serv-
ings by these children.

Although, the effect of mother's education was elimi-
nated when examined in conjunction with other variables, the
existence of a weak correlation between mother's education
and energy intake and the higher mean energy intake for
children whose mother's had attended school is important.
The relationship between mother's education and the health
status of her children has far reaching implications for
health and nutrition policy in the developing world. Health

policy planners must join forces with education planners to

 

7

113
insure that young girls have equal access to education and
that health and nutrition information is included in the
basic primary school curriculum. The importance of this
relationship has been demonstrated by other researchers
(Moench, 1983; Moreno-Black, 1983; Mosley, 1983).

Protein. While protein rich foods do provide calories
for the diet, they also serve a more important and complex
function. Amino acids are incorporated with other nutrients
into body proteins that replace tissue that has been broken
down and forms new tissue during growth. Cell walls and
various membranes are composed mainly of protein. Enzymes,
hormones and antibodies are proteins. Protein rich foods
are, thus, an essential component of the diet, especially
for growing children (Goodhart, 1980). As has already been
noted, the recorded protein intake for this sample was high
and should be reflected in their growth rate. Because
height and weight were measured at one point in time, it is
not possible to make statements about these children's rate
of growth. Longitudinal data would have to be obtained to
ascertain the affect of intake on the rate of growth. The
CA children would have to be measured at two points in time
with a year long interval between measures. The difference
between the two measures could then be calculated to show
the rate of growth (Healy, 1978).

Protein foods most commonly consumed by CA children
were meat, milk, eggs and beans. Other foods making a

contribution to protein nutriture were grains.

‘manm [A 0'.

 

114

Iron. Meat and beans made the major contribution to

 

iron intake among this sample of CA children. Some contri-
bution to iron intake was made by greens and some was made
by grains. If the meat intake of these children was over
estimated through the use of the recipe method, their iron
consumption was calculated higher than it actually was. Sex
was found to be a significant predictor of iron intake for
this population with girls having higher intake than boys.
Per capita food expenditure was related to iron intake.
Iron intake was found to decrease with increased food ex-
penditure but increased again after food expenditure reached
a higher level. This can be explained by the consumption of
home grown greens and beans by those at the lower end of the
per capita food expenditure scale, with those in the middle
ranges neither purchasing nor growing iron rich foods and
those at the upper range purchasing more iron rich foods.

Calcig.. .Milk and milk products made major contribu-
tions to calcium nutrition of these children with some
contributions being made by greens. Although the mean per-
cent calcium intake of the FAO standards was 84 percent, 44
percent of these children were receiving less than 66 per-
cent of their calcium recommendation. Because calcium func-
tions with phosphorus in the synthesis and remodeling of the
skeletal tissue, low intakes of calcium could result in
decreased rates of growth.

Vitamin A. Major sources of vitamin A for this sample

were juices made from tree tomatoes, oranges and papaya.

 

'1

115

Avocados, oranges, tangerines, bananas and plantains were a
second major source of vitamin A. Soups containing carrots
and seasoned with parsley and fresh corrainder added mini—
mally to vitamin A intake. Milk and egg consumption also
made some contribution to the vitamin A nutrition of these
children. Vitamin A intake would vary seasonally with fruit
consumption, increasing during mango season when this fruit
is inexpensive, readily available and frequently consumed.
Sixty-nine percent of these children consumed less than 66
percent of their daily recommendation of vitamin A putting
them at nutritional risk with regard to this nutrient. The
lack of vitamin A in the diets of Ecuadorian families may
result from a lack of education as to the importance of this
nutrient and which foods would supply it, rather than a lack
of availability'or affordability of vitamin A containing
foods.

Riboflavin. Milk, meats and beans contributed signifi-
cantly to the riboflavin intake of these children. Fava
beans are an important source of riboflavin and were con-
sumed by these children. Riboflavin intake was found to be
affected by the sex of the child, per capita income and per
capital food expenditure in families where both parents had
migrated. Further interpretation of these results is not
merited due to the questionable nature of the dietary data.

Thiamin. Meat and beans were those foods making major
contributions to thiamin in the diet of these children. If

the calculations of meat in the diet are high, then thiamin

 

 

116

intake was recorded higher than it actually was.

Anthropomentrics

Weight and height were measured and compared to the
NCHS (1976) standards for boys and girls. This standard is
currently recommended by WHO as an acceptable international
standard and has been recognized by the Ecuadorian Ministry
of Health for official use in Ecuador. This comparison
found 51 percent of these children to be below the 5th
percentile weight-for-age and 61 percent below the 5th per-
centile height-for-age. The skewed nature of this distribu-
tion which concentrated most of the sample at one end of the
growth chart made it necessary to examine these anthIOpo-
metric variables in another way. ZResearchers have recom-
mended the use of z-scores for the presentation of anthropo-
metric data (Waterlow, et al., 1977; Krick, 1982). The 2—
score allows the researcher to locate each observation on
the normal curve in terms of its number of standard devia-
tions from the center of the curve (Johnson, 1976). Often
this method is employed by obtaining the mean and standard
deviations from the National Center for Health Statistics/
Center for Disease Control which reports height, weight and
weight/height by age and sex according to percentiles and
notes upper and lower standard deviations (NCHS, 1976).
Values for individual points are published by age and sex
from the 5th to the 95th percentile, however, are unavail-
able at either extreme. Waterlow g; 91,, (1977) has stated

that in populations where large numbers of children are

 

 

117

outside the range of the reference population they cannot be
accurately classified by percentiles. Garn §_t_: al., (1983)
used country specific z—scores to compare statural attain-
ment of fat and lean individuals in Central America. Taking
the six Central American countries as a whole, but using
country specific normalized z-scores, Garn g; 3;. found that
fat boys and girls in the 8-12 year age range averaged 0.5
z-scores taller than their lean peers. This trend was
repeated in direction for Central American adolescents and
adults.

Neither the methodology of comparing these data to an
international standard nor calculating z-scores based on the
NCHS standards was feasible for this study. Weight and
height data were, thus, examined by calculating a z-score
for each child as he or she distributed around age and sex
specific means of the sample itself. This methodology
yielded a normal distribution for children's heights and a
positive z-score for weight for more than 50 percent of the
children.

The question of whether all child populations through-
out the world have the same genetic potential for growth is
unresolved. Mueller and Titcomb (1977) examined the genetic
and environmental determinants of growth in a rural
Colombian population and found parent—child correlations
similar to those in well nourished Colombian populations
concluding that heritability is not reduced by malnutrition.

Garn (1962), advocating growth standards for children based

 

 

118

on their parents maximum growth, as stated that parental
build may be the chief determinant of offspring growth in
well-nourished populations but that nutrition may play a
more important role where caloric insufficiency exists.
Newman (1975) hypothesized that environmental factors might
override genetic factors affecting growth in lower class
Guatemalan children. Martorell (1982) looked at the effect
of genetics and environment on growth by comparing anthropo—
metric data from numerous international studies involving
children for all socioeconomic classes. He concluded that
for the most part low stature is evidence of wretched condi-
tions of poverty, malnutrition and disease to which a popu-
lation has been exposed for many generations.

Another factor possibly affecting the growth potential
of this sample of Ecuadorian children is the high altitude
environment in which they live. Mueller g; 31., (1980)
studied growth and development in a hypoxic environment in
Bolivia and Chile and found growth retardation at high
altitudes apparent for height, weight, transverse chest and
arm circumference but found that high altitude children
exceeded coastal children in anterior-posterior chest meas-
urements at most ages. These researchers concluded that
hypoxia may induce differential growth acceleration of ana-
tomical features related to oxygen transport (chest) and
diminution of linear and soft tissue measurements. Varia—
tions in soft tissue measurements of high altitude popula-

tions suggest difference in socioeconomic and related

 

119

factors. If the growth pattern exhibited by the z-score
analysis in this study is accurate, these children distrib—
ute around their own age and sex specific means in such a
way that the majority of the sample is within a normal
range, with a small percentage of the sample at either
extreme. If the analysis of these anthropometric data had
ended with a comparison to an international standard, we
would have been forced to conclude that this was a sample of
children suffering from both past and present malnutrition.
The z—score separates those children who are within a normal
range in relation to each other and those who have deviated
from their own norm. It may be more realistic to focus on
those children at either extreme of the z-score scale as
being those children with nutritional problems. Taking into
consideration possible genetic factors, the hypoxic environ-
ment in which these children live and the long-term environ-
ment of poverty, population specific z-scores are a more
accurate means of assessing the growth of these children.
Weight-for-height as compared to the NCHS standards
found the largest percentage of these children to be within
the 25-75 percentile range, indicating that when age expec-
tations of growth were disregarded, most of these children
had a satisfactory weight for their height. This could be
evidence of past malnutrition which has been alleviated or
as many researchers have suggested (Garn, 1962; Newman,

1977; Martorell, 1982) it may be evidence of a population

 

 

120
that.has experience poverty, malnutrition and disease for
generations.

A weight/height index was calculated to yield a single
observation that could be utilized as a dependent variable
in the regression analysis. Weight divided by height was
selected from those indices available as one of those least
biased by height (Lee th al., 1981). Per capita income and
sex were the only variables found to explain differences in
the weight/height index within this population. Girls were
found to have higher weight/height indices than boys. ZBe-
cause part of the sample was already 11 years old at the
time of measurement, it is possible that some of the girls
had already begun their pre-puberty growth spurt whereas the
boys had not. If these girls had, in fact, begun the pre-
puberty growth spurt, their nutrient needs would also have
increased, possibly explaining the consistently higher
nutrient intake of female children.

The findings related to per capita income as a pre-
dictor of child growth supports statements by Ecuadorian
researchers (Rivadeneira, 1980; Chauvin, 1983) that income
is the single most important factor affecting the nutrition-
al status of children in Equador. Independent of whether
children are rural of urban or how long their families have
lived in the city, an increase in the families income can
mean a more adequate diet and better nutritional status for

the children.

>P
‘1
. l

 

121
Dietary Change and Migration

A number of significant differences in rural and urban
food consumption.for the same person were found (Table 13,
In 81). Differences in present food consumption patterns
between persons who had migrated and persons who had not
migrated had no more significant results than could be
expected from performing 104 t-test (Table 14, p. 83). When
between 100—105 t-tests are run, 5 of those tests will be at
or below the p g_.05 level regardless of the data (Snedecor
and Cochran, 1980). Overall, this indicated that migration
from rural to urban areas in Ecuador affected the dietary
patterns of the migrating families and that they adapted
completely to the dietary patterns of their urban counter-
parts. Further interpretive analysis of these data revealed
certain patterns of change which could have an effect on
nutritional status of migrant children. Dietary patterns
which emerged from this analysis will be presented.

In the process of nutritional adaptation, Kolasa (1974)
has identified three categories of changes in dietary pat-
terns: those changes which have a potentially positive
effect, those changes which have~ru> effect and those
changes which have a potentially negative effect. Discus-
sion of these dietary trends related to migration will be
summarized in light of these categories for nutritional

adaptation.

 

 

122

l — Decreasgd yhole grain consumption, replaced by re-
fined grains and refined grain products. Corn consumption,

in all those varieties in which it has traditionally been
consumed, barley and barley flour consumption decreased.
These products are indigenous foods, grown and eaten by
subsistence farmers in the Ecuadorian Sierra. Migrants eat
less of these traditional grains and begin consuming the
'city‘ grains and grain products: bread, rice, spaghetti.
Rice is not grown in the Sierra but is grown in the costal
region of Ecuador and brought up to the Sierra. In the
recent years, Ecuadorians have come to include rice as an
essential part of the any meal (Chauvin, 1983). Bread has
replaced toasted barley flour consumption at breakfast and
afternoon snacks. Rice and spaghetti have both replaced
barley and corn use in the traditional mid—day soups.
Cornstarch consumption increased. Cornstarch is pre-
pared as a thick gruel replacing other gruels which may be
made of barley flour, pumpkin or, possible, bean flour.
Grain products such as bread, rice and spaghetti uti-
lized by these homemakers were not enriched products, hence
those nutrients lost in the refining process were not re-
placed. ‘This change from whole grains to refined grains and
refined grain products results in a dietary loss of micro-
nutrients and a lower fiber intake. ZEven though fruit and
vegetable consumption was increased (see below), there would
be a net decrease in total dietary complex carbohydrates due

to the fact that the grain consumption changes were major

 

 

123
while the fruit and vegetable consumption changes were
minor. Diets low in complex carbohydrates may increase the
risk of heart disease, diabetes and obesity (Select Commit-

tee on Nutrition and Human Needs, 1977).

2 - Increased frpit pngvegetable consumption. Con—
sumption of swiss chard, tomatoes, onions, scallions and
lettuce was increased by frequency of consumption. Green
beans, cucumbers and radishes were new foods incorporated
into the diet for the first time. First time incorporation
into the diet also explains the significant difference in
consumption of pears, apples, andean cherries, passion
fruit, babaco and grapes. These were unavailable to people
in the rural area either because of cost or limited supply.
The increased fruit and vegetable consumption, for the most
part, represented an increased complexity of the diet, ian,
inclusion of foods not previously eaten. The evidence of
the diet increasing in complexity and diversity with in—
creased urbanization has been previously documented (Chassy
pp 91., 1967). Although, these foods were not incorporated
into the diet with great frequency, their sometime incorpo—
ration and the number of foods added should effect both
vitamin A and vitamin C nutrition. Vitamin C nutriture in
Ecuador is rarely at risk and most people exceed their
recommendation for this nutrient. However, vitamin A defi-
ciency in Ecuador has been frequently reported and this
study found vitamin A to be the most limiting nutrient in

the diet, with 69 percent of the children ingesting less

 

Fri

 

124
than 66 percent of their recommended intake for this

nutrient.

3 - ncreased use of sugared foods such as copkies,
candies, colas and ice cream. Homemakers reported a marked

increase in the frequency with which their families consumed

 

sugared foods such as cookies, candies, colas and ice cream.
Ice cream was often found to go from never being consumed in
the rural area to daily consumption in the urban area. Ice
cream is easily purchased at the small neighborhood stores
for the equivalent of a few pennies. The ice creams are
sometimes prepared with flavored water, sometimes with
flavored watered down milk and are always very sweet. Their
major contribution to nutriture would be calories rather
than calcium and protein.

Cookies, candies and colas are also bought at the
neighborhood stores and purchased at recess time by the
children during the days These foods are status foods and
are purchased for a few sucres. Parents frequently give
children money'to purchase snacks during school recesses.
Although, each individual expenditure for a sugared food may
be small, it is done daily by all family members, making the
overall cost to the family high.

'Panela' or crude brown sugar cakes are the traditional
sweetener in the rural areas of Ecuador. Homemakers indi-
cated reduced use of this sweetener in the urban area. Many
abandoned its use completely and replaced it with the use of

refined white sugar. This change would be of little

 

 

125

nutritional consequence, although there are some trace vita-
mins and minerals in the crude brown sugar that are no
longer found in the refined white sugar. Mainly this
change, indicated an overall increase in the use of sweet-
ener because white sugar is easier to use than brown sugar
cakes. White sugar is used daily in most homes in coffee
and teas and in homemade fruit juices. Homemade desserts
were not common among these families and those which are
valued, like fig preserves, were made with panela.

Sugars, especially foods that contain sticky forms of
refined and processed sugars have been implicated in tooth
decay (Select Committee on Human and Nutrition Needs, 1977).
The most important problem resulting from the increased
consumption of sugared foods is the danger in displacing
complex carbohydrates which are valuable sources of micro-
nutrients with refined sugar which is essentially an energy
source with little additional nutritional value (Mayer,
1975).

4 - Decrgased u§g pf milk. Milk consumption in the
rural area frequently meant a family cow or milk purchased
inexpensively from a nearby family or relative. .All milk in
the city must be purchased. Most of it is carton packaged
milk purchased daily in the small neighborhood grocery
stores. Milk is most often consumed in coffee by using one
full cup of hot milk and a teaspoon of instant coffee. it

is also added to soup for flavor and consistency.

 

 

126

Forty—four percent of the sampled children consumed
less than 66 percent of their recommended nutrient intake
for calcium when compared to FAO standards, and, as previ-
ously stated, this low calcium intake could have a deleteri-
ous effect on growth especially during critical periods of
growth. At between 15 and 18 sucres a liter, economics
should not limit milk consumption for these families. Most
of these families spend more in colas, ice creams, cookies
and candies in a one-week period than it would cost to
purchase a liter of milk a day. A well designed educational
program to promote milk consumption as essential to child
growth could affect the calcium intake of school-aged
children.

5 - Decreased use of granulaped salt, replaced by io—
dized sa_l_t_. Endemic goiter and cretenism has been a major
nutritional problem in Ecuador (Greene, 1973; Rivadeneira,
1980; Murgueytio, 1980). ‘The 1968 iodized salt law made
this product available to the public but it has been re—
ported that the use of iodized salt is not common in remote
rural areas and that there hasn't been a sufficient educa-
tion campaign to promote its use (Freire, 1983).

Moving to the city made these homemakers more aware of
the availability of the iodized salt and more aware of the
importance of using this product. The use of iodized salt
daily provides sufficient iodine in the diet to prevent
goiter and cretenism. This change in dietary pattern makes

a large contribution to the nutritional well being of the

 

 

127
Ecuadorian population. Better distribution of the product
in the rural areas is called for as is an educational pro-
gram directed at rural homemakers to encourage the use of

iodized salt.

6 - Decreased use of praditional animal protein sources,
replaced by beef, fish and shellfish. The use of pork,

guinea pig and rabbit decreased significantly with migra-
tion. 'The significant increase in fish and shellfish repre-
sents families eating a food sometimes which they had never
before eaten. Neither fish no shellfish make a significant
contribution to the protein intake of these families. Pork,
guinea pig and rabbit have virtually disappeared from these
families' meals and all have been replaced by beef consump-
tion. Chicken as a source of animal protein has remained
fairly constant, appearing on the family table approximately
once a week.

While this change would have little nutritional conse-
quences, it is a change in dietary pattern which merits
discussion. Of primary importance, this change results in
an increased cost for animal protein in the urban areas than
in the rural areas. All three traditional sources of animal
protein are cheaply available in the rural area. Pigs are
raised around the house, guinea pigs are raised under the
hearth and the rabbits are caught wild. There is little
cost in raising these animals as they are fed the refuse
from the human table. Beef, however, always involves a

cost. Because these families have increased their incomes

 

 

128
by moving to the urban area and decreased their ability to
raise animals or catch them wild, this is a logical change.
Another consequence of this dietary pattern change is lack
of variety in the diet resulting from replacing three animal

protein choices with one animal protein choice.

7 — Decreasgd cpnsumppion of those foods considergd to
bg “Indian“ or low status fpods. Foods native to the Andeas

and considered indigenous are appearing with less frequency
on the tables of urban and rural Ecuadorians, as well.
Summer squash and pumpkin are both considered to be the food
of the rural poor and their consumption is abandoned as soon
as possible. Toasted barley flour or 'Machica' was the
traditional breakfast food of the Quechua Indian of the
Ecuadorian Sierra. It is difficult to get in the city
whereas bread is both cheap and readily available. Corn is
eaten in the rural areas in a number of varieties ranging
from corn on the cob to hominy corn. This grain is also
associated with Indian dietary patterns and is decreased
when families move to the city.

A move away from traditional dietary patterns is a
consequence of urbanization and industrialization. The
market becomes saturated with packaged foods which are asso-
ciated with progress and increased status. These foods are
attractive because they are easier and faster to prepare.
These changes in dietary patterns are not negative or posi-

tive but all changes must be weighed as a whole.

 

‘—-_ -‘II'L‘I HYHiu '

 

129

Table 18 summarizes these migration related dietary
changes and their potential effect on nutritional status.
Increased fruit and vegetable consumption and the increased
use of iodized salt have a potentially positive effect on
the nutritional status of the migrant child. The reduction
in whole grain consumption replaced by refined grains and
grain products, the decreased milk consumption and the in—
creased use of sugared foods can be regarded as changes
which could have a potentially negative effect on the nutri-
tional status of migrant children. The change in the source
of animal protein and the decreased consumption of Indian
foods would have no effect on nutritional status.

It is important to examine the total dietary pattern as
it relates to the nutritional status of the migrant child
and remember that one food or one dietary change cannot be
implicated in nutritional status. The interrelationship
between these changes produces an effect that combines posi—
tive, neutral and negative affects. The migration of fami-
lies from the rural Sierra to the city of Quito does produce
changes in food consumption that affect dietary adequacy
and, therefore, potentially affects the nutritional status
of migrant children.

The change from growing food to purchasing food is a
factor mentioned as causing nutritional stress to migrating
families (Calinedo, 1979). The presence or absence of nu-
tritional stress in a migrating family would depend on the

families' premigration rural circumstances. Families with

 

 

130

 

 

 

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131

insufficient land or no land in the rural area who have
obtained employment in the city might not undergo nutri-
tional stress due to migration. If the homemaker was from a
remote rural area, food which was grown or raised would have
comprised all that was available to feed her family. In the
city, where she purchased food, greater choices would be
available to her.

Changes in fuel sources meant an increaserin expendi-
ture for fuel in all cases. The change from wood to another
source such as gas or kerex meant a reduction in cooking
time. This change from wood to gas could also have health
implications since many rural residents suffer from respira-
tory problems related to smoke inhalation.

Food in the rural areas was stored longer because the
entire crop of harvested tubers and grains was stored for
family use. Shelves versus boxes, barrels or baskets kept
on the floor would reduce food infestation by vermin and
insects. Many additional changes are still needed in food
storage techniques in order to provide a safer food supply
for these families.

Viewed as a*whole, these changes affected the role of
the family“s food system gatekeeper. The change from whole
grains to refined grains reduced the meal time preparation.
The change in fuel source further reduced cooking time and
relieved the woman from the chore of collecting wood. The
change from growing food to purchasing food reduced the time

necessary for food acquisition. The change away from

 

 

132
traditional protein sources represents a change from raising
to purchasing animal protein sources further reducing a
woman's food acquisition time.

Ninety-six percent of those homemakers who migrated
reported satisfaction or happiness with their lives in
Quito. Changes in dietary patterns and dietary customs due
to rural to urban migration resulted in the decreased
drudgery of the gatekeeper's work and in the time needed to
fulfill her feeding obligations to her family, without
threatening her primary role as wife and mother. These
changes are believed to be primary contributors to the
gatekeepers satisfaction with her post-migration life in the
city. Figure 7 depicts the relationship between changes in
dietary patterns and customs due to migration and the gate-
keepers satisfaction with life.

Sims pp al., (1972) assessed the qualitative facets of
family life by measuring the mother's social-psychological
attributes. The mother‘s self-concept contributed to the
mother's social-psychological attributes which was a factor
influencing the nutritional status of the child. A mother
who is satisfied with her life would provide better care for
her children that could indirectly influence nutritional
status. Many other factors impacting the lives of these
migrating gatekeepers would have to be examined before this

statement could be proven.

 

ass-w -'- -.

 

133

 

 

 

MIGRATION

l

CHANGE IN ANIMAL PROTEIN SOURCE
CHANGE IN MAJOR GRAIN SOURCE
CHANGE IN FOOD ACQUISITION
CHANGE IN FUEL SOURCE

REDUCTION OF

GATEKEEPER'S
WORK LOAD

1

GATEKEEPER
SATISFACTION
WITH LIFE

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 7. The relationship between migration related die-
tary pattern changes and gatekeeper satisfaction

with life.

 

 

 

VII. SUMMARY, IMPLICATIONS & RESEARCH RECOMMENDATIONS

W

The objective of this study was to examine the rela-
tionship between the nutritional status of school-aged mi-
grant children and their families' length of residence in
Quito, Ecuador. A small sample size resulted in an uneven
distribution of new, recent and settled migrants limiting
the between group comparisons of children's nutritional
status.

No relationship was found between length of family
residence and the children's dietary adequacy as determined
by calculations and their intakes of energy, protein, iron,
calcium, thiamin, riboflavin and vitamin A. Percent means
of the 1974 FAO/WHO Recommended Nutrient Intakes adjusted
for sex and age were all greater than 50 percent, although
the range was wide with 30 percent or more of the children
found to consume less than 66 percent of their daily recom—
mendation for energy, calcium, vitamin A, riboflavin and
thiamin. The use of only one 24-hour dietary recall to
obtain dietary data limited the interpretation of the
results.

A linear relationship was found between the weight of

the child and the length of family residence in Quito, with

134

 

1‘1

 

 

135

an interaction effect of the number of parents migrating
(none, one or both). When the sample was stratified by
number of parents migrating to examine the interaction, no
effect of length of residence was found. Age was the only
variable linearly related to height. Sex was found to be a
predictor variable for weight/height ratio, with females
having a higher mean index than males. When one family with
unusually high income was removed from the sample, the
weight/height ratio was linearly related to income. showing
an increase in the weight/height ratio of approximately .04
for every 1000 increase in income. This weight/height ratio
and income relationship indicates that as the family"s in-
come increases, the child's weight-for—height also in—
creases. Rivadeneira (1980) examined nutritional studies in
Ecuador and«concluded that nutritional status of children
was more dependent on the economic situation of the childks
family than on any other factor. These data support the
conclusion that economic factors are the most important
predictor of the nutritional status of children. Regression
analysis showed income to be the only significant predictor
of the weight/height ration for the CA children.

A number of significant differences in rural and urban
food consumption were found for the same person. No differ-
ence in present food consumption patterns were found between
those persons who had migrated and those persons who had not
migrated. Indications were that migration from the rural to

urban areas in Ecuador affected the dietary patterns of

 

 

136

migrating families and that they eventually adapted com-
pletely to the dietary patterns of their urban counterparts.
Further interpretive analysis of these data revealed pat-
terns of change which could affect the nutritional status of
migrant children. Increased fruit and vegetable consumption
and increased use of iodized salt were found to be adapta-
tions with a potentially positive effect on nutritional
status. The change from complex grains to refined grains
and refined grain products, the decreased consumption of
milk and the increased consumption of sugared foods were
found to be adaptations with a potentially negative effect
on nutritional status. The change in the source of animal
protein and the decreased consumption of Indian foods were
adaptations found to have no effect on nutritional status.

Other major changes in1dietary patterns were a change
in cooking fuel source and a change from growing to purchas-
ing food. The combined changes in dietary patterns reduced
the female work load as she migrated from the rural to the
urban area. The relationship between migration related
dietary changes and the gatekeepers' overall satisfaction
with life was demonstrated (Figure 7, page 133). The gate-
keepers satisfaction with life on child care and, therefore,
directly on nutritional status of the child can only be

postulated.

 

 

137
IMPLICATIONS

Although the literature reports deplorable slum condi-
tions in cities in the developing world that may, in fact,
be deplorable; they may also be less deplorable than condi-
tion in the rural areas. Regardless of the conditions of
the cities slums and squatter settlements, as long as life
in the city is perceived to be better than life in the
countryside, migrants will continue to leave the rural coun-
tryside for the bright lights of the city.

The Ecuadorian government is aware of the strain which
the migration process is putting on both the urban and the
rural areas, and can choose many directions to slow this
process. Money for research that will increase agricultural
productivity needs to be provided. Farmers need to be given
incentives to try new varieties, new crops and new farming
methodologies. Because the decentralization of industry can
function as a deterrent of out migration, small industries
to generate income in the rural areas need to be identified.
More credit and loan opportunities need to be made available
for small businesses and small farms. Improvement of basic
services in the rural areas, such as water, electricity,
education and health, is critical to slowing down the pro-
cess of our migration from the rural Sierra to Ecuador.

The interaction of internal migration and nutrition is
far too complex for a better-worse hypothesis. Migration
does result in changes in dietary patterns. Some of the

changes are positive adaptations, some are neutral and some

r7.

 

 

138

are negative adaptations. Nutrition education programs are
needed in both the rural and the urban areas. In the rural
areas, particular emphasis should be placed on the consump—
tion of iodized salt and the increased consumption of fruits
and vegetables. The maintenance of traditional dietary
patterns such as whole grain consumption, complementary
protein consumption and the use of indigenous protein
sources make a positive contribution to nutritional status
and need to be encouraged. In the urban areas, there is a
need to perpetuate the trend towards increased fruit and
vegetable consumption. Increased consumption of calcium
rich foods for growing children needs to be promoted. Nu-
trition educators need to create programs that will counter
the effect of large scale advertising promoting the consump-
tion of sugared foods such as colas, cookies, candies and
ice creams. Following Rody%3(l977) model in the Western
Caroline Islands, the people's own pride in indigenous
Andean foods could be developed to promote the consumption
of these foods and to decrease consumption of pre-packaged,
readily available sugared foods.

Impact could be made on the nutritional status of
migrant and non-migrant school-aged children through the
Ecuadorian school breakfast program. Stricter provisions
need to be made for the control of food included in the
school breakfast. Education needs to be provided to school
personnel as to the needs of the children and the nutri-

tional value of foods provided.

 

 

139
RECOMMENDATIONS FOR FUTURE RESEARCH

l - The 3-day dietary record as an instrument for the
collection of dietary data from school-aged children needs
to be further researched. 'The number of days recorded and
the Food and Nutrition Board's recommendation (1982) of a 4-
day record needs to be considered. Various means of admin-
istering theldietary record within the school environment
need to be examined. A high level of researcher involvement
is recommended.

2 - Further examination of length of residence needs to
stratify the sample by length of residence and random sample
within each group.

3 - Research is needed to examine those factors which
interact with the migration-nutrition relationship and af-
fect its course. Factors causing variance among migrating
families of similar socioeconomic levels and variance among
rural families of similar economic levels need to be identi-
fied. Studies of greater depth need to be done to develop a
model of the internal migration-nutrition status relation-
ship. A matched sample of brothers, one who migrated and
one who remained in the rural area is suggested. lkndepth
data should be collected on socioeconomic and demographic
variables and attitudes and beliefs as well as dietary and
anthropometric data for assessment of dietary adequacy and
nutritional status. Previous studies have focused on either
the urban or the rural side of the relationship. 'There is a

need to look at both sides simultaneously in a well designed

 

 

140
research project that can be analyzed to explain variance
among urban families, among rural families and between rural

and urban families.

 

APPENDICES

 

 

 

APPENDIX A

THREE DAY DIETARY RECORD FORM, TWENTY FOUR HOUR DIETARY
RECALL FORM AND ANTHROPOMETRIC DATA RECORD SHEET

 

 

 

1A

PROYECTO: Estado Nutritional Je Nxfios

Eiusftl I .1! cu: COLVL‘UI 1.»: [.41 L0 .

I55“.

REGISTRO DE ALIMENTOS

 

 

 

"CHER:
ESCUELA GMADO
EEC” DE NisCXMl LIN'rU EDAD

 

 

HOMBRE DE JEFE DF FAMILIA

 

 

 

 

DIRECCION ___

EARRIO

INSTRUCCIONES:

11 Apunt- tudos los alimentos consumidos durante la: 3 dias dcl deber.

2) Durante los 3 dias del dcber. midan sus conidas cone halos aprendido hacer
en la escuula. usando tasas, vasos y cucharaa.

3) S; 1. comida coublnd varies alimentos, cs necesario apuntar loa ingredientas.

4) 51 no come en c1 dcsayuno, cl alnuexzo o la nerienda. indicar apuntando la
palabra “nada“.

5) Es importante apuntar todo lo quc se come y no olvidar nada, incluycndo cars.
melee. galletas. colas, etc. .

6) Es tamLién importante que no apunte 1a couida que usted no ha consumido.

7) Sun sicmpre honesto. Esta deber cs confidencial y rcaervado. Nadia Ii: co-

N)

HJsSKJ ans ruspuustas.

Iu-uqur. gas-a 1.0V.” , come ha ”disk: I... ctmidls:
Yo mcdi m1 comida usando: (cscoje una alternative en coda columna).

Una tasa de porCcIana. sin ore). Una cuchara dc metal

1.... Una tasa dc porCelana; con ureja Una cuchara dc pale.
Una tasa dc loza

Una tasa dc plistico

141'

 

 

142

Indique. por raver, usando los ndneros de estos dibujos, c1 portc del pcdazo

dc carne u pcscadu CORSUMldO:

Ejemplo: Un pedazo de carne, I 1.

 

 

 

 

I 3

PROYIZC'I'O: Estudo Nutritional do "160:.

DCSAYUHO

ENTRE DESAYU-
NO Y ALHUER -
20.

MEMO .

ENTRE ALHUER-
20 Y HERIEN -
DA.

HERIENDA.

ENTRE HERIEN-

M 7 INT]:- DI?

DORHXR.

143

HOMBRE

 

Esvoluros: Ceiocollan Alto rsw

FECHA DE "07

 

DIA DE SEHANA

 

 

ALIHENTOS

CANTIDAD

KC

P

T

:10 APUN‘I'E EN ESTAS cowrfms
C c

I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

144

(Form 1A)
WWW

Name

School — Current Grade

Birthdate - Age

Head-of—Family Name

Address

Neighborhood

n. l'

1)

2)

3)

4)

5)

6)

7)

Write down all foods consumed during the 3 days of the
assignment.

During the 3 days of the assignment, measure your food
as you have learned to do at school, using cups, glasses
and spoons.

If a dish contains many different foods, please write
down the ingredients.

If you do not eat breakfast, lunch or dinner, please
note this by writing "nothing“ in the appropriate space.
It is important to write down all that.you consume and
not to forget anything, including candies, cookies,
colas, etc.

It is also important not to write down foods which you
did not consume. .

Always be honest. The information obtained from this
assignment will be kept confidential. No one else will

see your answers.

 

 

 

 

145
(Form 1A)

WWW (Continued)
8) Please indicate how you measured your foods: I measured

my foods using (Check one alternative in each column)

enameled cup, no handle a metal Spoon
enameled cup, with handle a wooden spoon
a porcelain cup

a plastic cup

REELZ

Please indicate using the numbers on these drawings, the
size of any piece of meat you consume:
Example: One piece of meat, #1
123ng (Utilized in triplicate; one page for each day of
the record)
Name
Date - Day of the Week
Column across reads: - Foods - Quantities - Do not write in
these columns
Column down reads: Breakfast
Between breakfast and lunch
Lunch
Between lunch and supper
Supper

After supper and before you go to bed

 

 

 

146

18

PROIEC'I‘O: L3: atu- ”UL I. 1 (71417.61) dc Nil-10$

Eacclnr. : C.)l.-.0I'.so ’tJIL.

FICIIA NITROE‘GIE‘I'PICA

 

HOME-k1. {LIL NIII'“

 

 

 

 

 

HOMBRE DEL JEFE DE FAMILIA

 

 

 

 

 

ESCUELA GRADO

 

 

 

 

 

 

 

 

 

 

FECMA DE MACIMIENTO Edad en noses m
. . , . . ., r' . .
Docu-wmos pars.) lADua ”an" en m DUDE

- Parlida dc Nscamiento
.. ...... IDDEDD

 

 

- Partxdu dc buntiac

- In fomaczén Part-ma

- Ve.;fxcuda

DUDE!

(II'Is. .

 

 

 

 

u.-

 

 

147

(Form 1B)
W

W
Name of the child

Name of the Head of Household
School - Grade
Date of birth

Documents presented

Birth certificate Age in months

Baptismal certificate Stature in centimeters

Parental information Weight in grams
Verified

Other

 

 

 

Proyecto:l

Hombre

por usted an 105 ultimas 24 horas.

 

consumida per usted.

DESAYUNO

EHTRE DESAYII-
HO 7 ALHUER -
20.

ALHUERZO .

DITRE ALHUER—
EO Y HERIEW -
DA.

HERIDIDA.

WIRE HERIEN-
DA V ANTI-:5 DIS
”MIR.

ISM-3150
Ifllflfls
1982-83

148

Estado Nutritional dc Nines
scolares: ‘fbtocollao A110

mflw___ _
Formulario: It

Dia de Semana

Vamps recordar juntos todos 10s a11mentos. comidas y bebidas consumidos
Empezarcnos por recordar Ia ultima cos:

 

 

 

 

 

 

 

 

 

 

ALIMEN’I‘OS CANNON) NO ANINTE EN ESTAS COLUMNAS
Kc P E T R I C
I
P

 

 

 

 

 

 

 

 

 

 

 

149

(Form 1C)
WWW
Name Day of the Week
Together we are going to remember all the foods and drinks
which you have consumed in the last 24 hours. Lets start

with the last thing which you consumed.

Column across reads:

Foods - Quantities - Do Not write in these columns

Column down reads:
Breakfast
Between breakfast and lunch
Lunch
Between lunch and supper
Supper

After supper and before you go to bed.

 

APPENDIX B

SOCIOECONOMIC INTERVIEW SCHEDULE

 

Instituto de Investigaciones Nutricionales
y Midico Sociales-ININMS

coozoo -----

Fur-ulario: 2

EHCUESTA SOCIO-ECOHOHICA
PROYECTO: ESTADO NUTRICIONAL DE HINOS ESCOLARES: COTOCOLLAO ALTO

la voy a hacer unas preguntas aobre nated y eu familia. La: pregug
ta: eerin aobre varies temas. No es necesario contests: cualquier pre -
gunta con lo cual usted ee siente incdmoda. Sue respueatas eerin reser-

vades y ccnfidencialee.

d

. Hombre del entrevistado

 

2. lelacién al entrevistado

 

e1 nifio
____Madre
‘___ Padre
Her-ancta)
TTOIe)
AbueloIe)
Otto ~
IS" 3. Hombre del nifio
H50-
ININMS
1982 4. Sexo del nine Masculine Fenenino
5. Edad del nifio Afios ___!bees

150

 

 

 

151

6. 'Fecha de nacimiento del nifio

 

 

(dialses/ano)
7. Lugs: de nacimiento del nifio:
QuitoIO) ___Polfvar(4)
__Pichincha (1 ) __Cotopaxi IS)
Imbabura (2) ___'Nngurahua(61
CarchiIJI ChinborazoI?)
_Lcja (8)
0. Qui‘n es el jefe de familia?.
___Padre del nifio ___Abuelo del nifio
Madre del nifio ___Abuala del nifio
Tic dal nifio Otto
Tia del nifio __Otra

 

Mar-ans dal nifio
Mariana del niiio

9. M1 es la actividad eccndnica principal del jefe da tm1n:_

 

10. Ade-Is da su actividad principal eccndnica, qua ctr-o tipo de activi
dades econd’uicas tiene nated? DIgales an orden de i-portancia.
(Entrevistadcr: Pena e1 abate an frente de cada actividad) .

arrienda casaIs) __arrienda tan-anon)

venta de productos subradcs en sus terrenos
use familiar da productcs sanbrados en sus terranos

.5" ...—
DSU- diners racibido de otrcs familiar-as
3:2” alimentos u otros productos raqalados

Otto trabajo. Explique
Otto

 

 

 

HSU-
ININMS
1 982

‘1.

'2.

13.

14.

15.

152

hpleo de fueria de trabajo familiar adicicnal

Esposa Si Mo
Mijos
Otros quienes min

 

Cull es su ingreso nensual familiar por:

 

 

Actividad eccnénica principal SI.
Otras actividadas SI.
Otros miembros de la familia 5].

TOTAL SI.

 

Estima, por favor, los gastos sensuales en los siquientes:

__Ccnida __Casa
___Transporte __lbpa
_0tilidades (luz, aqua, tele., catnstiblas
_Divers16n __La saltfl

Otros qastos : Define

 

Les préxinas prequntas sarln sobre la vivienda y los sarvicios
disponiblas. (Entrevistador: Apunte lo que ea puede an base de ob-

servacién y pregunte solanente lo que es necesario) .

Lugar de residencia:

_Sta. Anita (1) _£1 Triunfo (5)
_8ta. AnaIZI __San Joe! da Jarrin (6)
_Iallavista AltaI3)

__El Basque (4)

Area de construccién total de la can an

 

__Arrianda Duefio

 

 

 

 

15.

17.

10.

19.

20 .

2'.

22.

153'

Ml es el nfinero de personas que viven en esta casa? persona

Material de construccidn de las parades:

bareque ladrillo
adobe nadara
bloque otro

 

Material de la construccidn del tacho:

teja ___losa

sine tro

 

Material de la ccnstruccién del piso:

 

baldosa tierra
tabla __parquet
mm otro
Cantos cuartos tiane la casa? cuartos.

 

Composicidn de los cuartos: (Apunta el nfi-ero an cada raya, utili-
sando 0 (cero) si la casa no tiena este cuarto) .

_cocina _sala-conador

__cuartos da dormir __banos (s61o sarvicio _ bano capleto)
__1etrina __bodeqa

__otro

mebles y aparatos donlsticos: (Apunte un nhero an cada rays. uti-
lisando 0(cero) si no hay).

_-esas _sillas

__sof£ _nsas paquenas

_l‘Qaras ___cuss

_cortinas ___alfowras

_radio __talavisor

__-Iquina de coser _liquadora

_refriqarador _astu£a (co-bustibla: _ el‘ctrica __ gas
_horno __la5a __qasolina __l£rex.

otro

 

 

 

23.
24.
25.
26.
27.
28.

.5“-

H50-

ININMS

1902

154

Facilidades para alnacenaniento de alimentos:

anaqueles I abiertos tapados con cortinas cerrados)

___cajones pipes
___barril sacos
Otto

 

Servicios: Aqua

 

__potable entubado
vertiente ' acequia/rio
__yoso otro
Distancia que tiene que caminar para recojer aqua Its

control de basura

___la entierra _la quena
___la tira a la quebrada

___colecci6n de basura l___bota a1 canpo
___ptro

 

Control de escretas

latrines

___FIIP°
_canalizacidn __otro

 

has pr6xinas 6 preguntas son las Glti-as. Estes preguntas s5
r‘n sobre la venida de usted y su fanilia a Quito

Cfiao vino la familia a Quito?.
toda la familia junta
adultos separados. antes del natrieonio

el padre primero, daspues la familia

la Isdre primers, despues la fandlia

nifios prinero, despues los padres

l I
§

 

 

 

 

EU-
IHIHIG
1932

29.

31.

32.

33.

Qué tiempo lleva residiendo en este barrio? leases
sfios

 

Qué tienpo lleva residiendo en la ciudad de mite? oases
shoe

 

Tania usted parientes ya residiendo en Quito cusndo lleg6?

sf n6 . Si tenia, quién?

 

__sbuelos paternales del nifio
___sbuelos saternsles del nifio
__tios del nifio

__t£os de los padres del nifio

_coupadres
__smis tsde s

Vivid con slqin pariente cusndo lleg6 a mitoth

Si vivid, por cusnto tiewo? senanss
_neses
shoe
Les prdximas preguntss son abiertss. Voy hacer cada prequn—
ts y escribir sus couentarios en cusndo usted contests la pregun-

9..

For qué sotivoIs) se vino s vivir en la ciodsd de Quito?

 

 

 

 

 

H50

1982

63.

156

Odno se siente sobre su venids a Quito? Quiere decir. cree usted
que ha logrado lo qua quarts con su venida a Quite?. Cuties sen

sus reaccienes negatives y positives sobre su venids s Quito?.

 

 

 

 

 

 

157

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

88:!“
a.
H_ ..
I1. 1 I
O.
o
O
a
o
o
0
a
a- --I' I ...! ll- 0' H '9‘! 'H-
u .
c
He
.9 I
958‘s .0...
EEO:- . o I -1 35.8: ~ .. ...-8a .8 8...
g “(g £5: as. ea . e a. {suave-5e .8! . .e no In ...-e5. .2, 3
uses [es 3 so: 30.: es :5 e0 .05.: 9 e ease-es ease 5 use 5e est assesses e3
. Eves!— n‘suqmeseee. ass: assesses-Ive is; es, 5330.535. eie'eueeeeee'seee. ‘-
25 — 8.5. .
. - i H. 3‘: Ci d. He.
II- a H 22 Res
1‘ 9 I e I. O .
<IJI I~IO “W’o‘ou” <.s‘..
""" u u

 

 

158

(Form 2)

I
1'. :1 '0 - .1 9 0 9' ...II 0 ' ' ‘. 0".

I am going to ask you some questions about you and your
family. These questions will be on all subjects. It is not
necessary to answer any question with which you feel uncom-
fortable. Your answers will remain anonymous and confiden-
tial.

1. Your name

2. Your relationship to the child
Name of the child

 

Sex of the child

Age of the child

Birthdate of the child
Place of birth of the child

Who is the head of household

‘0 (n ‘4 01 U1 h N
e

. What is the principle economic activity of the head-of-
household
10. Besides the principle economic activity, what other
type of economic activity do you engage in? (Record in
the order of importance)
House rental Land rental
Sale of agricultural products Other
Family use of agricultural
products grown on your own land
Money received from relatives
Food or goods received as gifts

Other work. Explain

159

(Form 2)

,. _. .. . '., . . .- ...u , - -. ,-.
(Continued)
11. Additional family members in the work force
Wife
Children
Others
12. What is your monthly family income from:
Principle economic activity
Other economic activities
Other family members
Total

13. Please estimate your monthly expenses on the following:

Food House
Transportation Clothes
Utilities

Recreation Health

Other expenses. Explain

The next questions are about housing and services available.
(Interviewer: Record these answers based on your observa-
tion and ask questions only when necessary)
14. Location of residence within the neighborhood
15. Total square feet of your house

Rented Owned

16. How many persons live in your house?

 

 

 

17.

18.

19.

20.
21.

22.

160
(Form 2)

(Continued)

What are the walls made of:

Clay Brick
Adobe Wood
Cement block

What is the roof made of:

Tile

Zinc

What are the floors made of?

Dile
Planks

Cement

Cement slabs

Dirt

Parquet

How many rooms does the house have?

Composition of the rooms.

(Note the number of each

type of room, using 0 if the house does not have the

room)
Kitchen

Bedrooms

Latrine

Living—dining area

Bathroom (toilet only -
full service)

Storage room

Furniture and appliances (Note number in each space,

using 0 if they do not have it)

Tables
Sofa
Lamps

Curtains

Chairs
Small tables
Beds

Rugs

 

22.

23.

24.

25.
26.

27.

161

(Form 2)

:e .9: . e. e e e‘ eeeu . - ', a‘e

(Continued)

Furniture and applicances (Cont.)

Radio Television
Sewing machine Blender
Refrigerator Steve (fuel source:

electric, gas, wood,
gasoline, kerosene)

Oven

Facilities for storing food:

Shelves (Open-covered with curtains-closed)
Boxes Bins

Barrels Sacks

Services: Water

Potable Piped
Watershed Creek or river
Well

Distance you must walk to your source of water?
Garbage control

Buried Burned

Thrown in ravine

Collection service Thrown in the countryside
Human waste control

Latrines Countryside

Sewage system

 

162

(Form 2)

(Continued)

The next six questions are the last. These questions

deal with you and your families coming to Quito.

28.

29.
30.
31.

32.

How did your family come to Quito?
All the family together
Adults separate, before marriage
The father first, then the family
The mother first, then the family
Children first, then the family
How long have you lived in this neighborhood?
How long have you lived in the city of Quito?
Did you have relatives already living in Quito when you
arrived?
If yes, who?
Paternal grandparents of the child
Maternal grandparents of the child
Aunts and uncles of the child
Aunts and uncles of the parents
God—parents
Friends
Did you live with relatives when you first arrived in
Quito?

If you did, for how long?

 

163

(Form 2)
o .0 - 00 o o 0‘ 000" o ’ -. 0‘0
(Continued)
These last two questions are open-ended. I am going to

ask each question and write down your comments while

you answer the question.

33. For what reasons did you come to live in the city of
Quito?

34. How do you feel about having come to Quito? What I
mean is, do you feel that you have accomplished what
you wanted by coming to Quito? What are your positive
and negative reactions to being in Quito.

Damaszanhic_nata_5heet

Question asked in each column across:

Give the name of each person living in this house,

starting with the head-of—household.

What is the relationship of each person to the child?

Each persons sex

Each persons age

How many formal years of school each person has com-

pleted?

Can this person read or write?

What is this persons principle activity?

Each persons place of birth

 

 

APPENDIX C

FOOD FREQUENCY INSTRUMENT AND DIETARY CHANGE INSTRUMENT

 

T’f

"GORE m. HIHO
mic: It LA PEIGOHA ENTREVISTADA
MON 121. ENTREVISTAm AL HINO

CODIOO - - - - -
Permisrie: 3a

mourners DE ALIHDH‘OS

Figins 1

PMYEC‘PO: ESTAN MRICIOHAL DE HINOS ESCOLARES: someone ALTO

 

 

RSV-ISO
mm C

Indique per favor, cuintss veces en el
filtino mes su familia ha censmide los
siquientes slinentos.

Indique, por favor cuintss
veces sl mes su familia
scostunbrabs censuir los
siquientes alimentos antes
de venir a Quito.

 

(W5, ETC) HINCA A CADA QDA
VEGS SEHAHA DIA

INCA A CADA CADA
VECES SEHAHA DIA.

 

(0) (1) (2) (3)

 

(4) I5) (6) (7)

 

Qulpi

 

Oiecle

 

Clnquil

 

Mair tostsdo

 

 

1902-83)

 

mu

 

Meroche

 

Arrer d: cabsda

 

Trigo

 

mines

 

Otuthucs

 

ll‘chics

 

Marina dc trige

 

mins de Mai:

 

Harina de Hsbs

 

 

 

Marina de uroche

 

 

 

 

 

 

 

 

 

164

 

 

 

165

(W , ETC) MCA

(0) (1)

Ruin: dc amja

mm dc mum

 

CADACADA

(7)

 

 

 

166

Zanahoria blanca

 

 

 

 

167

CARNES, PESCADOS
cone

Cane dc cuy .

Carne dc gallina

PRODUCTOS LACTEOS

Lech:

SSW-’50
ININMS .
1982-83

ADICIONALES

826w

 

DIA.

(7)

 

 

168

(Form 3A)
WWW

Name of the child

Name of the interviewee

Relation of the interviewee to the child

Please indicated how many times
in the last month your family

consumed the following foods

Response choices:

never, sometimes, weekly, daily

Please indicate how
many times during

a one month period
your family consumed
these foods before
coming to Quito.

Response choices:

never, sometimes, weekly,

daily
W
l-Grains 3-legstablss
Small p0pping corn Cabbage

Corn on the cob

pop corn

toasted corn

hominy

hard dried corn
barley

wheat

quinoa

dried corn mush
toasted barley flour
wheat flour

corn flour

fava bean flour

hard dried corn flour
pea flour

cornstarch

barley flour

Z-Legumgs

Peas
Lentils
Fava beans
Beans
Lupine

purple cabbage
turnip greens
swiss chard
spinach
bermuda onions
white onions
tomato

lettuce

hot peppers
green beans
peppers
cucumbers
avocado

summer squash
summer squash seeds
pumpkin
carrots

white carrots
radishes

beets

ullucus tubers
okas

potatoes

 

 

169

(Form 3A - Cont.)
E J' l I J l' E E i E I l I

Liai_2£_£QQd& (Cont.)

4-Eruits G-W
pears Milk

apples yogurt

figs cheese

tree tomatoes ice cream
andean cherries eggs

papaya

Pineapple 7-Miscellansous
passion fruit

orange Sugar

lemons Granulated salt

plantains (green)
red bananas
bananas

Iodized salt
Crude brown sugar cakes
bread

ripe plantains rice
babaco melon noodles
chamburo spaghetti
taxo Food supplement
naranjilla semola
blackberries cookies
strawberries candies
grapes coffee
mangos tea
canteloupe colas
soursop mineral water
chirmoya

tangerines

S-neatsi_£ish

rabbit

guinea pig

chicken

pork

lamb

beef

fish

shellfish

 

 

170

 

 

Pogino 1

moron --------- .
rcnulorio : 3b

1.

3.

“BO
1982-83

4.

 

W0 u ”105 macs

gaiorc hocorle uno: proguntoo :cbto 1o oli-octocido do :u fonilio.

no quo II: no interon :cn 1c: cubic: on cccooquix 1c: olioontcm pr;
pan: 1: ccnido y guordor 1o cuido quo :cn rolocicnodc: o lo vonido
do :u fonilio o vivir on Quito. u coy hocor cincc progmato: y onctor
on: roopuo:to:.

oncuidosquoccolononolcowcquuccaoooqufonmitc?
Bi -- .0...
ti o: quo :u ro:puo:to o: oi. cunos?

 

 

loyccniduquocaonoqufonouithuoccuiononolcoopc?
:1 ..- lc-o-
ti o: quo :u ro:puo:to o: oi, cull“?

 

 

Qu‘ cubic: hon hobidc on 1: (on: do ccmoquir 1c: olioontc: dude
:uv mid: o Quito

Cubic: on 1o: culpro: dol oorcodc
Cubic: on lo: olioontc: cccooguidc: do :u: prcpic: torxonc:

 

 

Otto:

 

 

euno: cubic: hon bobidc on 1: proporocido do 1o cuido doodo :u v;
nido o Quitc7.

Coobic: on 1c: oporotc: poro cccino:

 

M

 

 

Colbic: on cabuotiblo: pox: cccinor

 

Cofiicoonti-pcporocccinor

 

Cubic: on Io mot: do cccinox

 

Otto:

 

 

Gallo: cubic: hon hobidc on 1: (on: do W in coopro: dad:
on vonido o Quito.
Mic: on :1 oopocio pox: gun-dor

 

Coobicoonlofcroodoguordor

 

Colbic:on1o:ccoidooguordodoo

 

Coobicoooolti-podoguordoxouocaidoo

 

m

 

 

 

171

(Form BB)
WW

I wish to ask you some questions about feeding your family.

What.I am most interested in are those changes in‘acquisi-

 

tion, preparation and storage of foods that are related to
you and your family moving to Quito. I am going to ask you

5 questions and write down your responses.

1. Are there foods which you ate in the rural area which g

 

You no longer eat in Quito? If yes, which ones? i.

2. Are there foods which you eat in Quito which you did not

eat in the rural area? If yes, which ones?

3. What changes have taken place in the way that you ac-
quire food since you moved to Quito?
Changes in foods purchased
Changes in foods acquired from your own land

Others

4. ‘What changes have taken place in the way which you
prepare food since you came to Quito?
Change in cooking utensils
Change in fuel source
Change in cooking time
Change in the way you prepare food

Others

172

(Form BB — Cont.)
E J' l I J l' E E' | :1 I l |

What changes have taken place in the way in which you
store food since you came to Quito?

Change in storage space

Change in storage method

Change in foods stored

PW
Change in storage time '

 

 

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