Development and Demographic Change: The Reproductive Ecology of a Rural Ethiopian Oromo Population Thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to University College London University of London Mhalrl Alexandra Gibson 2002 ProQuest Number: U642639 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. uest. ProQuest U642639 Published by ProQuest LLC(2015). Copyright of the Dissertation is held by the Author. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. Microform Edition © ProQuest LLC. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 Abstract Across the developing world, labour-saving technologies have been designed to introduce savings in the time and energy that women allocate to work. In rural Arsi, Southern Ethiopia, a water supply pipeline installed in 1996 has reduced long arduous trips spent carrying water, and is associated v^th a permanent improvement in women’s energy budgets. Assuming that nutritional levels remain constant, evolutionary life history theory predicts the energy saved may be diverted into reproductive effort and may increase fertility. Previous clinical studies have revealed that fecundity is responsive to changes in maternal energetic status. This thesis examines whether a reduction in workload translates into a measure of reproductive outcome (live births). The main aims are to detect effects of the installation of village-level taps on birth spacing, and to identify the major correlates of maternal condition, health and child survivorship. Demographic, health and nutritional status data were collected in 1999-2000, during ten months of field research in Arsi. The survey included a single-round demographic survey with full birth histories and a matemal-child health survey of 1574 households, and an anthropometric survey of 464 reproductive-aged women. These were conducted in villages both with and without access to water points, which were matched for comparability in all other aspects (e.g. altitude, religion, size). Multivariate event history regression analyses indicate that the introduction of the new water supply scheme is associated with a reduction in first and subsequent birth intervals, following a shorter period of post-partum amenorrhoea. This effect is likely to be mediated by the reduction in women’s energetic workload, as there is no evidence of reduced child mortality or any improvement to women’s health and nutrition. In addition, reproductive scheduling is strongly correlated with maternal condition in this population; evidence for maternal parity-specific depletion in body condition is presented. Furthermore, the Trivers-Willard model of adaptive variation in sex ratio at birth relating to maternal condition is supported. Overall, the findings indicate that in the absence of adequate health care, food availability and education, the new water supply has not obviously improved maternal well-being or child survivorship. Closer birth-spacing patterns associated with the labour-saving technology may impose severe constraints on maternal (and consequently child) health. These results have potential policy implications for a range of water and other development projects designed to save energy expended by women. Table of Contents ABSTRACT I TABLE OF CONTENTS I l-V LIST OF TABLES VI LIST OF FIGURES Vli-Vlil ACKNOWLEDGEMENTS IX 1.0 INTRODUCTION 1.1 A im s o f t h e s is 1 1.2 C o n t e x t o f t h e s is 2 1.3 T h e o r e t ic a l a p p r o a c h e s 3 1.3.1 E volutionary l if e h i s t o r y t h e o r y 3 1.3.2 R eproductive e c o l o g y 4 1.4 P a t h w a y s o f f e r t il it y c h a n g e 6 1.4.1 B io -e n e r g e t ic s 6 1.4.2 B io -behavioural f a c t o r s 7 1.5 P a t h w a y s o f m o r t a l it y c h a n g e 8 1.5.1 H e a l t h , f e r t il it y a n d m o r t a l it y interactions 9 1.6 O u t l in e o f t h e s is 10 2.0 METHODS OF DATA COLLECTION AND ANALYSIS 2.1 S t u d y d e s ig n 12 2.1.1 S it e S e l e c t io n 12 2.1.2 S t u d y organisation 14 2.1.3 S a m p l e d e s ig n 15 2.2 L o g is t ic s 16 2.2.1 R e s e a r c h s t a t u s 16 2.2.2 E n u m e r a t io n 17 2.2.3 P il o t & Tr a in in g 17 2.3 H o u s e h o l d demographic s u r v e y 18 2.3.1 Fe r t il it y & m o r t a l it y 18 2.3.2 N u p t ia l it y & r e s id e n c e 19 2.3.4 H o u s e h o l d characteristics 20 2.3.5 Ma t e r n a l s t a t u s 20 2.3.6 W a t e r s u p p l y 21 2.4 B ir t h -s p a c in g d a t a a n d a n a l y s is 21 2.4.1 E v e n t / l if e h i s t o r y c a l e n d a r 22 2.4.2 E v e n t h is t o r y / Ha z a r d s a n a l y s i s 22 2.4.3 M o d e l l in g h a z a r d s 23 2.5 A nthropometric s u r v e y 24 2.5.1 B o d y SIZE 24 2.5.2 B o d y composition 25 2.6 H e a l t h s u r v e y 26 2.6.1 D e f in it io n s o f il l n e s s 26 2.6.2 S e v e r i t y o f il l n e s s 27 2.6.3 H e a l t h c a r e p r a c t ic e s 28 2.7 Q u a l it a t iv e d a t a c o l l e c t io n 28 2.8 D a t a organisation & a n a l y s is 28 3.0 STUDY SITE 3.1 G e o g r a p h y a n d c l im a t e 29 3.1.1 L o c a l e c o l o g y 30 3.2.1 S e a s o n a l v a r ia t io n 30 3.2 E t h n o g r a p h y 31 3.2.1 S u b s is t e n c e p r a c t ic e s 32 3.2.2 V il l a g e /H o u s e h o l d r e s id e n c e 32 3.2.3 Ma r r i a g e p a t t e r n s a n d k in s h ip s t r u c t u r e 33 3.2.4 S o c io -e c o n o m ic c o n d it io n s 35 3.2.5 E d u c a t io n l e v e l s 37 3.3 H e a l t h a n d p o p u l a t io n 37 3.3.1 H e a l t h s e r v i c e s 38 3.3.2 P o p u l a t io n LEVELS 39 3.4 P r o b l e m s o f w a t e r s u p p l y 40 3.4.1 W a t e r c o l l e c t io n 40 3.5 D e v e l o p m e n t infrastructure 42 3.5.1 Th e H it o s a g r a v it y w a t e r s u p p l y p r o j e c t 43 4.0 THE IMPACT OF LABOUR-SAVING TECHNOLOGY ON FERTILITY DIFFERENTIALS 4.1 F e r t il it y l e v e l s 44 4.1.1 P e r io d f e r t il it y r a t e s 44 4.2.1 Fluctuations in f e r t il it y r a t e s o v e r t im e 45 4.2 D o e s l a b o u r -s a v in g t e c h n o l o g y im p a c t o n f e r t il it y ? 46 4.3 M a in a n a l y t ic a l m e t h o d s 47 4.3.1 Da t a s e t 47 4.3.2 D e p e n d e n t v a r ia b l e s 48 4.4 In d e p e n d e n t v a r ia b l e s 49 4.4.1 SOCIO-ECOLOGICAL COVARIATES 49 4.4.2 D e m o g r a p h ic c o v a r ia t e s 50 4.4.3 E n e r g e t ic c o v a r ia t e s 51 4.5 T im in g o f t h e f ir s t b ir t h 52 4.5.1 A g e AT MARRIAGE 53 4.6 A n a l y s e s o f t h e f ir s t b ir t h in t e r v a l 53 4.6.1 Un iv a r ia t e a n a l y s e s 53 4.6.2 M u l t iv a r ia t e a n a l y s e s 55 4.7 A n a l y s e s o f in t e r -b ir t h in t e r v a l s 62 4.7.1 Un iv a r ia t e a n a l y s e s 62 4.7.2 MUL TIVARIA TE ANAL YSES 62 4.8 D is c u s s io n 69 4.8.7 C h a n g e in nutritional s t a t u s ? 69 4.8.2 A l t e r e d b r e a s t -f e e d in g p r a c t i c e s ? 70 4.8.3 R e d u c e d d i s e a s e l o a d s ? 70 4.8.4 R e d u c e d e n e r g e t ic expenditure ? 71 4.8.5 In c r e a s e d c o it a l f r e q u e n c y ? 72 4.9 C o n c l u d in g r e m a r k s 72 5.0 WOMEN'S HEALTH AND BODY CONDITION - EVIDENCE FOR MATERNAL DEPLETION______________________________________________ 5.1 T he STATUS OF WOMEN 73 5.2 H ea lth characteristics 74 5.2.1 Health seeking beha viour 75 5.2.2 Reported ILLNESS 76 5.2.3 Miscarriages and still births 76 5.3 L e v e l s o f e n e r g e t ic s t a t u s 77 5.4 D o e s im p r o v e d w a t e r s u p p l y im p r o v e m a t e r n a l c o n d it io n ? 78 5.5 D o e s c l o s e r b ir t h -s p a c in g e f f e c t m a t e r n a l c o n d it io n ? 79 5 .