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ECUADOR: All-Out Offensive Against Child Malnutrition

Gonzalo Ortiz

QUITO, Aug 12 2010 (IPS) - The Ecuadorean government aims over the next five years to eradicate chronic malnutrition among children under one — 10 percent of whom are now undernourished — and reduce the rate among children under five from the current 22 percent to seven percent.

“It is a huge challenge. The malnutrition rate among children under one was 12 percent in 2006, one of the highest rates in Latin America,” the minister of social development, Jeannette Sánchez, told foreign correspondents Wednesday.

The minister pointed out that malnutrition has repercussions on the cognitive development of children and their future possibilities of becoming economically productive citizens, and on the overall health of the population.

She also noted that “there is no precedent in Latin America of such a large reduction in malnutrition in such a short time.

“The most successful case was that of Chile, which cut the malnutrition rate from 11 to 1.6 percent in 10 years, followed by that of Mexico, where it fell 1.5 percent a year over the space of several years,” she added.

The vice minister of social development, Alexandra Lastra, told IPS that “the new target is more ambitious” than the one set in the national development plan presented in December, which was to “reduce chronic malnutrition among children under five by 45 percent by 2013.”

The new goal, which specifically targets “children under the age of one, means that we will have to halve the malnutrition rate every 12 months — an achievement that will become more and more difficult as we approach 2015,” she said.

Pablo Samaniego, an expert on social indicators, pointed out to IPS that the chronic malnutrition rate among children under five remained steady from 2004 to 2008, when it stood at 26 percent.

The Observatorio de los Derechos de la Infancia, a non-governmental group that advocates for children’s rights, reported in late July that 22 percent of the 1.4 million children under five in this South American country of 13.5 million people are malnourished.

In his message to the nation marking the first year of his second term Tuesday, leftwing President Rafael Correa stressed that the fight against malnutrition is a top priority of his government.

The five-hour speech delivered to Congress followed the style of his Saturday TV and radio broadcasts, complete with videos and electronic presentations.

Although the main emphasis was on economic and international questions, the president, a U.S.-trained economist who first took office in 2007 and was reelected under the new constitution in 2009, also mentioned the government’s social goals and significant social achievements.

The malnutrition rate is highest in the highlands provinces of Ecuador where most of the population is indigenous, like Chimborazo, Bolívar and Cotopaxi, where around 50 percent of children under five are chronically undernourished.

Social spending was raised from 7.6 percent of GDP in 2009 to 8.3 percent this year. Although that proportion is still considered low compared to other countries in the region, it represents a major increase from the annual average of 4.3 percent between 2000 and 2006, and from two percent in 1999.

The government strategy — the Integral Territorial Nutrition Intervention, whose acronym is INTI, which means “sun” in Quechua — is multi-sectoral, involving a focus on the most-affected areas and joint action by the national government, local and regional authorities, and civil society, Minister Sánchez explained.

“The INTI plan has a focus on prevention and puts a priority on families with children under one, from conception to their first birthday, but includes coverage for children up to five,” says the ministry of social development’s agenda of social issues published this week.

The strategy “was launched in 2009 in the three provinces mentioned, and has had visible results, such as a 12 percentage point reduction in anemia among children in the targeted populations. This year we are in a phase of expansion, and have incorporated the provinces of Imbabura, Cañar, Tungurahua and Manabí,” Lastra told IPS.

“We focus on all causes of the problem,” Sánchez said. “We are ensuring that the families in the top priority areas have access to basic services — clean water, sanitation, and housing — while we provide health and nutritional services.”

Access to water and sanitation is provided through programmes implemented by the local authorities and chiefly financed — 80 percent — by the central government.

On the nutritional front, supplements are made available through the rations provided by the Plan Aliméntate Ecuador (the Feed Yourself Ecuador Plan — a joint strategy carried out by several ministries), breastfeeding is encouraged, the height and weight of children are regularly charted in developmental checkups, and a greater emphasis has been put on ensuring regular checkups for pregnant and nursing women.

The strategy also includes improving access to education, and outreach training and technical assistance for peasant farmers, to help them grow and consume healthy food.

To that end, the Correa administration and local authorities encourage the participation of local communities and grassroots organisations, Sánchez said.

Health care is offered through the Seguro Social Campesino — the rural social security system — clinics, which according to the minister functioned patchily and poorly in the past, and by mobile health brigades sent out by the government.

The Observatorio de los Derechos de la Infancia, which keeps an “index on children’s rights”, gave the government a score of 6.5 on a scale of 1 to 10 in terms of compliance with the rights of children up to five, up from 5.1 in 2008. The previous government, led by Alfredo Palacio, was given a score of 4.6.

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