The internal disparities in Ecuador are tremendous. The infant mortality rate in rural areas is almost double the rate in urban areas and the fertility rate for women with no or little education is almost three times that of women with the highest level of education. Despite the fact that 69% of women give birth with the assistance of a skilled attendant and 65.8% of women in Ecuador use some method of contraception, maternal mortality rates remain high. Furthermore, the use of health care services is low, especially in rural and indigenous areas. Perceptions of health care providers as culturally insensitive prevent many indigenous women and their families from taking advantage of reproductive health care services, even when they are available at no cost.
Promoting safe motherhood with local and national partners
In the Andean Region, FCI works with national and local organizations and networks that ensure that woman and their families have access to high quality and culturally appropriate sexual and reproductive health services. Ecuador’s national Maternal and Child Health Law (Ley de Maternidad Gratutia y Atención a la Infancia) ensures that women have the right to free, public reproductive health servicee National Council of Women, the Ministry of Public Health, and a number of other partners in response to these challenges.
In 2007, FCI and the National Council of Women (CONAMY) created and published, “Ruta de Denuncia” (Route Complaint), a guide to guarantee the maternal and child rights that are outlined in the law. The two organizations also developed, “La Llave” (The Key), a comprehensive guide to strengthen the User Committees, to help raise awareness within communities about legal rights, and to provide the community with tools to monitor maternal health care services. Also, FCI recently completed a set of guidelines to explain the procedures for filing claims in the case that a woman’s right to quality health care has been violated. We are also leading a series of workshops with indigenous organizations, using these resources to foster the creation of User Committees in rural areas. All of these initiatives are part of our broader effort to increase vulnerable communities’ access to comprehensive and quality sexual and reproductive health services.
Increasing access to skilled care for indigenous people
It is important to understand why maternal health services in Ecuador remain severely underutilized. Research shows that maternal health services are culturally unacceptable to some women and their families, either because they feel they are not treated with respect or because services do not take into account cultural treats and values. In collaboration with the Ministry of Health, UNFPA, and the Quality Assurance Project (QAP), FCI is working on an initiative to address these barriers and make maternal health services more culturally appropriate. Our initiatives aim to increase indigenous women’s access to skilled care during childbirth by overcoming cultural barriers at health centers. Since 2003, QAP has been working with three district level hospitals in the Province of Tunguaruaga to improve the health care facilities and train providers on how to manage obstetric complications. To complement these efforts, project partners began leading a series of interactive workshops involving health workers, traditional birth attendants and users of the maternal health services and community members to generate recommendations about specific changes to remove barriers to care. Based on requests from the Ministry of Public Health and the Maternal Health Law Execution Unit (Unidad Ejecutora de la Ley), we hope to replicate this model in other provinces. The manual is available for download.
Prevention of violence against women in Pando and Sucumbíos
In Bolivia and Ecuador, FCI works with local partners to raise awareness about and develop strategies to address violence against women in indigenous communities. In Ecuador, FCI and AMNKISE have developed the flip chart El Camino al Buen Trato to inform and educate community’s promoters on how to manage and prevent situations of violence against women in the community of Sucumbios.
Photo credits: Joey O'Loughlin
For more information contact:
Veintimilla E10-50 y Av. 12 de Octubre
Edificio El Girón - Torre W - Piso 13 - Oficina 133
Tele/Fax: 593 (2) 2235 702
E-mail: fciecuador [@] fcimail [.] org
Family Care International
Latin America and Caribbean Program
588 Broadway, Suite 503
New York, NY 10012
Tel : (212) 941-5300
Fax: (212) 941-5563
E-mail: fcilac [@] fcimail [.] org