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Geographical Locations - Ecuador
Categories
Country Information
- (Statistical) Number of Inhabitants per Doctor: 980
- CIA - World Factbook : Ecuador
Organisations and Networks
UN and Multinational
Government
Non-Government
Academic Institutions
National Policy and Related Documents
Reports, Guidelines, and Projects
- Advanced Life Support in Obstetrics in Ecuador: Teaching the Teachers
The advanced life support in obstetrics (ALSO) course is designed to help maternity care providers prepare for obstetrical emergencies. A team of 12 US physicians and a medical interpreter recently taught the ALSO course in Ecuador, with the goal of addressing Ecuador’s high maternal and infant mortality rates. To have a greater impact, a teach-the-teacher model was used so that Ecuadorian physicians can now hold their own ALSO courses. In the process of implementing the courses, valuable lessons were learned which can be applied to future ALSO courses in developing countries and in the United States. [publication abstract] [J Am Board Fam Pract 2004; 17: 276–82]
- Assessing the context of health care utilization in Ecuador: A spatial and multilevel analysis
Background: There are few studies that have analyzed the context of health care utilization, particularly in Latin America. This study examines the context of utilization of health services in Ecuador; focusing on the relationship between provision of services and use of both preventive and curative services. Methods: This study is cross-sectional and analyzes data from the 2004 National Demographic and Maternal & Child Health dataset. Provider variables come from the Ecuadorian System of Social Indicators (SIISE). Global Moran’s I statistic is used to assess spatial autocorrelation of the provider variables. Multilevel modeling is used for the simultaneous analysis of provision of services at the province-level with use of services at the individual level. Results: Spatial analysis indicates no significant differences in the density of health care providers among Ecuadorian provinces. After adjusting for various predisposing, enabling, need factors and interaction terms, density of public practice health personnel was positively associated with use of preventive care, particularly among rural households. On the other hand, density of private practice physicians was positively associated with use of curative care, particularly among urban households. Conclusions: There are significant public/private, urban/rural gaps in provision of services in Ecuador; which in turn affect people’s use of services. It is necessary to strengthen the public health care delivery system (which includes addressing distribution of health workers) and national health information systems. These efforts could improve access to health care, and inform the civil society and policymakers on the advances of health care reform. [author abstract] [BMC Health Services Research 2010, 10: 64]
- Baseline Assessments of Essential Obstetric Care: Bolivia, Ecuador, and Honduras
In an attempt to address high maternal mortality and morbidity in Latin America and the Caribbean, the United States Agency for International Development (USAID) began the Latin America and Caribbean Regional Initiative to Reduce Maternal Mortality (LAMM) in 1996. Recognizing that existing USAID-supported programs already address family planning, prenatal care, and clean delivery strategies to reduce maternal mortality, LAMM targets essential obstetric care at the first level of referral facilities. Bolivia, Ecuador, and Honduras were sites for the development and pilot testing of essential obstetric care (EOC) interventions. Under LAMM, the Quality Assurance Project (QAP) is responsible for supporting process redesign and quality improvement teams as they address weak components in the EOC system. QAP conducted a baseline assessment of the quality of care and compliance with EOC standards at the facility level in a selected area of each country in 1998. The QAP LAMM team developed a set of 21 indicators to measure quality of care and how each system was functioning. Data on the indicators were collected through the review of patient medical records and other facility records, structured observation of deliveries, and a questionnaire completed by healthcare professionals. The assessments indicate that adequate infrastructure to provide EOC exists in all three study areas. However, deficits were documented in the capacity of these facilities to deliver quality EOC services. Inadequate supplies and equipment, lack of trained personnel, and failure to comply with quality standards all limit the functional access to EOC. The assessments also suggest that low utilization of the study facilities is an important barrier to the delivery of EOC in all three countries. [extract from publication summary] [Technical Report Summary 1(3), U.S. Agency for International Development (USAID) by the Quality Assurance Project (QAP), 2001]
- Correlates of condom use in a sample of MSM in Ecuador
Background: In Ecuador, the prevalence of HIV in the general population is approximately 0.3%. However, up to 17% prevalence has been reported among specific groups of homosexual and bisexual men. The objective of this study is to explore correlates of condom use among men who have sex with men (MSM) across eight cities in Ecuador. Methods: A cross-sectional survey design was used. A questionnaire including variables on sexual behaviour, demographics, and socio-economic characteristics was distributed to a sample of MSM in eight Ecuadorian cities. Results: Information was obtained for 2,594 MSM across the eight cities. The largest subcategory of self-identification was active bisexuals (35%), followed by those who described themselves as "hombrados" (masculine gays, 22%). The mean age was 25 years, and the majority were unmarried (78%), with a median of 10 years of schooling (IQR 7 – 12). Regarding condom use, 55% of those interviewed had unprotected penetrative sex with each of their last three partners, and almost 25% had never used a condom. The most important correlates of condom use were single status, high life-skills rating, and high socio-economic status (RP 5.45, 95% CI 4.26 – 6.37; RP 1.84, 95% CI 1.79 – 1.86, and RP 1.20, 95% CI 1.01 – 1.31, respectively). Conclusion: Our data illustrate the urgent need for targeted HIV-prevention programs for MSM populations in Ecuador. MSM have the highest HIV prevalence in the country, and condom use is extremely low. It is imperative that prevention strategies be re-evaluated and re-prioritized to more effectively respond to the Ecuadorian epidemic. [author abstract] [BMC Public Health 2006, 6: 152]
- DOTS strategy and community participation: an experience in the Ecuadorian Andes
Setting: The Chine community in Angamarca parish, Cotopaxi Province, in the Ecuadorian Andes. Objective: To relate the DOTS [Directly Observed Treatment, Short-course] strategy to the world view of the indigenous community in the diagnosis and treatment of smear-positive pulmonary tuberculosis (TB) patients. Design: Cross-sectional study involving all inhabitants of Chine. Results: Aspects of the community’s world view were considered in the community-based application of DOTS. A cure rate of 100% was attained, with 0% defaulting from treatment. Conclusion: The results obtained indicate that involving the world view of the community in the management of tuberculosis has several advantages. [publication summary] [Int J Tuberc Lung Dis, 13(12): 1569–1571, 2009]
- Epidemiology of Chagas Disease in Ecuador. A Brief Review
Chagas disease is a complex public health problem that has been underestimated in Ecuador. Here we review the relevant published information, and present unpublished and new data that help to understand the current Chagas disease epidemiological situation and its evolution in the country. Three main characteristics have been identified: (i) persistence of Trypanosoma cruzi transmission in already known foci; (ii) a marked endemicity in some urban areas of Guayaquil; and (iii) the transformation of new Amazon foci into truly endemic areas. The situation in other suspect areas remains uncertain. Five Triatominae species have been implicated in the transmission of T. cruzi to people in Ecuador (Triatoma dimidiata, Rhodnius ecuadoriensis, R. pictipes, R. robustus and Panstrongylus geniculatus), but some others may also play a role in some areas (P. rufotuberculatus, P. howardi, T. carrioni and P. chinai). Other Triatominae reported seem to have little or no epidemiological relevance (T. venosa, T. dispar, Eratyrus mucronatus, E. cuspidatus, P. lignarius and Cavernicola pilosa). High frequency of acute cases and severe chronic disease has been observed. Although cardiomyopathy is more frequent, serious digestive disease is also present. It is estimated that around 120,000-200,000 people may be infected. 2.2 to 3.8 million people are estimated to live under transmission risk conditions. [author abstract] [Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 94, Suppl. I: 387-393, 1999]
- Health in the Americas 2007: Ecuador
As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Ecuador addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Ecuador, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]
- Immunization campaigns and political agendas: Retrospective from Ecuador and El Salvador
Since the mid-1980s international donors have promoted vertical, campaign-based strategies to help improve immunization coverage in poor countries. National immunization days (NIDs) are currently in vogue and are prominent in the worldwide polio eradication efforts. In spite of their widespread use, campaigns that include NIDs have not been well evaluated for their effects on coverage, reduction in vaccine-preventable diseases, or effects on the health system. An assessment of the results of two such campaigns implemented in Ecuador and El Salvador shows limited impact on short-term coverage and questionable effects on long-term coverage and disease incidence. Although NIDs may have substantial short-term political benefits, the vertical approach can undermine provision of routine services by ministries of health and may be counterproductive in the long-term. [publication abstract] [International Journal of Health Services, Volume 33, Number 1: 113 – 128, 2003]
- Incidence of Childhood Leukemia and Oil Exploitation in the Amazon Basin of Ecuador
To determine whether there was any difference in childhood leukemia incidence rates between populations living in the proximity to oil fields and those living in areas free from oil exploitation in the Amazon basin of Ecuador, 91 cancer cases among children (0–14 years) from the provinces of Sucumbios, Orellana, Napo, and Pastaza during the period 1985–2000 were studied. The relative risks for all leukemias indicated significantly elevated levels in the youngest age group (0–4 years), both genders combined (RR 3.48, 95% CI 1.25–9.67), and in all age groups (0–14 years) combined for females (RR 2.60, 95% CI 1.11–6.08) and both genders combined (RR 2.56, 95% CI 1.35–4.86). There was no significant difference between the two groups in all other cancer sites combined. Study results are compatible with a relationship between childhood leukemia incidence and living in the proximity of oil fields in the Ecuadorian Amazon. [author abstract] [Int J Occup Environ Health, vol 10, no 3: 245-250, Jul/Sep 2004]
- Innovative intersector practices for health and equity: the case of Cotacachi Ecuador
"Since 10 August 1996, the municipality of Cotacachi (local government) has been building a new inclusive and transparent model for local development and participative democracy that promotes the exercise of the fundamental rights of its multiethnic population. The cantonal unity assembly (AUC), which is the chief participative body, established the Cotacachi intersector health council (1996) in conjunction with the local government, which is responsible for strengthening and institutionalizing the cantonal health system, allowing for the effective exercise of universal human rights and the collective right to health, well-being, and quality of life. Since its creation, the intersector health council (CIS) has been working actively; its role is to coordinate and lead the work with the health sector and other sectors and players such as education, environment, labour, environmental sanitation, community organizations, women’s and youth organizations and others, under the premise that health problems extend beyond curative care and welfare and that the health sector alone will never be able to respond to the problems related to the well-being of a population… This document will give a summary account of the start-up of the CIS, the processes implemented, the strategies, achievements, and difficulties, as a contribution to enable other localities to share the dream of being shapers of their own development." [WHO, August 2007]
- International collaboration to protect health workers from infectious diseases in Ecuador
The Healthy Hospital Project, an international collaboration, aimed to strengthen Ecuador’s capacity to promote healthier and safer hospitals by reducing occupational transmission of infectious diseases. Team members conducted a needs assessment to identify workplace hazards and health risks in three hospitals. A survey of health care workers’ knowledge and practices of occupational health (OH) and infection control (IC) revealed positive practices such as a medical waste disposal program and widespread dissemination of health information. Challenges identified included a high frequency of recapping needles and limited resources for workers to apply consistent IC measures. The survey revealed underreporting of needlestick injuries and limited OH and safety (OHS) training. Therefore, project collaborators organized a training workshop for health care workers that aimed to overcome the identified obstacles by integrating interdisciplinary local, national, and international stakeholders to build capacity and institutionalize work-related infection prevention and control measures. The knowledge transferred and experience gained led to useful hospital-based projects and serves as a basis for implementation of other OHS projects nationwide. International interdisciplinary, interinstitutional collaboration in OHS and IC can build capacity to address OHS concerns in health care. [publication synopsis] [Rev Panam Salud Publica. 2010; 27(5): 396–402]
- Microdistribution of Sylvatic Triatomine Populations in Central-Coastal Ecuador
Chagas disease is a serious public health problem in Ecuador, where nearly 230,000 individuals show Trypanosoma cruzi infection. Sylvatic T. cruzi transmission is a threat to current control strategies. This is because of the possibility of house reinfestation by sylvatic triatomines after insecticide treatment. This work quantiÞed the spatial distribution of triatomines in sylvatic habitats and its relationship with nearby human dwellings. A simple random sampling design using live-baited traps and manual searches for triatomines was used in areas near human communities in Manabí province, Ecuador, during June and July 2007. We identified risk factors associated with triatomine density using generalized linear models, and developed predictive maps for triatomine density interpolation. There were 345 triatomines belonging to the species Rhodnius ecuadoriensis and Panstrongylus howardi collected in sylvatic areas. Spatial analyses revealed an aggregated distribution pattern of the sylvatic triatomine populations (clustered mostly at a distance smaller than 100 m). Generalized linear models showed that the distance from the nearest house, nest type, and height from ground level were the main factors explaining triatomine densities. Squirrel nests (Sciurus stramineus), located in plants other than palms, above 5 m and close to the domicile presented higher infestation. Interpolation maps of triatomine microdistribution are presented as potential tools to predict triatomine occurrence. The presence of sylvatic populations and the synanthropic tendency of the vectors highlight the need for continuous active and passive entomological surveillance for the long-term control of Chagas disease. [author abstract] [Journal of Medical Entomology, Vol. 47, no. 1, pp.80-88, January 2010]
- Nutritional Failure in Ecuador: Causes, Consequences, and Solutions
"The central argument of this study is that the causes of nutritional failure in Ecuador are not immutable, but are the product of policy failure. The primary health and nutrition sectors are poorly articulated and prone to politicization, and they pay little attention to the measurement of outcomes. Ecuador can achieve its goal of reducing stunting to 12 percent by 2015 if it adopts an aggressive strategy to target the relevant populations with the right interventions. The strategy will need a strong accountability framework with clear goals, which holds the relevant agencies to account based on transparent standards for service production and quality. Given the structural roots of the problem, the strategy will need to extend to other sectors, such as water and sanitation and education. However, its focus should be in the primary health and nutrition sectors." [A World Bank Country Study 38689, The World Bank, Washington DC, 2007]
- Oil exploitation in the Amazon basin of Ecuador: a public health emergency
"Since the beginning of oil exploitation [in the Amazon basin of Ecuador], foreign oil companies and Petroecuador have extracted more than two billion barrels of crude oil from the Ecuadorian Amazon. However, in this development process, billions of gallons (1 gallon = 3.7853 liters) of untreated wastes, gas, and crude oil have been released into the environment. This paper examines the environmental and health impacts brought about by the oil development process in the Amazon region of Ecuador." [Rev Panam Salud Publica/Pan Am J Public Health 15(3): 205-211, 2004]
- The Framework Convention on Tobacco Control (FCTC) and the adoption of domestic tobacco control policies: the Ecuadorian experience
Background: The present work concerns the adoption of domestic tobacco control legislation in Ecuador after ratification of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC). Methods: Analysis of legislation, and data collection via interviews with key actors involved in the adoption and implementation of domestic legislation passed purportedly to implement the FCTC and research of the Ecuadorian Congressional Archives. Results: While the FCTC helped raise awareness about tobacco’s imminent and future threats to public health, paradoxically, it had the effect of further entrenching tobacco-friendly norms. Philip Morris, with 87% dominance over the Ecuadorian tobacco market, subtly harnessed the FCTC to protect its interests. This outcome was also influenced by poor governmental readiness and intervention, lack of legislative technical capabilities and weak civil society involvement. Conclusions: The Ecuadorian experience suggests that more support should be provided to health ministries, legislatures and local tobacco control organisations to offset the power of the tobacco industry as developing nations get ready to adopt domestic tobacco control legislation. [author abstract] [Tobacco Control 2009; 18: 18–21]
- Unintended Pregnancy and Low Birthweight in Ecuador
Objectives: This study assessed the relationship between unintended pregnancy and infant birthweight in Ecuador, differentiating between unwanted and mistimed pregnancies. Methods: Analyses focused on a subsample of women (n=2490) interviewed in the 1994 Ecuador Demographic and Maternal–Child Health Survey. Logistic regression was used to assess the relationship between pregnancy intention status and low birthweight after control for other factors. Results: Infants from unwanted pregnancies were more likely than infants from planned pregnancies to have low birthweight (odds ratio=1.64, 95% confidence interval=1.22, 2.20). Mistimed pregnancy was not associated with low birthweight. Conclusions: Unwanted pregnancy, but not mistimed pregnancy, is associated with low birthweight in Ecuador. Further research is needed to understand the mechanism through which pregnancy intention status affects birthweight. [author abstract] [Am J Public Health. 2001; 91: 808–810]
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