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Ikiama Nukuri, which means “Women as Defenders of the Forest” in the Achuar language, is an intercultural community-based health program of Fundación Pachamama that incorporates transferable practices of indigenous birthing traditions and western midwifery. The program was co-founded in 2006 by Shuar leader and activist, Narcisa Mashienta and midwife, Margaret Love, in response to the Achuar women’s expressed desire to improve their own health. In 2020, Ikiama Nukuri expanded to work with women from the Shuar Nation of Ecuador.

The mission of Ikiama Nukuri is to build collective power among indigenous women and to amplify their voices in order to improve the maternal, infant, and reproductive health of indigenous nations of the Ecuadorian Amazon. To achieve these objectives, Ikiama Nukuri has trained a team of 63 Achuar women  and 18 Shuar women to serve as Community Health Workers (CHWs) in their own communities: completing prenatal visits, assisting childbirths, providing postpartum care and, when necessary, facilitating a connection to the public health system. Ikiama Nukuri has served more than 1,500 women between 2013 and 2021.


Ikiama Nukuri CHWs work with the indigenous nationalities Achuar and Shuar, located in the provinces of Morona-Santiago and Pastaza, Ecuador, where best estimates indicate that maternal and infant mortality rates are 3-4 times higher than Ecuador’s national ratio. The indigenous Achuar Nation of Ecuador (NAE) is made up of approximately 10,000 individuals who face significant health inequities in comparison with other population groups in Ecuador. Shuar CHWs work in the municipal parish of Macuma, made up of 8,000 Shuar inhabitants.

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Although the CHWs primary role is to provide services, an important part of their work is related to promoting, convening and mobilizing in favor of community health and the general well-being of women and children. To support this secondary role of the CHWs, Ikiama Nukuri hosts women’s advocacy workshops. Additionally, the program puts together Safe Birth Kits, which every woman served by a CHW receives. Birth Kits contain reusable sanitary pads, soap, underwear, diapers, a candle, a blanket, gloves, and a string to detach the umbilical cord.

For more information visit:  https://www.pachamama.org.ec/en/ikiama-nukuri
Co-Founder and Program Director: Narcisa Mashienta