During the 2024–2025 biennium, PAHO supported Ecuador in strengthening the intercultural health approach as a structural strategy to improve access, quality, and cultural relevance of maternal and neonatal care. In coordination with the Ministry of Public Health, PAHO provided guidance on strengthening the intercultural health approach to reduce maternal and neonatal mortality, consolidating a model of articulation between the national health system and traditional ancestral medicine.

PAHO contributed to generating evidence on coordination mechanisms between ancestral midwives and health services, formulating recommendations to strengthen the regulatory framework and intercultural governance. In addition, it supported the institutionalization of intercultural dialogue through the publication of the document Círculo de la Palabra, which adapts PAHO’s knowledge dialogue methodology to the national context.

Capacity building of health personnel and traditional midwives through more than 200 workshops nationwide, together with the delivery of 1300 safe childbirth kits in prioritized territories, strengthened community based childbirth care. Finally, an intercultural communication strategy was designed and implemented for Indigenous, Afro Ecuadorian, and Montubio territories, with materials produced in local languages, reinforcing community action and progress toward health for all.

These actions contribute to reducing cultural and geographic barriers, improving continuity of care, and strengthening trust in health services, with the potential to reduce avoidable maternal and neonatal deaths, particularly among populations in situations of vulnerability.

Photo caption: Intercultural workshop for ancestral midwives in the city of Cayambe, Ecuador

Credit: PAHO - Roberto Peñafiel