Ecuadoran Amazon Indigenous Fertility Dynamics Revisited: Why Sizable Contraceptive Uptake has not Dampened High Fertility

In 2001, demographic data were collected from 36 communities, representing five indigenous populations residing in the Northern Ecuadoran Amazon. Results showed high fertility rates (TFR 7.6-8.3) and negligible use of modern contraception. Follow-up data collected in 2012 show continuing high fertility (TFR 7.1-7.5) despite desires to have fewer births and an appreciable increase in the use of modern contraception. This indicates a disconnect between reported use of modern contraception and observed fertility. Meanwhile, with fertility remaining very high while mortality continues to fall due to vaccination campaigns, the virtual disappearance of traditional tribal warfare and other factors, natural increase is rising, increasing pressures on the extraordinarily rich ecosystem. Thus, these fertility results, along with continuing in-migration to the Amazon from the outside, portend medium-term challenges. However, the long-term prospects for ecosystem protection would be better if contraceptive effectiveness could be improved. What are the prospects for such improvements?