Violence Against the Indigenous Women: Methodological and Ethical Recommendations for Research

Abstract

The importance of more countries contributing to precise and comparable statistics on violence against women (VAW) is undeniable. Methodological adaptation is a very important aspect to increase the probability of women disclosing violence and safeguard their integrity. Research on VAW adapted to ethnic populations is scarce. Colombia has great ethnic diversity and is the country in the region with the second highest percentage of women reporting having suffered physical or sexual violence. However, statistics on VAW are limited, and no guidance or recommendations exist with respect to adapting the VAW research protocol to indigenous communities with unique forms of social organization. The indigenous Nasa community functions as a small society with its communal organization, own social norms, and indigenous customary law. In addition, the indigenous Nasa population has a worldview that is reflected in the way women suffer and face violence and discrimination. This article is based on a pilot survey that adapts and implements the WHO multicountry study’s survey methodology on women’s health and domestic VAW in three resguardos (communal lands) of the Nasa indigenous community in Colombia. The goal is to contribute to and improve the methodological adaptation of VAW research to cultural diversity, and simultaneously attempting to obtain high-quality data that can be comparable at the national and international levels. Recommendations for adaptation, ethical considerations, challenges, and implications for future studies with indigenous populations are discussed.

Keywords

Introduction

Studies sponsored by the World Health Organization (WHO) reveal that almost one third of women worldwide will suffer physical and/or sexual violence at some point in their lives and that this violence will mainly be perpetrated by their partners (Devries, Mak, García-Moreno, Petzold, Child, Falder, . . . Watts, 2014; García-Moreno, Pallitto, Devries, Stöckl, Watts, & Abrahams, 2013). In Latin America, according to a report by the Pan American Health Organization (PAHO), which gathered data from 12 countries between 2000 and 2009, Colombia’s violence against women (VAW) rates exceed this global estimate. Furthermore, it is the country in the region with the second highest percentage of women reporting having suffered physical or sexual violence by their current or former intimate partner at some time in their lives (38.6%) and within the 12 months prior to the survey (20.7%). The Encuesta Nacional de Demografía y Salud (ENDS) [National Demographic and Health Survey] showed that, in 1990, 18.8% of Colombian women declared that they had suffered some type of physical violence by their partner. After 20 years, the percentage was 37.0%, an increase of 18 percentage points. Similarly, the percentage of women who admitted having suffered sexual violence went from 8.8% to 9.7% in the same period (ENDS, 1990, 2015). It is likely that this increase in the statistics is not due to an increase in the number of cases of violence but due to greater awareness and better data collection. In any case, it shows the need for a more exhaustive study of the phenomenon on a national level.

In the past several decades, there have been some legal and political advances in response to VAW in Colombia. Directly and indirectly, these measures aimed to promote equality and eliminate discrimination and VAW. At the same time, in the past 30 years, the national government has developed various policies. Despite government efforts, these policies have not ensured a qualitative change in the approach to VAW. The decisive impulse toward equal opportunity policies, gender as a category of analysis, and the pursuit of women’s empowerment came with the proclamation of the Constitution of 1991, in which, for the first time, the principles of equality and nondiscrimination were addressed. This was achieved with the support of international agreements adopted by the United Nations, such as the Inter-American Convention on the Prevention, Punishment, and Eradication of Violence Against Women (Convention Belém do Pará, 1994) and the Beijing Platform for Action from United Nations World Conference on Women (Jansen, Watts, Ellsberg, Heise, & García-Moreno, 2004). The most notable achievement was the Política Pública Nacional de Equidad de Género para las Mujeres (CONPES¹ 161 of 2013) [National Public Policy of Gender Equality for Women], which includes a comprehensive plan to guarantee women a life free of violence. Finally, Law 1761 of 2015 defined femicide as a crime. Although great emphasis was placed on the design of regulations, important difficulties were encountered when applying them (Lineamientos de la Política Pública Nacional de Equidad de Género para las Mujeres, 2012).

The recommendation to promote research conducive to more accurate and up-to-date information on VAW was among the agreements of the Beijing Platform for Action (United Nations, 1995). Hence, it is necessary for more regions in the country to progressively study and measure VAW in a way that offers exhaustive data on the frequency and prevalence of different types of violence, the circumstances in which this violence occurs, the impact on women’s and children’s health, the characteristics of male perpetrators, women’s economic autonomy, the response of women and society toward abuse, and risk and protective factors. To provide comparable data, the WHO designed the Multi-Country Study on Women’s Health and Domestic Violence (WHO, 1996, 2003) to standardize a methodology that offers an accurate picture of VAW and is adaptable to different countries and cultures. However, the great ethnic and cultural diversity in Colombia creates added challenges for this pilot survey. The methodology must be adapted to this diversity to obtain a more precise view of the phenomenon.

The indigenous Nasa population of Colombia has a worldview that is reflected in the way women suffer and face violence and discrimination (Vitonás, 2015). Our methodological review considers the particularities of the Nasa community with respect to gender roles in families and the community and documents the traditional institutional response by the indigenous authorities. So far, there is no data on prevalence or types of violence or the circumstances under which it occurs in indigenous communities in Colombia. Approximate data using demographic and health studies that offer homogenized data on VAW for the country present several gaps. They do not represent the reality at the community level, questionnaires are not translated to a language that could more precisely capture the different types of violence, and surveyors are not generally trained to work in indigenous contexts. Thus, methodological adaptation would not only increase the probability of women disclosing violence but also safeguard women’s integrity (Ellsberg & Heise, 2007). The WHO’s protocol (WHO, 2005) includes a series of methodological and ethical requirements to protect the integrity and well-being of women and requires adaptation to the context of the study. However, no guidance or recommendations exist with respect to adapting the protocol to indigenous communities with unique forms of social organization. Therefore, a pilot study was conducted in a Nasa community in Valle del Cauca, Colombia. A series of aspects regarding design and implementation had to be considered to protect and respect the confidentiality of Nasa women. Also, specific ethical recommendations were considered to access Nasa women’s stories while maintaining their autonomy.

In this article, we describe the methodological and ethical considerations followed to adapt the WHO VAW study (WHO, 1996, 2005) to the Nasa population. Also, we discuss the lessons learned and the challenges that could be encountered by future studies with indigenous populations with similar characteristics, particularly those in Latin America and the Caribbean. Our goal is to contribute to and improve the methodological adaptation of VAW research to Colombia, taking into account cultural diversity and simultaneously attempting to obtain high-quality data that can be comparable at the national and international levels. This pilot study may also provide a case study to illustrate some methodological recommendations for research with indigenous communities around the world.

Characteristics of the Nasa People

United Nations (1995) determined that the violence suffered by women is related to them being in a situation of unequal power in all societies, and therefore, this violence is rooted in the structure of matrimony, family, and society. In the case of Nasa women, being indigenous is an added inequality. The Nasa population we studied lives in the Cauca Department in southwestern Colombia, which is one of the regions most affected by the armed conflict that has affected the country for more than 50 years (Urrea-Giraldo, Bermúdez, Lucero-Posso, & Canaval, 2017). Specifically, this pilot study was carried out in Toribío, which ranks third among indigenous municipalities with regard to the rate of girls and adolescents displaced by the armed conflict.

Further to the effects of this armed conflict, Nasa women suffer severe problems such as domestic violence and sexual aggression, although information is scarce in surveys and administrative data on these issues. This may partly be explained by the low number of reports recorded by the jurisdiction of the local municipality and the fact that, to this point, the surveys carried only present data at a regional level. Data from the ENDS (2015) show that, in this area, almost 70% of women aged 13 to 49 years have suffered some type of violence at some point in their lives (physical, psychological, sexual, and/or economic), 35.4% suffered physical violence, and 7.7% sexual violence; slightly higher rates were revealed in the urban area. These women were frequently forced to have sex and continued suffering different types of abuse throughout their lives by their male partners and other men in the community (Vitonás, 2015).

The Constitution of 1991 regulated certain rights for indigenous people, including their own laws. Each indigenous resguardo (communal land that is owned through a single collective title and cannot be sold) has its own cabildo (special public indigenous institution that legally represents an indigenous community and regulates legislation and security issues within each resguardo), which is presided over by the gobernador (the highest authority). Under this structure, the next level of organization is the family, which is normally assigned land for its use (Urrea-Giraldo et al., 2017). Historically, the common Nasa family model has been an extended family based on a patriarchal order and the violent subordination of women (León, 1982; Pachón, 1987). A characteristic of the Nasa people is that they exercise their own jurisdiction within their territories, with their own language and their own regulation of law and education. Although the classification of crimes is mostly equivalent to the classification established by the Colombian penal code, indigenous law does not include state legislation on VAW or state prevention and victim support mechanisms.

The sixth wave of the World Values Survey (2018), coordinated by the Departamento Nacional de Planeación [National Planning Department], aimed to analyze certain aspects of people’s opinions and values to shed some light on the social and cultural pillars on which the functioning of the indigenous communities is built (Urrea-Giraldo et al., 2017). They found a generalized tendency among the indigenous people, slightly higher than the national trend, to agree with traditional and stereotyped beliefs, such as, that men make better leaders or have more right to inherit or to obtain paid employment. In addition, Nasa women experienced the worst working conditions, carried out most of the unpaid work, and, in general, had a lower level of education than men (Gualiche, 2014) within a population with a low percentage of people with higher education (37%). Notably, research carried out specifically with women of the Nasa community is extremely scarce. The lack of statistical records in this municipality is probably due to government neglect, institutional discrimination, and the armed conflict, among other factors (Urrea, 2016).

Objectives

The general objective of this pilot survey was to adapt the WHO (2005) VAW study’s instrument and methodology to the indigenous Nasa population and to gain greater knowledge of the phenomenon of VAW in this community. Given that this is a pilot survey, the specific objectives pursued are those cited by Jansen et al. (2004) as process-oriented objectives:

To develop and test new instruments to measure violence cross-culturally;

To increase national capacity among researchers and women’s organizations working on violence;

To increase sensitivity to violence among researchers, policy makers, and health providers; and

To promote a new model of research on domestic violence involving women’s organizations with expertise on VAW and fully addressing safety issues and safeguarding women’s well-being (Jansen et al., 2004, p.834).

Methodology of the WHO VAW Study and Ethical Considerations

In the past 30 years, international research on gender-based violence has not only deepened our understanding of the dynamics and dimensions of this type of violence but also shed light on the challenges researchers still experience doing this type of study (Ellsberg & Heise, 2007). The WHO (2005) methodology applies an instrument that has been adapted from the Conflict Tactic Scale (Strauss, 1979), which has been the most widely used instrument to measure violence within intimate relationships. However, this instrument only measures violent behaviors occurring in the context of relationship conflict and does not reflect other forms of partner VAW or other forms of VAW. The WHO instrument aims to fill gaps by including control, emotional abuse, and physical and sexual violence, as well as the frequency and intensity of each type of violence. In addition, it identifies other circumstances related to VAW, such as the impact of VAW on physical, mental, and reproductive health; injuries due to violence; response to abuse; impact on children; and violence risk factors, all of which provide a more accurate and comprehensive picture of the phenomenon. Furthermore, the WHO methodology intends to have an international character that has been used in a diversity of countries in population studies and representative samples of cities or regions to obtain global estimates and perform cross-country comparisons. It includes a procedure to adapt the protocol to the particular study population through an initial phase of qualitative research that consists of interviews with women survivors of violence, key informants, and focal groups. Its aim is to incorporate familiar terms within the population and include or exclude variables according to their pertinence. In addition, as a requirement of implementing the protocol, a team structure must be complied with to ensure data quality and comparability that includes a country consultative group composed of entities with paramount responsibility in the country in relation to the subject matter and an advisory group coordinated by the PAHO/WHO and composed of female researchers who have participated in similar studies in other countries. By enabling cross-cultural comparisons, this instrument also helps determine which societal norms and institutions promote or discourage these violent behaviors (Ellsberg & Heise, 2007).

The prevalence of VAW together with the lack of appropriate assistance protocols for victims of violence in the Nasa community places women in a position of particular vulnerability. This situation requires a methodology capable of including these considerations in researching VAW, paying special attention to the ethical aspects of research and the safety of both the women and the team (Jansen et al., 2004).

The Experience With the Nasa Population: Considerations for Research

The pilot study was carried out in three Toribío resguardos (the communal lands of Tacueyo, Toribío, and San Francisco). The sample included 301 indigenous women aged 15 to 49 years, who were interviewed face-to-face. The process for adapting the WHO VAW study (WHO, 1996, 2003) is described below.

Review by National and International Ethics Committees

The first challenge that arose when designing this pilot study was how to approach the jurisdictional autonomy and customary law of the Nasa people. This was a core aspect of the protocol evaluated by the ethical review committees. The scarcity of prior experience in research with this type of population entails a lack of references regarding specialized action protocols, apart from the existing recommendations on negotiating community access with community leaders (Ellsberg & Heise, 2007). Points of special consideration are the informed consent process that all women interviewed had to complete, confidentiality, and victim support options. In these small communities, women may assume the added risk of being threatened by their husband or other family members, as well as the shame and stigma of admitting that they are victims of violence, where everyone knows each other and where the authorities of the community must give their permission for the research to be carried out. For this reason, we decided to prepare two versions of the informed consent, an individual one for the women that included detailed information on the research and the other one for the indigenous governors with more general information, omitting VAW as the objective of the study.

Another sensitive matter is related to the child protection legislation applicable in each country. According to national legislation, it is normally mandatory to report to the corresponding authorities any case of violence against minors or violations of their fundamental rights that might emerge during the interviews. This information must be included in the informed consent. However, in the case of our research with the Nasa population, according to their indigenous law, only close family members must inform the abuse of a minor, and they must do so at the corresponding cabildo (special public indigenous institution). This needed to be explained and justified to the research ethics committees, and it was respected as a part of indigenous customary law.

Translation and Adaptation of the Questionnaire

We adapted version 11 of the questionnaire from the national survey of VAW in El Salvador (Navarro-Mantas, Velásquez, de Lemus, & Megías, 2018). The adaptation was conducted based on prior qualitative research that consisted of interviews with key informants and focal groups of community women and men. The changes made in the questionnaire are shown in Table 1. These changes were related to specific terminology, but mainly to the response options associated with the indigenous worldview, rituals, and institutional structure.

Table 1.

Categories of Modifications Made to the Questionnaire for Its Adaptation to the Indigenous Nasa Population.

• Specific names of the Nasa community structure: by municipalities, resguardos, and veredas (administrative section of a municipality)

• Specific categories of the Nasa institutional structure: guardia indígena (indigenous guard), cabildos (special public indigenous institution), police stations, and specific programs

• Nasa spirituality and religion denominations

• Categories of occupation, employment, and income sources according to the Nasa context

• Categories and terminology of marital status according to the Nasa institutional structure

• Categories of association and attendance to Nasa community groups according to community organization, production groups, and work groups

• Categories and terminology referred to the health–illness system in relation to medical conditions, medication, health providers, and traditional indigenous rituals for healing

• Response options in several items related to cultural idiosyncrasy and tradition, such as beliefs, attitudes, and customs

• Types of emotional and control violence specific to the context

• Types of violence perpetrated by others related to the historical context of armed conflict: violence inflicted by soldiers, militias, or guerrillas

Next, the questionnaire was translated to the Nasa Yuwe language by two Nasa Yuwe–speaking female translators who followed a procedure of translation and retranslation. The changes were discussed with the research group to obtain the final version of the instrument. Most of the women interviewed spoke Spanish, yet there were several women who spoke only Nasa Yuwe, which is why the translated questionnaire had to be used.

Recruitment and Selection of the Field Team

International research indicates that the selection of interviewers is a key element of the success of a study because it increases the probability of women revealing the violence they suffer (Jansen et al., 2004). Moreover, it has been demonstrated that factors such as interviewers’ attitudes, marital status, interpersonal skills, sex, and age can influence women disclosing their experience (Ellsberg, Heise, Peña, Agurto, & Winkvist, 2001; WHO, 2001). In this particular pilot study and based on the information yielded by the qualitative research, it was established that the interviewers had to be indigenous Nasa women because the participants would not feel comfortable with women who were not indigenous or did not come from the same community. In addition, the team was formed ensuring that there were at least two Nasa Yuwe–speaking women and that all interviewers were indigenous women who came from one of the resguardos (communal land that is owned through a single collective title and cannot be sold) of the community being studied. To ensure that the interviews were not conducted between women who previously knew each other, the interviewers could change resguardos for fieldwork. Of the four groups recommended by Ellsberg and Heise (2007) to form the group of interviewers—professional interviewers, community women, health promoters, and human rights advocates—this pilot survey used women from the community and human rights advocates. The interviewer selection process was conducted with special care following the recommendations made by Ellsberg and Heise (2007) in their guide Researching Violence Against Women. It was designed to assess skills that are valued in this type of study, but as Ellsberg and Heise suggest, interviewers’ personal skills and commitment are more important than a professional profile. We chose a group of indigenous women who showed sensitivity and were committed to the issue and who in most cases had participated in movements, workshops, or other initiatives to empower the women in their communities. The selection was conducted with the support, on one hand, of team workers from the cabildos (special public indigenous institution) who are in charge of preventing and studying crimes and other violent issues against women, family, children, and elderly people and who were highly experienced in fieldwork and training. On the other hand, they were supported by a team of former health promoters. The fieldwork supervisors were also indigenous women, leaders in their community, who were part of a small group of Nasa women with high levels of education and experience in research. Personal commitment was demonstrated by all team members at all times. Comradeship, support, solidarity, and the common goal of contributing to improve the reality of women in their community were crucial.

The required number of interviewers was estimated according to the size of the sample, the geographical area covered, the timing of the fieldwork, and the seasons of crop harvesting and rain. As Jansen et al. (2004) advised, given the high prevalence of VAW worldwide, it was likely that the interviewers would also have had previous experiences of violence. For this reason, the first element of discussions with potential interviewers was intended to identify the impact of previous experiences of violence, thus questions regarding posttraumatic stress symptoms were included (Echeburúa, Corral, Amor, Zubizarreta, & Sarasúa, 1997). One of the candidates showed clear symptoms of not having overcome her experience of abuse, so she was encouraged to seek psychological help. The second element of discussions was intended to identify explicit and implicit prejudices toward sensitive issues. This information would later guide the design of the interviewer training. To observe whether candidates clearly showed any prejudice against women who are suffering violence, scenarios adapted from those designed by Megías, Romero-Sánchez, Durán, Moya, and Bohner (2011) were used to identify the degree of blame attributed to the female victim and the male aggressor in relation to a violent situation. In line with a previous study (de Lemus, Navarro, Velásquez, Ryan, & Megías, 2014), less blame was generally attributed to the aggressor in the case of psychological violence; therefore, special attention was paid to this during training. Finally, a female psychologist sensitive to the subject matter and also from the community was chosen to accompany the fieldworkers and attend to the needs of both the team and any women interviewed who requested additional support.

Training Interviewers

Jansen et al. (2004) pointed out that diverse research had been carried out in previous years to determine the prevalence of VAW in different countries. However, in general, much attention has been paid to data gathering techniques, analysis, samples, instruments, and generalization of results, among other factors, but hardly any attention has been given to the important role of training interviewers. According to the authors, this part is decisive in ensuring data quality and minimizing risk to women interviewed. Moreover, as stated by Ellsberg et al. (2001), addressing these aspects, as well as an effective selection of interviewers, can increase the likelihood of women disclosing their experiences. Ellsberg and Heise (2007) cited three fundamental goals that must be accomplished in the training sessions: “to sensitize your team to issues of gender and violence, to instruct them in the use of the research protocol and interviewing techniques, (and) to build a team spirit that motivates field staff” (p. 171).

A female psychologist with expertise in gender violence and experience in studies using the WHO methodology led the interviewer training. The sensitive topics that were detected during the selection procedure were also included in the training program. Myths about violence were dismantled by building awareness of the subtler forms of violence and discrimination against women and of the causes of and possible prejudices toward gender violence. The aim was to ensure that the interviewers understood the phenomenon to enable them to be empathetic and sensitive and to not revictimize the women interviewed. The team was instructed in using the instrument and the fundamental bases of the WHO methodology. At the same time, efforts were dedicated to teambuilding through different group dynamics and creating spaces to share experiences and express emotions. Interviewers’ evaluations of the training sessions showed that the experience was very positive.

The design of the interviewer training adhered to the WHO protocol’s recommendations (Ellsberg & Heise, 2007) by addressing the advised topics: gender-based violence, stress management, review of the research protocol, employment expectations, interviewing techniques, and ethics in gender-based violence research. Interviewers were informed that they could withdraw from the study at any time if they felt overwhelmed by the difficulty or the sensitivity of the topic. Following the recommendations of Jansen et al. (2004), special attention was paid not only to identifying possible interviewers who may need support during fieldwork but also to observing personal emotional changes related to disclosing violence and its implications for the study. However, it is worth noting that the training sessions had a strong emotional impact on the group due to the severity of some of the experiences that were disclosed and because for many women, it was the first time they had spoken of and analyzed the violence they had suffered. Consequently, some pauses had to be made to share emotions and practice relaxation techniques. It was agreed to extend the time assigned to learning self-help group strategies and stress-management interviewing techniques to enable the interviewers to maintain supporting nonjudgemental attitudes toward the women interviewed. Furthermore, as forewarned by Velázquez (2003), to normalize, this type of effect can entail risks for women’s physical and mental health, and in this specific context, it can trigger fieldwork dropouts. For this reason, it was necessary to seek individual and group strategies to help interviewers confront their own experiences, consequently liberating them from their traumas. As indicated by Dutton (1992), interviewing women victims of violence can, on occasion, mean confronting one’s own life and not being able to modulate the anxiety that arises, which can lead to the extreme of being unable to act or the task becoming unfruitful. As in previous experiences, interviewers were trained to respond in the most appropriate way to specific questions or particularly stressful situations, offering support, showing empathy, and giving women the opportunity to rest or interrupt the interview (Jansen et al., 2004).

Protecting the Safety of Respondents and Fieldworkers

To ensure participants’ safety while researching VAW, researchers must consider the potential risk to respondents’ safety due to their participation in the study (Ellsberg & Heise, 2007), if their partners discover that they have been speaking to others about their relationship. There is no systematic research to establish the frequency with which women suffer negative consequences as a result of their participation in research on violence. However, in previous experiences, some alarming cases have been documented that must be taken into account with regard to addressing safety issues appropriately. The specific context in which this pilot study was carried out—small communities in which confidentiality is harder to guarantee—made it necessary to intensify safety measures. Support was provided by the guardia indígena, and in many cases, people from the cabildo (special public indigenous institution) accompanied interviewers. All team members wore identity cards. The instructions received during training were essential in relation to presenting the survey, seeking a safe place to conduct the interview, ensuring that no children over the age of 2 years were present, and paying special attention to the risk of women being abused by partners or others if they participated in the study (Ellsberg & Heise, 2007). In addition to the recommendations of the WHO protocol, in this pilot survey with Nasa communities, particular considerations were followed, such as a carefully planning the fieldwork to ensure that the interviewers would never conduct interviews in their own communities and the duration of the fieldwork (overall 28 working days) to avoid dropouts and the consequent difficulty of finding substitutes who met with the same selection criteria. Furthermore, since fundamentally fieldwork would have a significant emotional impact on the interviewers, the duration of the fieldwork also included several days of group therapy and group dynamics to share impressions and self-help techniques.

Support Systems for Women Victims of Violence

As pointed out by Jansen et al. (2004), training must address interviewers’ expectations in relation to the support they can offer the interviewees. Expectations must be realistic in relation to the interviewer’s role and the available resources to support women in the community. Although training aims to enhance attitudes of support and empathy, interviewers must always bear in mind that their training and function is limited regarding their capacity to offer guidance or support. Nevertheless, as in previous studies, an informative leaflet was prepared about the support system available in case of violence. The leaflet was offered to all women independently of whether they had suffered violence or not. For the Nasa women, the support system became a sensitive issue because many women stated that they were familiar with the assistance provided by the cabildos (special public indigenous) and that they had felt revictimized when they reported their experiences. This increased the vulnerability of these women and created a sense of frustration and helplessness among interviewers due to the impunity in many of the cases. Although it was a reality the interviewers were familiar with, they admitted feeling overwhelmed by the magnitude of the issue. This was a key aspect of the characteristics of the study with indigenous populations as other support systems for women who requested assistance had to be included in the design. In the case of this pilot survey, this support was limited to the assistance offered by the psychologist who accompanied the fieldworkers.

Lessons Learned and Challenges

As a result of the adaptation process, we now have an instrument that can provide a more accurate picture of VAW in this community, its causes and impacts, the risks, and protective factors, as well as the strategies used by women to deal with it. Furthermore, the lessons learned during the research process will help improve future research with indigenous populations, including certain key aspects related to the challenges encountered when addressing diversity during research on VAW.

Because many indigenous people have their own rules for functioning and their own laws, it is necessary to adapt the research methodology to their idiosyncrasies. Therefore, one critical aspect of implementing this research was having the community participate in the planning phase and agree on all elements of the design and budget before proceeding. In this pilot survey, there were certain delays and planning mismatches due to the reviewing processes of the ethics committees as an indigenous perspective was not included in the approach from the beginning. A lesson learned for future studies is that the indigenous worldview and functioning must be taken into consideration to appropriately justify the protocol adaptations presented to ethics committees. This must be done with the support of women leaders and indigenous women advocates. Another aspect to keep in mind to avoid difficulties during the process is that often women who on the field team have to leave their families the days they work, that they do not have any other source of income, or that they depend on wages coming from agricultural work. The indigenous women in our pilot study were, in general, dedicated to housework and farming, and most of them had children. This experience shows us that it is necessary to plan training and fieldwork bearing in mind, as far as possible, women’s needs. Timetables need to be adjusted, adapting them to women’s responsibilities or planning shifts for fieldwork. These are matters that need to be considered to provide support to interviewers and their families during the period of the work. Therefore, a first challenge would be to design the research process with community teams and adapt it to the communities’ specific needs and the characteristics of the field teams.

Ellsberg et al. (2001) noted that correctly selecting and training the team of interviewers is key to the success of this type of study and that it is more important to find interviewers who are committed to the subject matter than who have a specific professional profile. A notable aspect of the experience of researching Nasa women was the trauma from past experiences of some of the interviewer candidates. Some even showed signs of possibly suffering from posttraumatic stress disorder due to their own experiences of domestic violence. In some cases, it was possible to detect these issues during the selection process, but in other cases, they arose during fieldwork, with some interviewers suffering a sudden crisis while conducting an interview and being unable to continue. In terms of lessons learned, we recommend that recruitment include a more thorough analysis of psychological health and emotional strength and, more specifically, that it incorporate posttraumatic stress disorder symptomatology as protection for the team and to foresee possible dropouts. In addition, we suggest that support mechanisms should be available to interviewers who suffer an emotional crisis and that a group of trained substitute interviewers is available to fill vacancies if necessary.

As pointed out by Jansen et al. (2004), training interviewers can be more important for the success of this type of study than other elements of the methodology. For this reason, planning training must be a core aspect of the research’s design and protocol and must be reflected carefully in the budgets. However, according to our experience, in the case of indigenous populations, training programs must be adapted to the characteristics of the community and be extended if necessary. It is important to focus on the contents pointed out by the women as important for understanding the phenomenon, as well as other sensitive issues identified during the selection interview to avoid judging and revictimizing the women interviewed. Furthermore, a more extensive module on safety and self-help for interviewers must be included, incorporating relaxation techniques, emotion management, coping strategies, problem solving, and other specific techniques. For all these reasons, one of the main challenges is to develop training programs adapted to the indigenous women, their needs, and their vulnerability. Empowering women with training will, without doubt, contribute to greater quality of the data and increase the probability of yielding more precise prevalence figures for VAW in these populations.

An ethical matter of fundamental importance in the WHO methodology is that women interviewed must be offered a valid support option after the interview and information on support systems must guarantee their safety and offer assistance that does not revictimize them (Ellsberg & Heise, 2007). This was one of the main obstacles encountered when studying Nasa women, as there was an absence of support systems with specialized staff and lack of efficient legal mechanisms to sanction the abusers. Some women stated that they felt revictimized when reporting to the cabildos (special public indigenous institution that legally represents an indigenous community and regulates legislation and security issues within each resguardo). Consequently, it is also a key challenge for future studies to identify and secure assistance mechanisms for indigenous women that, apart from the cabildos, can provide them with specialized emotional and psychological support, as well as information and legal resources. Moreover, greater involvement of female psychologists with expertise in assisting women victims of violence, both during training and fieldwork, is a crucial aspect that must be taken into account for future studies with this type of population. All these matters must be carefully discussed with local teams, simultaneously respecting indigenous authorities while offering women specialized and efficient assistance.

Finally, the last challenge is presenting research findings to the population studied, consequently contributing to the community’s commitment to eradicate VAW, without violating women’s right to privacy and without provoking resistance or rejection in light of unfavorable information. Given the specific characteristics of this population, the restricted geographical area they inhabit, and the need to preserve women’s confidentiality, it is necessary to carefully plan the means and mechanisms that will be used to communicate findings. These findings should be shared through participatory workshops and other disseminating initiatives within the community, in coordination with local stakeholders, and always respecting the institutional structure, autonomy, and laws of the indigenous people (Ellsberg & Heise, 2007).

Discussion

The research experience with Nasa women provided access to a population that has traditionally been neglected in records and national statistics and thus has increased their visibility (Urrea-Giraldo et al., 2017). This research has also enabled us to adapt the WHO methodology to a population with legal and educational autonomy and particular idiosyncrasies, attending to the diversity. In this way, we have contributed to the aim set out in the Beijing Platform for Action (United Nations, 1995) of widening the scope of countries and cultures coming together to continue to conduct research that will provide prevalence estimates of all forms of VAW around the world.

Data available at the national level in Colombia show the extreme severity of the issue, with approximately 70% of Colombian women having suffered some type of violence. The Cauca and Nariño Department, where the community under study is located, has a physical violence rate of 35.0%, which is above the world average of 30.0% for physical and/or sexual VAW throughout women’s lives (Devries et al., 2014). It is also higher than indicators of VAW in Central America (El Salvador, Guatemala, and Honduras), which currently has the highest rates of femicide worldwide (Navarro-Mantas, Velásquez, & López-Megías, 2015). These statistics evidence the need to adapt and consolidate specific methodologies to study VAW in Colombia, beyond demographic and health surveys, and offer an accurate and timely picture of VAW while addressing the ethnic and racial diversity that characterizes it.

The study by Bott, Guedes, Goodwin, and Mendoza (2012) that collected the results of national health surveys from 12 countries found that the prevalence of intimate partner violence varied significantly according to the ethnic group in Paraguay, Guatemala, and Peru. Overall, the responses to surveys that determined the self-identified ethnic group showed that indigenous women reported slightly higher levels of physical or sexual violence than nonindigenous women in Bolivia and Ecuador. However, we do not have these data for Colombia. Although this is the general trend, there are differences between countries, so studying how prevalence varies according to sociodemographic characteristics in various countries can be particularly important.

A valuable aspect of this pilot study was building community capacity, one of the process-oriented objectives of the WHO VAW study (WHO, 2005). Specialized training was provided to a group of Nasa women who learned to conduct interviews, collect and systematize data, and other research-related tasks, as well as strategies to support women who suffer violence. All of this contributed to them developing greater knowledge of the subject matter and empathy toward the experiences of their female neighbors. Furthermore, during the training sessions, the women lived a personal therapeutic process that included the understanding and denormalization of their own life experiences, healing, and self-help, as in other studies in other countries (Jansen, 2010). As pointed out by Ellsberg and Heise (2007), “research is a means to an end” (p. 234), and it must not end once the results have been obtained; the product must be delivered to the interested parties. This principle is also reflected as a part of the ethical considerations pointed out by the main WHO protocol. In researching VAW, Ellsberg and Heise (2007) identified that the interested parties are generally policy makers, legislators, providers of support services for female victims, the primary health service, the academic community, and also the women interviewed. However, in the case of the study population, certain special considerations must be made in relation to returning this information to the community, and when addressing men and women community leaders, gobernadores, and indigenous institutions involved. This action should be carried out with caution given the impact of revealing, in such a small community, data that is without doubt disheartening. As part of the conclusions obtained in the subsequent discussions of the research team, the pertinence of presenting this data, especially to gobernadores and leaders of the cabildos (special public indigenous institution), was expressed. It was considered an opportunity to evaluate indigenous laws that condemn and penalize violence and revising the existing mechanisms to support victims, consequently encouraging authorities’ involvement.

Finally, in the description of this adaptation process of the WHO methodology to the study of VAW in indigenous populations, all that remains is to assess the implications it has for other indigenous communities, with similar characteristics. Always bearing in mind that the initiative must come from the communities themselves and that studies must be led by local women with whom the entire process must be elaborated and discussed. We hope this experience serves as a reference to adapt the WHO protocol to indigenous languages and cultures with specific particularities. And, also, that it serves as an incentive to encourage initiatives like the pilot survey under this methodological review so progressively more women can embrace a life based on human rights and free of violence.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Laura Navarro-Mantas

Notes

Author Biographies

Laura Navarro-Mantas is a researcher at the University of Granada (Spain) and works as a consultant specialized on gender-based violence for Inter-American Development Bank. Her research interests are oriented to gender violence, focusing on national surveys and prevention.

Luana Marques-Garcia Ozelema is a senior social development specialist at the Gender and Diversity Division of the Inter-American Development Bank. She has led the design and evaluation of projects and public policy reforms to prevent violence against women in Latin America and the Caribbean.

References

Bott

Guedes

Goodwin

Mendoza

J. A.

(2012). Violence against women in Latin America and the Caribbean: A comparative analysis of population-based data from 12 countries. Washington, DC: Pan American Health Organization.

Convention Belém do Pará. (1994). The Inter-American Convention on the prevention, punishment, and eradication of violence against women (Adopted in 1994). Organization of American States. Retrieved from www.oas.org/en/mesecvi/convention.asp

de Lemus

Navarro

Velásquez

Ryan

Megías

J. L

. (2014). From sex to gender: A university intervention to reduce sexism in Argentina, Spain and El Salvador. Journal of Social Issues, 70, 741-762. doi:10.1111/josi.12081

Devries

K. M.

Mak

J. Y. T.

García-Moreno

Petzold

Child

J. C.

Falder

. . . Watts

C. H.

(2014). The global prevalence of intimate partner violence against women. Science, 340, 1527-1528. doi:10.1126/science.1240937

Dutton

M. A.

(1992). Empowering and healing the battered woman. New York, NY: Springer.

Echeburúa

Corral

Amor

P. J.

Zubizarreta

Sarasúa

(1997). Escala de gravedad de síntomas del trastorno de estrés postraumático: propiedades psicométricas [Post-traumatic stress disorder symptom severity scale: Psychometric properties]. Análisis y Modificación de Conducta, 23, 503-526. doi:10.4067/S0718-48082016000200004

Ellsberg

M. C.

Heise

(2007). Investigando la violencia contra las mujeres. Una guía práctica para la investigación y la acción [Researching violence against women: A practical guide for researchers and activists]. Managua, Nicaragua: Organización Mundial de la Salud, PATH.

Ellsberg

M. C.

Heise

Peña

Agurto

Winkvist

(2001). Researching violence against women: Methodological and ethical considerations. Studies in Family Planning, 32, 1-16. doi:10.1111/j.1728-4465.2001.00001.x

Encuesta Nacional de Demografía y Salud. (1990). Encuesta de Prevalencia, Demografía y Salud [Prevalence, Demographic and Health Survey]. Retrieved from http://profamilia.org.co/docs/ENDS%201990.pdf

10.

Encuesta Nacional de Demografía y Salud. (2015). Encuesta Nacional de Demografía y Salud, Tomo II [National Demographic and Health Survey, Volume II]. Retrieved from http://profamilia.org.co/docs/ENDS%20TOMO%20II.pdf

11.

García-Moreno

Pallitto

Devries

Stöckl

Watts

Abrahams

(2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Geneva, Switzerland: World Health Organization.

12.

Gualiche

M. A.

(2014). Participación de la mujer Nasa en el mercado de trabajo y cambios demográficos en el municipio de Toribío, Cauca [Participation of Nasa women in the labour market and demographic changes in the municipality of Toribío, Cauca] [Monograph]. Retrieved from http://bibliotecadigital.univalle.edu.co/bitstream/10893/8163/1/0508786-P-S-15.pdf

13.

Jansen

H. A. F. M

. (2010). Swimming against the tide: Lesson learned from field research on violence against women in the Solomon Islands Kiribati. Suva, Fiji: UNFPA Pacific Sub-Regional Office.

14.

Jansen

H. A. F. M.

Watts

Ellsberg

Heise

García-Moreno

(2004). Interviewer training in the WHO Multi-Country Study on women’s health and domestic violence. Violence against Women, 10, 0831-0849. doi: 10.1177/1077801204265554

15.

León

(1982). Sociedad, subordinación y feminismo. Debates sobre la mujer en América Latina y el Caribe, Tomo III [Society, subordination and feminism. Debates on women in Latina America and the Caribbean, Volume III]. Colombia, Bogotá: Asociación Colombiana para el Estudio de la Población.

16.

Lineamientos de la Política Pública Nacional de Equidad de Género para las Mujeres [Guidelines for the National Public Policy on Gender Equity for Women]. (2012). Alta Consejería Presidencial para la Equidad de la Mujer. Colombia: Presidencia República de Colombia. Retrieved from http://www.equidadmujer.gov.co/Documents/Lineamientos-politica-publica-equidad-de-genero.pdf

17.

Megías

J. L.

Romero-Sánchez

Durán

Moya

Bohner

(2011). Spanish validation of the Acceptance of Modern Myths About Sexual Aggression scale (AMMSA). The Spanish Journal of Psychology, 14, 912-925. doi: 10.5209/rev_SJOP.2011.v14.n2.37

18.

Navarro-Mantas

Velásquez

M. J.

de Lemus

Megías

J. L.

(2018). Prevalence and sociodemographic predictors of intimate partner violence against women in El Salvador. Journal of Interpersonal Violence. Advance online publication. doi:10.1177/0886260518779065

19.

Navarro-Mantas

Velásquez

M. J.

López-Megías

. (2015). Violencia contra las mujeres en El Salvador. Estudio Poblacional 2014 [Violence against women in El Salvador. Population Study 2014]. El Salvador: Tecnoimpresos. Editorial Universidad Tecnológica.

20.

Pachón

C. X.

(1987). Los paeces. Introducción a la Colombia Amerindia [The paeces. Introduction to the Amerindian Colombia]. Bogotá, Colombia: Instituto Colombiano de Antropología.

21.

Strauss

M. A.

(1979). Measuring intrafamily conflict and violence: The Conflict Tactics Scales. Journal of Marriage and the Family, 41, 75-88. doi: 10.2307/351733

22.

United Nations. (1995). Plataforma de Acción de Beijing y la violencia contra las mujeres [Beijing Platform for Action and violence against women]. Retrieved from http://www.un.org/womenwatch/daw/beijing/fwcwn.html

23.

Urrea

(2016). Informe final: Consultoría para el mapeo de las variables sobre raza y etnicidad en las estadísticas de seguridad ciudadana en Colombia [Final report: Consultation for mapping race and ethnicity citizen security statistics in Colombia]. Washington, DC: Inter-American Development Bank, and Brussels: Coopération Internationale pour le Développement et la Solidarité.

24.

Urrea-Giraldo

Bermúdez

R. E.

Lucero-Posso

Canaval

G. E.

(2017). Estudio sobre salud y experiencia de vida de las mujeres en el municipio de Toribío, Cauca. Informe Final del Proyecto [Study on women’s health and life experience in the Toribío municipality, Cauca. Final Project Report]. Unpublished document.

25.

Velázquez

(2003). Violencias cotidianas, violencia de género. Escuchar, comprender, ayudar [Daily violence, gender violence. To listen, to understand, to help]. Buenos Aires, Argentina: Paidós.

26.

Vitonás

(2015). Cabildo de la Familia y aproximaciones a las relaciones de género en el territorio Nasa Toribío, Norte del Cauca [Family cabildos and approaches to gender relationships in the Toribío Nasa territory, North Cauca] (Master’s thesis). Santiago de Cali, Colombia: Universidad del Valle, Facultad de Humanidades, Programa de Trabajo Social.

27.

Word Health Organization. (1996). Violence against women, WHO Consultation (FRH/FHD/96.27). Geneva, Switzerland: Author.

28.

Word Health Organization. (2001). Putting women first: Ethical and safety recommendations for research on domestic violence against women (WHO/FCH/GWH/01.1). Geneva, Switzerland: Author.

29.

Word Health Organization. (2005). WHO multi-country study on women’s health and domestic violence against women: Initial results on prevalence, health outcomes and women’s responses. Geneva, Switzerland: Author.

30.

World Health Organization. (2003). WHO multi-country study on women’s health and life experiences. Core questionnaire, Version 10. Geneva, Switzerland: Author.

31.

World Value Survey. (2014). World values survey: Round Six, country-pooled datafile, 2010-2014. Retrieved from http://www.worldvaluessurvey.org/WVSDocumentationWV6.jsp