Strengthening the technical capacities of the teams in charge of comprehensive care for pregnant women and early childhood within the framework of the National Strategy 'Ecuador Grows Without Child Malnutrition'

Partnership
Project

Background

The relationship between the Ministry of Public Health of Ecuador, the Directorate-General of Health of Portugal and the Ministry of Social Development of Uruguay (MIDES) began with this partnership. However, there was already a history of cooperation between the countries.

Ecuador and Uruguay have maintained technical bilateral ties through their main cooperation institutions. In this regard, Ecuador's Ministry of Foreign Affairs and Human Mobility (MREMH) requested technical assistance from the Uruguayan International Cooperation Agency (AUCI) on early childhood and child malnutrition. The AUCI prioritised this theme since it is aligned with Uruguay's internationally recognised good practices and is managed by an institution, MIDES, that is capable of transferring and replicating its experiences.

On the other hand, the AUCI has been collaborating for several years with the Instituto Camões, which reflects the solid bilateral relationship between Uruguay and Portugal. Contact with the Ministry of Health has been established particularly through this cooperation opportunity. MIDES technicians identified similarities with the Portuguese experience, considering their technical assistance to support Ecuador in strengthening its strategy against child malnutrition to be very positive.

Entities and roles

Beneficiary entities

Ministerio de Salud Pública

Ecuador

First provider entities

Ministerio de Desarrollo Social

Uruguay

Second provider entities

Direção-Geral da Saúde / Dirección General de la Salud

Portugal

Development challenges

Early childhood is a crucial period for the training of individuals working in this field and the development of countries. From very early on in life, genetics interact with environmental conditions, as well as the quality of relationships and children's experiences in the home, health care, childcare and school. Problems in adulthood often take root at this stage, highlighting the importance of maternal and child well-being for ethical, psychosocial and economic reasons. Allocating resources to comprehensive early childhood programmes is thus a strategic and high-return investment for governments.

Malnutrition is a public health issue and a challenge for Ecuador. It is shaped by social determinants associated with poverty and inequality gaps, including exclusion and discrimination based on gender or ethnicity, lack of schooling among mothers, unplanned teenage pregnancy, inadequate child-rearing practices, and limited access to basic and health services, among others.

In the case of Uruguay, early childhood is a political priority. Uruguay Crece Contigo (Uruguay Grows with You) aims to develop and implement universal actions that guarantee the development and appropriate protection of pregnant women and families throughout the country. On the other hand, it seeks to accompany the trajectories of families in vulnerable situations, through targeted strategies and promoting access to social protection services through inter-agency coordination.

Strengthen the technical capacities of the teams in charge of comprehensive care for pregnant women, as well as early childhood and inter-agency coordination in order to contribute to the Sustainable Development Goals.

Triangular approach

The initiative is an opportunity for Uruguay to take on the role of First provider, transferring its capacities to other countries under a bi-directional approach in order to promote joint learning. Through the 'Crece Contigo' Programme Area, Uruguay shares its experience with the Ministry of Public Health of Ecuador in policies and strategies for accompanying, identifying and monitoring pregnant women, children up to four years of age and their families.

Ecuador is positioned as the Beneficiary country, presenting the need for capacity building among the teams in charge of comprehensive care for pregnant women and early childhood, within the framework of its national strategy and public policy on child malnutrition. This cooperation project aims to improve: i) the early detection of pregnancies, promoting strategies to improve the quality of care and a closer approach; ii) out-of-hospital intervention and health promotion, from both an individual and community approach, with a focus on the most remote communities; and lastly, ii) the strategy to support breastfeeding.

On the other hand, the Portuguese Ministry of Health has the role of Second provider, providing technical support through its health programmes and policies for children. These include an approach that considers the social determinants of health, ensures monitoring of low-risk pregnancies, and has a national early intervention system in place.

Sectoral approach - Contribution to the 2030 Agenda

Primary SDG

Goal 2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.

Secondary SDG

Goal 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.

Goal 3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.

ADELANTE SDG

Goal 10.2 By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status

Goal 10.3 Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard

Goal 17.16 Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources, to support the achievement of the sustainable development goals in all countries, in particular developing countries

Goal 17.17 Encourage and promote effective public, public-private and civil society partnerships, building on the experience and resourcing strategies of partnerships

Territorial approach

Intervention methodology

Specific objectives:

O1. Identify and map the main aspects and interventions of Ecuador's comprehensive early childhood and maternal and childcare system, as well as its main weaknesses.
O2. Strengthen the technical capacities and skills of the Ministry of Public Health of Ecuador, specifically of the personnel involved in the early childhood level of care.
O3. Improve the maternal and childcare system as well as the information management system.

Results:

R1: A situational diagnosis of the technical and operational capacities and skills of primary health care personnel and health promotion in Ecuador has been carried out.
R2: Technical knowledge of early childhood digital interventions and synergies with 'classic' interventions has been strengthened.
R3: Technical staff at the first level of care affiliated with the promotion of maternal and child health services have been trained.
R4: Institutional capacities have been strengthened in the generation of information, knowledge management and guidance on the subject.

Cooperación Triangular

Download the "Diagnosis of the visit to Ecuador" (Spanish)

Dowload the booklet "Uruguay grows with you" (Spanish)

Download the document "Technological interventions in early childhood" (Spanish)

Direct beneficiaries (individuals)

All persons participating in the activities of the project.

The project activities will involve 23,341 direct beneficiaries, the majority of whom belong to the Partnership member entities. They are the operational and technical staff of public institutions working in the field of early childhood and, in particular, those in charge of the general management of the 'Ecuador Grows Without Child Malnutrition' strategy.

Budget

EU contribution: 145,221.00 €

Co-financing - Triangular Cooperation Partnership: 45,550.00 €

Total budget: 190,771.00 €

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