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Peer Reviewed

Title: Molecular identification of endocervical Chlamydia trachomatis infection among gestations at risk for preterm birth in Ecuador.
Author: Medina M; Moya W; Hidalgo L; Calle A; Teran E; Chedraui P
Source: Archives of Gynecology and Obstetrics. 2009 Jan;279(1):9-10.
Abstract: AIM AND METHOD: To identify Chlamydia trachomatis (CT) endocervical infection among gestations at risk for preterm birth by means of DNA amplification. RESULTS: One hundred fifty eight (n = 158) gestations of Guayaquil (63.3%) and Quito (36.7%) Ecuador, at risk for preterm birth: threatened preterm labor (TPL, 60.8%) and preterm premature rupture of membranes (PPROM, 39.2%) were recruited. CT infection was presented in 8.2% of cases (TPL: 10.4% and PPROM: 4.8%). No significant difference was observed in this frequency in regard to city or diagnosis. CONCLUSION: Although the causative role of CT infection for these antenatal complications cannot be completely ruled out, its presence may justify an antenatal routine screening program in order to provide appropriate therapy.
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | PREGNANT WOMEN | CHLAMYDIA | PREMATURE BIRTH | RISK FACTORS | ANTENATAL CARE | PREGNANCY OUTCOMES | Developing Countries | South America, Western | South America | Latin America | Americas | Population Characteristics | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Pregnancy | Reproduction | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care
Document Number: 341009

Title: AWARENESS Project. Ecuador country report, 2001-2007.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [13] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: CEMOPLAF (the Centro M�dico de Orientaci�n y Planificaci�n) wanted to include SDM in its services in an effort to address unmet need. A pilot study showed a strong potential for the SDM to address this need and demonstrated feasibility of service provision in clinics and in the community. It also showed that clients were able to use the SDM correctly with a single counseling session. The longterm follow-up of pilot study participants continuing with the SDM demonstrated that while the majority of discontinuation during the first quarter of year one was due to cycles out of range; discontinuation during the second and third year had more to do with birth spacing and other life circumstances. Based on these results, CEMOPLAF provided training and technical input to its close partner, the MOH, and executed a social marketing program that introduced the SDM into pharmacies with mass media support. A study of the social marketing approach, conducted with the Population Council, showed awareness of the SDM increased from 4% to 34%, intention to use increased from 27% to 32%, demand for the SDM increased five-fold in pharmacies and clinics in one month during the mass media campaign, and both clinic-based providers and pharmacists provided correct information. CEMOPLAF used research results to advocate successfully for integrating the SDM into MOH norms and training curricula. Currently, the SDM is available in all CEMOPLAF and 11 MOH clinics in 11 of 22 departments. A number of local NGOs have also adopted the SDM. By including the SDM in national norms and the maternity program, the MOH committed to expanding the SDM to all its clinics by purchasing materials in exchange for training and technical assistance from CEMOPLAF. (excerpt)
Language: English
Keywords:
ECUADOR | TECHNICAL REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | CONTRACEPTIVE METHOD ACCEPTABILITY | CONTRACEPTION CONTINUATION | INTEGRATED PROGRAMS | FAMILY PLANNING TRAINING | FAMILY PLANNING PROGRAMS | GOVERNMENT PROGRAMS | SOCIAL MARKETING | CLINICAL DISTRIBUTION | Developing Countries | South America, Western | South America | Latin America | Americas | Family Planning | Family Planning, Behavioral Methods | Contraceptive Usage | Contraception | Programs | Organization and Administration | Training Programs | Education | Marketing | Economic Factors | Distributional Activities | Program Activities
Document Number: 327620

Title: Long-term use of Standard Days method: Experience of operations research study participants.
Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project
Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. [22] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00)
Abstract: This long-term follow-up (LTFU) study sought to learn more about Standard Days Method� (SDM) use beyond the six or 12 month follow-up period of a series of 14 operations research (OR) studies in six countries. The LTFU study followed participants of OR studies in Benin, Ecuador, Honduras, and two sites in India for up to 24 additional months to determine long-term continuation and effectiveness patterns, reasons for discontinuation, and whether women use the SDM to achieve pregnancy if their fertility intentions change. The 1,183 participants represented wide variability in geographic location, service delivery mode, age, parity, education level and ever use of contraception. Significant loss to follow-up at the point of transition between the OR and LTFU studies and the retrospective nature of the LTFU questions were taken into consideration in data analysis. (excerpt)
Language: English
Keywords:
BENIN | ECUADOR | HONDURAS | INDIA | RESEARCH REPORT | FOLLOW-UP STUDIES | FAMILY PLANNING, BEHAVIORAL METHODS | CONTRACEPTIVE USE-EFFECTIVENESS | CONTRACEPTION CONTINUATION | PREGNANCY RATE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | South America, Western | South America | Latin America | Americas | Central America | Asia, Southern | Asia | Studies | Research Methodology | Family Planning | Contraceptive Effectiveness | Contraception | Contraceptive Usage | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population
Document Number: 327647

Title: The meaning and consequences of tuberculosis for an at-risk urban group in Ecuador.
Author: Armijos RX; Weigel MM; Qincha M; Ulloa B
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2008 Mar 31;23(3):188-197.
Abstract: The objective was to explore knowledge, beliefs, perceptions, and attitudes about tuberculosis (TB) in a high-risk group in Ecuador. This included signs and symptoms, causation, transmission, treatment, treatment adherence, impact on lifestyle and role functioning, and stigma. A convenience sample of 212 adults undergoing diagnostic TB testing at a public health facility in Quito, Ecuador, was recruited for the study. Data were collected from subjects during face-to-face interviews using a structured instrument containing closed and openended questions. Descriptive and bivariate statistics were used for quantitative analyses; content analysis was used to analyze qualitative data. Most subjects were familiar with TB and some of its characteristics and treatment aspects. However, many also held misconceptions or lacked key knowledge which could adversely affect early diagnosis and treatment and adherence to treatment, and thereby allow the disease to spread. Subject education was the single most important predictor of knowledge, beliefs, perceptions, and attitudes followed by gender, age, and prior disease experience. The subjects linked TB to multiple adverse health, economic, psychological, and social consequences, including stigma. Although none knew if they had TB when interviewed, many reported feeling stigmatized just by being tested. The subjects identified a strong need for formal educational opportunities to learn about TB prevention and control but had little access to these. The study findings highlight a need for enhanced population access to TB education. Health education and social marketing directed toward increasing TB knowledge and changing perceptions and attitudes could ultimately contribute to improved early diagnosis, treatment adherence, prevention, and decreased stigma. This could be accomplished providing that the public health infrastructure is adequate to meet demands. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | URBAN POPULATION | POPULATION AT RISK | TUBERCULOSIS | KNOWLEDGE | BELIEFS | PERCEPTION | ATTITUDES | SIGNS AND SYMPTOMS | TRANSMISSION | STIGMA | USER COMPLIANCE | PREVENTION AND CONTROL | PROMOTION | COMMUNICABLE DISEASES | Developing Countries | South America, Western | South America | Latin America | Americas | Population Characteristics | Demographic Factors | Population | Research Methodology | Infections | Diseases | Sociocultural Factors | Culture | Psychological Factors | Behavior | Social Problems | Marketing | Economic Factors
Document Number: 326162

Title: The violence against women campaigns in Latin America: new feminist alliances.
Author: Cole S; Phillips L
Source: Feminist Criminology. 2008 Apr;3(2):145-168.
Abstract: This article urges caution in reading the backlash against gender-sensitive policies as a global phenomenon. Drawing inspiration from Latin America, the authors consider how international agreements for nation-states to adopt measures to prevent violence against women have been taken up in proactive ways through the collaboration of international organizations, national governments, and expanding and evolving women's movements. The push for the development of democratic citizenship in Latin America has opened up possibilities for bringing awareness of violence against women to a public that is in the process of engaging with a range of social justice issues and collaborating on multiple fronts. The authors argue that strategic coalitions across difference have been central to the success of the efforts to combat violence against women. They show how new feminist alliances have not only helped denormalize and deprivatize gender violence but revitalized feminist issues as part of a broad front to build progressive societies. (author's)
Language: English
Keywords:
LATIN AMERICA | BRAZIL | ECUADOR | CRITIQUE | VIOLENCE AGAINST WOMEN | POLICY DEVELOPMENT | INTERNATIONAL COOPERATION | GOVERNMENT PROGRAMS | WOMEN'S EMPOWERMENT | WOMEN'S GROUPS | GENDER ISSUES | FEMINISM | SOCIAL CHANGE | SOCIAL MOBILIZATION | Americas | Developing Countries | South America, Eastern | South America | South America, Western | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Planning | Organization and Administration | Political Factors | Programs | Women's Status | Socioeconomic Factors | Economic Factors | Interest Groups
Document Number: 307972

Peer Reviewed

Title: Maternal recognition and health care-seeking behavior for acute respiratory infection in children in a rural Ecuadorian county.
Author: Luque JS; Whiteford LM; Tobin GA
Source: Maternal and Child Health Journal. 2008 May;12(3):287-297.
Abstract: The objectives were to identify the factors which determine timely health care-seeking behaviors for childhood ARIs. A semi-structured questionnaire was administered to a non-random purposive sample of 91 female caregivers (age 18-57 years), and was analyzed using SPSS. In addition, six focus group discussions with female caregivers and 25 in-depth interviews with members from the health care setting were conducted. The primary obstacles reported for timely health care-seeking among survey respondents were money for medicines (n = 29, 32%), transportation fares (n = 19, 21%), and restrictive hours of the health centers (n = 13, 14%). The median household salary reported was $100 per month. There was an overall lack of recognition of the biomedical signs and symptoms of serious lower respiratory infections independent of socioeconomic status. Based on the study findings, the following recommendations are offered: (1) public health campaigns need to better address appropriate home health care management of childhood health and illness to improve maternal health-seeking behavior for ARIs; (2) provincial health authorities need to adhere to regular hours of operation, expand clinic hours and increase staff; (3) health posts should establish better policies for disbursement of antibiotics and ensure that patients follow prescribed regimens; and (4) through partnerships with economic development organizations and the private sector, there will be increased employment opportunities. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | QUESTIONNAIRES | RURAL AREAS | CHILD | RESPIRATORY INFECTIONS | HEALTH | BEHAVIOR | TREATMENT | ANTIBIOTICS | SOCIOECONOMIC FACTORS | Developing Countries | South America, Western | South America | Latin America | Americas | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Infections | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Drugs | Economic Factors
Document Number: 326158

8.
Peer Reviewed

Title: Dose-response trial of prophylactic zinc supplements, with or without copper, in young Ecuadorian children at risk of zinc deficiency.
Author: Wuehler SE; Semp�rtegui F; Brown KH
Source: American Journal of Clinical Nutrition. 2008 Mar;87(3):723-733.
Abstract: Multiple studies have shown the benefits of zinc supplementation among young children in high-risk populations. However, the optimal dose and safe upper level of zinc have not been determined. The objectives of this study were to measure the effects of different doses of supplemental zinc on the plasma zinc concentration, morbidity, and growth of young children; to detect any adverse effects of 10 mg supplemental Zn on markers of copper or iron status; and to determine whether any adverse effects are alleviated by providing copper with zinc. This randomized, double-masked, community-based intervention trial was conducted in 631 Ecuadorian children who were 12-30 mo old at baseline and who had initial length-for-age z scores Less than -1.3. Children received 1 of 5 daily supplements for 6 mo: 3, 7, or 10 mg Zn as zinc sulfate, 10 mg Zn + 0.5 mg Cu as copper sulfate, or placebo. The change in plasma zinc concentration from baseline was positively related to the zinc dose (P less than 0.001). Zinc supplementation, including doses as low as 3 mg/d, reduced the incidence of diarrhea by 21-42% (P less than 0.01). There were no other significant group-wise differences. Zinc supplementation with a dose as low as 3 mg/d increased plasma zinc concentrations and reduced diarrhea incidence in the study population. There were no observed adverse effects of 10 mg Zn/d on indicators of copper or iron status. The current tolerable upper level of zinc recommended by the Institute of Medicine should be reassessed for young children. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | CASE CONTROL STUDIES | CHILDREN | ZINC | COPPER | FOOD SUPPLEMENTATION | DEFICIENCY DISEASES | ADMINISTRATION AND DOSAGE | GROWTH | Developing Countries | South America, Western | South America | Latin America | Americas | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Nutrition Disorders | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Child Development
Document Number: 325221

Title: Designing surveys of international migrants: The needle in the haystack, or finding the right haystack? A case study of Colombians in Ecuador. Extended abstract.
Author: Bilsborrow RE
Source: [Unpublished] 2007. Presented at the 2007 Annual Meeting of the Population Association of America, New York, New York, March 29-31, 2007. [8] p.
Abstract: A major methodological issue is how to collect the data, since international migrants are generally a very small proportion of the population in host countries, and more so if one focuses on recent migrants rather than lifetime migrants. It is clearly the former that is of interest for formulating policies. The proposed paper is concerned with the testing of methodologies developed for designing samples to select international migrants, based on the "rare elements" problem in the sampling literature, and the results of an empirical study in one developing country, which also incorporated the use of snowball sampling to attempt to locate the international migrants. Several significant problems were encountered in the data collection, which may have useful lessons for future surveys on international migration. (excerpt)
Language: English
Keywords:
ECUADOR | COLOMBIA | SUMMARY REPORT | SURVEY METHODOLOGY | CASE STUDIES | HOUSEHOLDS | MIGRANTS | REFUGEES | INTERNATIONAL MIGRATION | REMITTANCES | Developing Countries | South America, Western | South America | Latin America | Americas | South America, Northern | Surveys | Sampling Studies | Studies | Research Methodology | Family and Household | Sociocultural Factors | Migration | Population Dynamics | Demographic Factors | Population | Microeconomic Factors | Economic Factors
Document Number: 318540

10.

Title: Population, land use change, and changing fortunes of migrant settler households in the Ecuadorian Amazon.
Author: Bilsborrow RE; Barbieri AF; Torres-Navarrete B
Source: [Unpublished] 2007. Presented at the Population Association of America 2007 Annual Meeting, New York, New York, March 29-31, 2007. 38 p.
Abstract: The Northern Ecuadorian Amazon, the principal region of colonization of migrants in Ecuador since the 1970's, has been experiencing major changes in recent years, including a growing rapidly population, fragmentation of agricultural plots, changes in land use, and increased off-farm employment, all of which are affecting farm household incomes and well-being. This paper draws on research based on data from a longitudinal survey of migrant settlers gathered in 1990 and 2000 by the University of North Carolina and collaborators in Ecuador. Based on detailed data, we estimate farm household incomes, show the components of on-farm and off-farm incomes, and estimate Gini coefficients for both land distribution and household income. We consider factors responsible for changes in household income but do not estimate a formal model. The paper has sections on data collection, methodology for estimating household income, results, and implications for policy and further research. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | LONGITUDINAL STUDIES | DEMOGRAPHIC SURVEYS | MATHEMATICAL MODEL | POPULATION | IMMIGRANTS | HOUSEHOLDS | FAMILY DEMOGRAPHY | AGRICULTURE | LAND TENURE | LAND AND RESOURCE DEVELOPMENT | EMPLOYMENT | INCOME | Developing Countries | South America, Western | South America | Latin America | Americas | Studies | Research Methodology | Population Dynamics | Demographic Factors | Theoretical Models | Migrants | Migration | Family and Household | Sociocultural Factors | Family Research | Macroeconomic Factors | Economic Factors | Socioeconomic Factors | Rural Development
Document Number: 317829

11.

Title: Vacuum assisted delivery in Ecuador for prolonged second stage of labor: Maternal�neonatal outcome.
Author: Chang X; Chedraui P; Ross MG; Hidalgo L; Penafiel J
Source: Journal of Maternal-Fetal and Neonatal Medicine. 2007 May;20(5):381-384.
Abstract: In South America, and particularly Ecuador, cesarean section rates have risen markedly over the past five years. The associated increases in maternal morbidity and healthcare costs indicate the need for alternative strategies. Operative vaginal delivery is minimally utilized in Ecuador, as neither vacuum nor forceps have been available. As vacuum delivery was recently introduced to our clinical service, we sought to examine our initial experiences (i.e., maternal and neonatal outcome) with operative vaginal delivery for prolonged second stage of labor. Following an initial educational program at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador, vacuum extraction cups (Mityvac, Cooper Surgical) were offered to laboring women with term singleton gestations and cephalic presentations no higher than +3 station. Maternal and neonatal data were analyzed. During the study period, 100 vacuum applications were performed on laboring women complicated with prolonged second stage of labor. Mean maternal age was 23.8 +or- 6.4 years (range 14-41 years) with 57% of patients nulliparous. Left anterior and right posterior fetal positions were the most frequent (85% and 11%, respectively). Maternal complications included need for blood transfusion (1%), shoulder dystocia (1%) and perineal tears (first degree 6%, second degree 5%). Vaginal delivery was successful in 97% of cases. Among neonates, the average weight was 3149 +or- 410 g, with 10% neonates small for gestational age and 5% large for gestational age. Only 1% of infants presented an Apgar score < 7 at 5 min. There were no scalp lacerations, cephalohematomas, or subgaleal bleeds. In this initial observational study, vacuum extraction for prolonged second stage was safe and effective. We propose that the introduction of operative vaginal delivery to developing countries will mitigate rising cesarean section rates. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | DATA ANALYSIS | PREGNANT WOMEN | CHILDBIRTH | PREGNANCY COMPLICATIONS | BLOOD TRANSFUSION | ABORTION | CONTRACEPTIVE USE-EFFECTIVENESS | South America, Western | South America | Latin America | Americas | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Fertility Control, Postconception | Family Planning | Contraceptive Effectiveness | Contraception
Document Number: 319642 Notification

12.

Peer Reviewed

Title: Knowledge and practice of family planning and HIV-prevention behaviour among just delivered adolescents in Ecuador: The problem of adolescent pregnancies.
Author: Chedraui P; Van Ardenne R; Wendte JF; Quintero JC; Hidalgo L
Source: Archives of Gynecology and Obstetrics. 2007 Aug;276(2):139-144.
Abstract: Adolescents constitute a high risk population for the spreading of sexually transmitted diseases, among them HIV/AIDS. Knowledge regarding reproductive issues among them is a key point in order to establish appropriate prevention programs. The objective was to obtain information regarding the knowledge and practice related to family planning and HIV-prevention behaviour among adolescents of low income. Adolescents aged 19 or less delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed in the immediate postpartum period with a structured questionnaire designed for the purpose. During the study period, 357 pregnant adolescents were surveyed. Mean age was 17.2 plus and minus 1.4 years, 30.8% were aged 16 or less. Demographical and obstetrical history differences were found when comparing adolescents in relation to age and educational level. A high rate of mothers had unplanned pregnancies (63.3%) or did not know what family planning was (49.6%). Despite high knowledge of what a condom or an oral contraceptive was, few had used them in the past. The most frequently known family planning methods in this series, which was age dependent, were: oral contraceptives (90.2%), condoms (84.9%), parenteral (66.7%) and intrauterine devices (63.3%). The majority knew what HIV/AIDS infection was, the most important sources of knowledge being: television, high school source, and family or relatives. A high rate of adolescents had never had an HIV test performed in the past with one prior tested adolescent resulting in a positive result. There was a high rate of knowledge regarding the most frequent HIV transmission routes: sexual intercourse, contact with infected blood and vertical transmission. In this series, although condom use was the most known way for HIV protection, only 22.2% answered having intercourse protected with this method. In this adolescent series, older age was related to higher knowledge in family planning methods; in global despite finding a relatively high knowledge in family planning and HIV related issues, contraception use and HIV protection behaviour was low. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | ADOLESCENTS | LOW INCOME POPULATION | ADOLESCENT PREGNANCY | KNOWLEDGE | FAMILY PLANNING | CONTRACEPTIVE METHODS | SEXUALLY TRANSMITTED DISEASE PREVENTION | HIV PREVENTION | INFORMATION SOURCES | Developing Countries | South America, Western | South America | Latin America | Americas | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Reproductive Behavior | Fertility | Population Dynamics | Sociocultural Factors | Contraception | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | HIV Infections | Viral Diseases | Information
Document Number: 313691

13.
Peer Reviewed

Title: Menopausal symptoms and associated risk factors among postmenopausal women screened for the metabolic syndrome.
Author: Chedraui P; Hidalgo L; Chavez D; Morocho N; Alvarado M
Source: Archives of Gynecology and Obstetrics. 2007 Mar;275(3):161-168.
Abstract: Although the frequency of menopausal symptoms may vary according to the studied population, in general severe intensity has been related to lower quality of life. The objective was to assess the frequency of menopausal symptoms and involved risk factors in an Ecuadorian postmenopausal population. Postmenopausal women that participated in a metabolic syndrome screening program were interviewed with the Menopause-specific quality of life questionnaire (MENQOL) in order to determine the most frequently presenting menopausal symptoms and correlate these symptoms with socio-demographic data and the main results of the screening program. Three hundred and twenty-five postmenopausal women (n = 325) were surveyed with the MENQOL. Mean age of participants was 55.9 � 8.1 years (median: 54 years). The most frequently presenting symptoms were: hot flashes (53.3%), sweating (49.2%), poor memory (80.6%), feeling depressed (67.4%), aching in muscles and joints (84%), drying of their skin (85.5%), avoiding intimacy (76.2%) and change in their sexual desire (76.5%). Multivariate analysis determined that abdominal obesity was a significant risk factor for presenting hot flashes, depression and muscle and joint pain. High triglyceride levels were associated to higher rates of sweating and depression. While women with basal hyperglycemia were associated to dry skin and changes in sexual desire in a higher proportion, those who were older and with more years of menopause onset were related less frequently to vasomotor symptoms. Older age was also significantly associated in a higher rate to dry skin. In this postmenopausal Ecuadorian population, the frequency of menopausal symptoms, as assessed with the MENQOL, was found to be relatively similar to other Latin and non-Latin American populations and associated to age, hormonal status and related metabolic conditions. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | MIDDLE AGED ADULTS | WOMEN | MENOPAUSE | SIGNS AND SYMPTOMS | QUALITY OF LIFE | RISK FACTORS | METABOLIC EFFECTS | OBESITY | AGE FACTORS | Developing Countries | South America, Western | South America | Latin America | Americas | Research Methodology | Adults | Population Characteristics | Demographic Factors | Population | Reproduction | Diseases | Social Welfare | Economic Factors | Biology | Physiology | Body Weight
Document Number: 311993

14.

Title: Estrogen receptor alpha polymorphisms and fertility in populations with different reproductive patterns.
Author: Corbo RM; Ulizzi L; Piombo L; Martinez-Labarga C; De Stefano GF
Source: Molecular Human Reproduction. 2007 Aug;13(8):537-540.
Abstract: The estrogen receptor (ER) plays an important role in mediating estrogen action on target tissues. ER-alpha, the most abundant, is found in all human reproductive tissues and studies on alpha-ER knockout mice have highlighted its role in reproduction. ER-alpha gene (ESR1) polymorphisms have been associated with a variety of disorders including human infertility. In this study, we examined the association of ESR1 PvuII and XbaI polymorphisms with fertility in two populations with different reproductive patterns and precisely in a sample of healthy Italian men and women (n = 178) and in a sample of healthy African-Ecuadorian women (n = 57). ESR1 xx and ppxx genotypes among the Italian men were found to be associated with an above-median number of children (P = 0.01 and P = 0.004, respectively). ESR1 pp genotype among the Italian women showed a tendency to be associated with a lower number of abortions (P = 0.04), whereas ESR1 pp and ppxx genotypes among African-Ecuadorian women were associated with a higher number of children (P = 0.02 and P = 0.03, respectively). These results are consistent with previous observations indicating a role of ESR1 genotypes in human infertility and give insight into the complex interactions between genotypes and reproductive behaviours in human populations. (author's)
Language: English
Keywords:
ITALY | ECUADOR | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | WOMEN IN DEVELOPMENT | MEN | HORMONE RECEPTORS | ESTROGENS | CHROMOSOME ABNORMALITIES | INFERTILITY | ABORTION, SPONTANEOUS | FAMILY SIZE | Europe, Southern | Europe | Developed Countries | Developing Countries | South America, Western | South America | Latin America | Americas | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Economic Development | Economic Factors | Demographic Factors | Population | Membrane Proteins | Physiology | Biology | Hormones | Endocrine System | Neonatal Diseases and Abnormalities | Diseases | Reproduction | Pregnancy Complications | Family Characteristics | Family and Household | Sociocultural Factors
Document Number: 313705

15.

Title: [Manual on the humanization and cultural adaptation of delivery care] Manual para la humanizaci�n y adecuaci�n cultural de la atenci�n del parto.
Author: Gonzalez Guzman D
Source: Quito, Ecuador, Direcci�n Provincial de Salud de Tungurahua, 2007. 74 p.
Abstract: This manual facilitates a process to adapt delivery care to cultural expectations. It provides guidance for conducting a series of three workshops that bring together health care providers, traditional birth attendants, community leaders, and mothers to discuss cultural practices and preferences and to identify changes that can be made to facility-based delivery care to make institutional delivery more acceptable to expectant mothers. Through role-playing and discussion, participants learn how delivery care is provided at a hospital and by traditional midwives in the community. Those who would change facility-based delivery are allowed to make suggestions, while medical staff have opportunities to consider community preferences and explain to participants any evidence that controverts those preferences. Through the process, hospital staff and midwives come to understand and respect each other's practices.
Language: Spanish
Keywords:
ECUADOR | MANUAL | TRAINING PROGRAMS | WORKSHOPS | MATERNAL-CHILD HEALTH SERVICES | CHILDBIRTH | HEALTH FACILITIES | CULTURE | SOCIOCULTURAL FACTORS | INTERPERSONAL COMMUNICATION | COMMUNITY RELATIONS | South America, Western | South America | Latin America | Americas | Developing Countries | Education | Primary Health Care | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Communication | Group Processes | Social Behavior | Behavior
Document Number: 308798

16.

Title: Rural out-migration to alternative destinations in the southern Ecuadorian Andes: the roles of environmental assets and livelihood diversification. Draft.
Author: Gray CL
Source: [Unpublished] 2007. Presented at the 2007 Annual Meeting of the Population Association of America, New York, New York, March 29-31, 2007. 20 p.
Abstract: Out-migration from rural areas is a key driver of socio-environmental change in the developing world, but connections between this process and rural livelihoods have not been fully explored. Motivated by the literatures on environmental refugees and livelihood diversification, this paper addresses the influence of environmental assets and livelihood strategies on rural out-migration from the southern Ecuadorian Andes. The data originate from a multilevel longitudinal survey implemented in a key region of out-migration and environmental risk. I use a multinomial event history model to compare the effects of demographic and contextual factors and livelihood activities and assets on out-migration to local, rural, urban and international destinations. The results indicate that (1) drivers of out-migration differ substantially across migration streams, (2) origin-area livelihood diversification primarily increases internal migration but mostly decreases international migration, and (3) environmental assets have important influences on out-migration, but effects are not unidirectional as predicted by the literature on environmental refugees. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | DEMOGRAPHIC SURVEYS | LONGITUDINAL STUDIES | EVENT HISTORY ANALYSIS | MATHEMATICAL MODEL | MIGRANTS | REFUGEES | RURAL POPULATION | SOCIAL NETWORKS | MIGRATION | DEMOGRAPHIC FACTORS | ORIGIN | MICROECONOMIC FACTORS | Developing Countries | South America, Western | South America | Latin America | Americas | Population Dynamics | Population | Studies | Research Methodology | Demographic Analysis | Theoretical Models | Population Characteristics | Friends and Relatives | Family and Household | Sociocultural Factors | Economic Factors
Document Number: 318531

17.

Title: Sociodemographic and nutritional correlates of neurobehavioral development: A study of young children in a rural region of Ecuador.
Author: Handal AJ; Lozoff B; Breilh J; Harlow SD
Source: Revista Panamericana de Salud P�blica / Pan American Journal of Public Health. 2007 May;21(5):292-300.
Abstract: The objective was to identify and describe the sociodemographic and nutritional characteristics associated with neurobehavioral development among young children living in three communities in the northeastern Andean region of Cayambe-Tabacundo, Ecuador. Women in the study communities who had a child 3 to 61 months of age completed a questionnaire about maternal and child health and sociodemographic characteristics. The Ages and Stages Questionnaire (ASQ) was directly administered to 283 children by two trained interviewers. Growth measurements and a hemoglobin finger-prick blood test were obtained in 2003-2004. Prevalence of developmental delay was calculated, and associations between child development and maternal, child, and household characteristics were explored. High frequencies of developmental delay were observed. Children 3 to 23 months old displayed delay in gross motor skills (30.1%), and children 48 to 61 months old displayed delay in problem-solving skills (73.4%) and fine motor skills(28.1%). A high frequency of both anemia (60.4%) and stunting (53.4%) was observed for all age groups. Maternal educational level was positively associated with communication and problem-solving skills, and monthly household income was positively associated with communication, gross motor, and problem-solving skills. The results suggest a high prevalence of developmental delay and poor child health in this population. Child health status and the child's environment may contribute to developmental delay in this region of Ecuador, but sociodemographic factors affecting opportunities for stimulation may also play a role. Research is needed to identify what is causing high percentages of neurobehavioral developmental delay in this region of Ecuador. (author's)
Language: English
Keywords:
ECUADOR | RURAL AREAS | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CHILDREN | FAMILY AND HOUSEHOLD | SOCIOECONOMIC FACTORS | DEMOGRAPHIC FACTORS | CHILD DEVELOPMENT | NEUROLOGIC EFFECTS | CHILD NUTRITION | CHILD HEALTH | South America, Western | South America | Latin America | Americas | Developing Countries | Geographic Factors | Population | Research Methodology | Youth | Age Factors | Population Characteristics | Sociocultural Factors | Economic Factors | Biology | Physiology | Nutrition | Health
Document Number: 319196

18.
Title: The efficacy of cervical mediastinotomy in children.
Author: Hubertus J; Hirsch W; Burkhardt U; Korholz D; Reck CA
Source: Journal of Indian Association of Pediatric Surgeons. 2007 Jul-Sep;12(3):125-128.
Abstract: The objective was to report our experiences with surgical diagnostic procedures in patients with mediastinal pathologies. From 1995 to 2004, seven children with mediastinal pathology had seven surgical procedures for the purpose of histological tissue diagnosis. Of these seven patients, five were male and the average age was 11 years. Anterior mediastinotomy was performed in all patients. Tissue diagnosis was achieved in all cases, enabling a specific diagnosis. The diagnoses were lymphoblastic lymphoma (n = 1), Hodgkin disease (n = 1) and thymus hyperplasia (n = 5). There was no operation-related mortality although one patient required a postoperative blood transfusion. Anterior mediastinotomy is a safe surgical procedure, which can be performed quickly in children with a high diagnostic yield. (author's)
Language: English
Keywords:
GERMANY | ECUADOR | UNITED STATES OF AMERICA | CALIFORNIA | RESEARCH REPORT | CASE STUDIES | CHILD | HISTOLOGY | SURGERY | PULMONARY EFFECTS | Europe, Central | Europe | Developed Countries | Developing Countries | South America, Western | South America | Latin America | Americas | North America | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology
Document Number: 320866

19.

Peer Reviewed

Title: Prevalence of intestinal parasites in young Quichua children in the highlands of rural Ecuador.
Author: Jacobsen KH; Ribeiro PS; Quist BK; Rydbeck BV
Source: Journal of Health, Population and Nutrition. 2007 Dec;25(4):399-405.
Abstract: The prevalence of intestinal parasites in young Quichua children was assessed in 20 rural communities in the highlands of Ecuador in August 2005. The caregivers of 293 children aged 12-60 months were interviewed about the status of child health, household socioeconomic and environmental factors, and water-use practices and were requested to collect a faecal sample from the study child. Two hundred three (69.3%) of the 293 children provided faecal samples that were tested for parasites. The overall prevalences of infection for specific agents were Entamoeba histolytica or dispar 57.1%, Ascaris lumbricoides 35.5%, Entamoeba coli 34.0%, Giardia intestinalis (lamblia) 21.1%, Hymenolepis nana 11.3%, Cryptosporidium parvum 8.9%, Chilomastix mesnili 1.7%, Hymenolepis diminuta 1.0%, Strongyloides stercoralis 0.7%, and Trichuris trichiura 0.5%. The prevalence of parasites increased with age. Water storage, water treatment, consistent latrine-use, and participation in a community-based clean water project were not strongly associated with the prevalence of intestinal parasites, although having dirt floors was a risk factor for infection with E. histolytica or dispar and G. intestinalis. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | EPIDEMIOLOGY | RURAL AREAS | CHILD | CHILD HEALTH | PARASITIC DISEASES | GASTROINTESTINAL EFFECTS | RISK FACTORS | WATER QUALITY | WATER SUPPLY | HYGIENE | SANITATION | WASTE MANAGEMENT | Developing Countries | South America, Western | South America | Latin America | Americas | Public Health | Health | Geographic Factors | Population | Youth | Age Factors | Population Characteristics | Demographic Factors | Diseases | Physiology | Biology | Water | Natural Resources | Environment
Document Number: 323851

20.

Title: Perceptions and attitudes toward the menopause among middle aged women from Guayaquil, Ecuador.
Author: Leon P; Chedraui P; Hidalgo L; Ortiz F
Source: Maturitas. 2007 Jul 20;57(3):233-238.
Abstract: Studies reporting the perspective of Latin American women, Ecuador, included, regarding the menopausal phenomena are scarce or lacking. The objectives were to obtain information regarding the perception and attitudes toward the menopause among middle aged women of Guayaquil, Ecuador. Women aged 40 or more, nursing staff members of two major associated teaching hospitals of the Universidad Catolica de Santiago de Guayaquil, Ecuador, were surveyed with a structured questionnaire containing items intended to assess women's perception and attitudes toward the menopause. Secondarily level of information related to the menopause was explored. During the study period, 349 women were surveyed of which mean age was 48 plus or minus 6.8 years. A 41.3% were postmenopausal, 55% premenopausal and 3.7% had a history of hysterectomy with conserved ovaries. Women more frequently perceived the menopause as a positive event as they agreed that it is a normal (93.7%) and important event (73.6%), that it gives more confidence and maturity (78.8%), that they may fully enjoy sexual relations (74.8%), that there is a relief as the risk of becoming pregnant is null (65.3%) and that life becomes easier and calmer (60.7%). A relatively high rate demonstrated a preoccupying attitude toward the menopause as 79.4% responded to be concerned about it indicating that seeking medical attention was important, moreover, 77.9% responded that health during this phase be taken care of and life styles changed. Less than 50% of surveyed women considered having enough information regarding the menopause whereas a high rate indicated wanting to receive educational sessions related to the menopause. Married and lower educated women were not concerned about the menopause in a higher rate than their counterparts. Despite the fact that women perceived the menopause as a positive event, displaying a concerned attitude toward it, their related knowledge was low. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | QUESTIONNAIRES | WOMEN | ADULTS | MENOPAUSE | PERCEPTION | ATTITUDES | KNOWLEDGE | Developing Countries | South America, Western | South America | Latin America | Americas | Demographic Factors | Population | Age Factors | Population Characteristics | Reproduction | Psychological Factors | Behavior | Sociocultural Factors
Document Number: 313621

21.

Peer Reviewed

Title: An experimental study and a randomized, double-blind, placebo- controlled clinical trial to evaluate the antisecretory activity of Lactobacillus acidophilus strain LB against nonrotavirus diarrhea.
Author: Lievin-Le Moal V; Sarrazin-Davila LE; Servin AL
Source: Pediatrics. 2007 Oct;120(4):e795-e803.
Abstract: Previous studies have shown that selected strains of Lactobacillus have the capacity to antagonize rotavirus-induced diarrhea. However, only a few reports have documented their efficacy against nonrotavirus diarrhea. This study involved an experimental investigation and a clinical trial of the antisecretory activity of Lactobacillus acidophilus strain LB in the context of nonrotavirus diarrhea. The activity of a culture of L acidophilus LB or of the lyophilized, heat-killed L acidophilus LB bacteria plus their spent culture medium was tested in inhibiting the formation of fluid-formed domes in cultured human intestinal Caco-2/TC7 cell monolayers infected with diarrheagenic, diffusely adhering Afa/Dr Escherichia coli C1845 bacteria. A randomized, double-blind, placebo-controlled clinical trial of male or female children who were 10 months of age and presented with nonrotavirus, well-established diarrhea was conducted to evaluate the therapeutic efficacy of a pharmaceutical preparation that contains10 billion heat-killed L acidophilus LB plus 160 mg of spent culture medium. Infection of the cells with C1845 bacteria that were treated with L acidophilus LB culture or the lyophilized, heat-killed L acidophilus LB bacteria plus their culture medium produced a dosage-dependent decrease in the number of fluid-formed domes as compared with cells that were infected with untreated C1845 bacteria. The clinical results show that in selected and controlled homogeneous groups of children with well-established, nonrotavirus diarrhea, adding lyophilized, heat-killed L acidophilus LB bacteria plus their culture medium to a solution of oral rehydration solution shortened by 1 day the recovery time (ie, the time until the first normal stool was passed) as compared with children who received placebo oral rehydration solution. Heat-killed L acidophilus LB plus its culture medium antagonizes the C1845-induced increase in paracellular permeability in intestinal Caco-2/TC7 cells and produces a clinically significant benefitin the management of children with nonrotavirus, well-established diarrhea. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | CLINICAL TRIALS | INFANT | DIARRHEA | ROTAVIRUS | TREATMENT | BACTERIAL AND FUNGAL DISEASES | ORAL REHYDRATION | Developing Countries | South America, Western | South America | Latin America | Americas | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections
Document Number: 321226

22.

Title: Does money matter? The effects of cash transfers on child health and development in rural Ecuador.
Author: Paxson C; Schady N
Source: Washington, D.C., World Bank, 2007 May. 51 p. (Impact Evaluation Series No. 15World Bank Policy Research Working Paper No. 4226)
Abstract: This paper examines how a government-run cash transfer program targeted to poor mothers in rural Ecuador influenced the health and development of their children. This program is of particular interest because, unlike other transfer programs that have been implemented recently in Latin America, receipt of the cash transfers was not conditioned on specific parental actions, such as taking children to health clinics or sending them to school. This feature of the program makes it possible to assess whether conditionality is necessary for programs to have beneficial effects on children. Random assignment at the parish level is used to identify the program's effects. We find that the cash transfer program had positive effects on the physical, cognitive, and socio-emotional development of children, and the treatment effects were substantially larger for the poorer children than for less poor children. Among the poorest children in our sample, children whose mothers were eligible for transfers had outcomes that were on average more than 20 percent of a standard deviation higher than those for comparable children in the control group. Treatment effects are somewhat larger for girls and for children with more highly-educated mothers. We examine three mechanisms-better nutrition, greater use of health care, and better parenting-through which the transfers might influence child development. The program appeared to improve children's nutrition and increased the chance they were treated for helminth infections. However, children in the treatment group were not more likely to visit health clinics for growth monitoring, and the mental health and parenting of their mothers did not improve. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | EVALUATION | RURAL POPULATION | MOTHERS | LOW INCOME POPULATION | FUNDS | FINANCIAL ACTIVITIES | CHILD HEALTH | NUTRITION | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | PARENTING EDUCATION | MENTAL HEALTH | SOCIAL DEVELOPMENT | GOVERNMENT PROGRAMS | Developing Countries | South America, Western | South America | Latin America | Americas | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Health | Delivery of Health Care | Education | Programs | Organization and Administration
Document Number: 318641

23.

Title: Population growth and land use intensification in a subsistence-based indigenous community in the Amazon.
Author: Siren AH
Source: Human Ecology. 2007 Dec;35(6):669-680.
Abstract: Shifting cultivation practiced by indigenous peoples living at low population densities in tropical forests has often been described as sustainable and compatible with conservation. However, shifting cultivation at increasing population densities has historically been, and still is, a main cause of deforestation worldwide. As many indigenous peoples in tropical forests currently experience rapid demographic growth, this raises the question to what extent their agricultural activities actually contribute to deforestation. This paper examines land use change in an indigenous community in the Ecuadorian Amazon which is only loosely connected to the market economy, and where agriculture is almost exclusively subsistence oriented. During the last seven decades, people have increasingly begun to clear fallows instead of old-growth forest to farm. Although the population was growing at an estimated 1.6% per year, the expansion of the area of land used for agriculture was only 0.4% per year, correspondingto an annual deforestation rate of only 0.015%. Whereas these changes may seem negligible in terms of deforestation, they do cause hardships to the local people, because of increasing walking distance to old-growth forest, and problems with weeds, pests, and decreasing soil productivity when farming after reclearing fallows. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | INDIGENOUS POPULATION | FORESTS | DEFORESTATION | POPULATION GROWTH | POPULATION PRESSURE | ENVIRONMENTAL DEGRADATION | AGRICULTURAL DEVELOPMENT | IMPACT | Developing Countries | South America, Western | South America | Latin America | Americas | Population Characteristics | Demographic Factors | Population | Natural Resources | Environment | Population Dynamics | Carrying Capacity | Rural Development | Economic Factors | Communication
Document Number: 322437

24.

Title: 'Bad mothers' and 'delinquent children': Unravelling anti-begging rhetoric in the Ecuadorian Andes.
Author: Swanson K
Source: Gender, Place, and Culture. 2007 Dec;14(6):703-720.
Abstract: In this paper I examine the rhetorics that circulate surrounding the lives of young indigenous women and children who beg on the streets of Quito, Ecuador. I focus particularly on rhetorics being produced and reproduced by urban planners, social workers, religious leaders and the media. Drawing on in-depth interviews, I reveal how these groups regularly imagine indigenous women and children in terms of child exploitation/child delinquency, false manipulation of public sympathies, ignorance, laziness and filth. Indigenous women and children are further understood as being fundamentally 'out of place' in the city. I unravel these rhetorics in order to draw attention to how begging is differentiated according to gender, race and age and to reveal how these rhetorics become inserted into exclusionary policies and practices. Moreover, and as a counterpoint to such rhetorics, I provide an alternative understanding of women's and children's involvement in begging by drawing upon the perspectives of indigenous women and children themselves. I argue that far from being passive victims, indigenous women and children work with and around oppressive conditions and mobilise them to their own advantage. (author's)
Language: English
Keywords:
ECUADOR | RESEARCH REPORT | INTERVIEWS | CASE STUDIES | WOMEN | CHILDREN | INDIGENOUS POPULATION | URBAN AREAS | RURAL-URBAN MIGRATION | POVERTY | LIVELIHOOD | SOCIAL PROBLEMS | STIGMA | KINSHIP NETWORKS | Developing Countries | South America, Western | South America | Latin America | Americas | Data Collection | Research Methodology | Studies | Demographic Factors | Population | Youth | Age Factors | Population Characteristics | Geographic Factors | Migration | Population Dynamics | Socioeconomic Factors | Economic Factors | Resources | Organization and Administration | Sociocultural Factors | Family and Household
Document Number: 313944

25.

Peer Reviewed

Title: Ecuador addresses cultural issues for pregnant women.
Author: Vivar SC
Source: Lancet. 2007 Oct 13;370(9595):1302.
Abstract: Last year, the founders of Intercultural Maternity-a private clinic in the Amazonian province of Sucumbios, Ecuador-faced a dilemma. They had found a donor for their much needed operating room but had no space for it. They had to choose between rejecting the money and adapting their delivery room to accommodate both. They chose the latter. Faced with criticism over their perceived choice of modern medical care over traditional models of care, Intercultural Maternity's president Darly Quinonez said: "There is no reason why we cannot have both: if our client needs an emergency operation, she can have one; if she wants to give birth according to her cultural needs and preferences, she can do so." This, like other initiatives in Ecuador, responds to a pressing need to consider cultural differences in a small but ethnically and culturally diverse country. Afro-Ecuadorians, several indigenous nationalities (mainly Kichwa, but also Cofan, Siona, and ten other nationalities), and non-indigenous people coexist in the equally varied geography of the highlands, coast, Galapagos, and Amazon region. (excerpt)
Language: English
Keywords:
ECUADOR | CRITIQUE | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | TRADITIONAL BIRTH ATTENDANTS | INDIGENOUS POPULATION | MIDWIVES AND MIDWIFERY | CULTURE | MATERNAL HEALTH SERVICES | TRADITIONAL HEALTH PRACTICES | PERFORMANCE IMPROVEMENT | Developing Countries | South America, Western | South America | Latin America | Americas | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Sociocultural Factors | Maternal-Child Health Services | Primary Health Care | Health Services | Management | Organization and Administration
Document Number: 321868

26.

Title: Nutritional failure in Ecuador: causes, consequences, and solutions.
Author: Walker I; Marini A; Lucchetti L; Waters W; Lastra A
Source: Washington, D.C., World Bank, 2007. [150] p. (World Bank Country Study)
Abstract: There is growing international awareness of the importance of early-childhood nutrition to development outcomes. Strong evidence shows that nutritional failure during pregnancy and in the first two years of life leads, ineluctably, to lower human capital endowments, negatively affecting physical strength and cognitive ability in adults. This feeds directly into the reduced earnings potential of individuals and damages national economic growth and competitiveness potential. Faced with this evidence, no country which seeks to be prosperous in the 21st century can afford to neglect the nutritional condition of its children. There is also abundant evidence that cost-effective options exist for improving nutritional outcomes. In a 2004 review by a panel of leading economists, 4 of the 13 top-ranked development interventions were directly related to malnutrition and hunger, and 6 others were linked to the related issues of primary health and sanitation. In this setting, the deleterious nutritional situation of Ecuador is a source of great concern. Ecuador forms part of a small group of Latin American countries which report persistently high rates of childhood nutritional deficiency. Like Peru and Guatemala, Ecuador has failed to convert its middle-income status into improved nutritional outcomes. In 2004, Ecuador had a chronic malnutrition (stunting) rate for children under age 5 of 23 percent (almost 300,000 stunted children) and an extreme stunting rate of 6 percent (77,000 extremely stunted children). Ecuador's stunting rate is similar to those reported by several Sub-Saharan countries (Botswana 23 percent, Ghana 26 percent, and South Africa 23 percent ). (excerpt)
Language: English
Keywords:
ECUADOR | PROGRESS REPORT | RECOMMENDATIONS | EPIDEMIOLOGIC METHODS | HEALTH SURVEYS | CHILDREN | POLICYMAKERS | MALNUTRITION | PREVALENCE | RISK BEHAVIOR | DISEASE PREVENTION | CHILD NUTRITION | HEALTH POLICY | PRIMARY HEALTH CARE | FOOD SUPPLEMENTATION | Developing Countries | South America, Western | South America | Latin America | Americas | Research Methodology | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Administrative Personnel | Organization and Administration | Nutrition Disorders | Diseases | Measurement | Behavior | Prevention and Control | Nutrition | Policy | Political Factors | Sociocultural Factors | Health Services | Delivery of Health Care | Nutrition Programs
Document Number: 318696

27.

Title: Anti-trafficking technical assistance: Ecuador anti-trafficking assessment, February 28 - March 15, 2006.
Author: Chemonics International
Source: [Quito], Ecuador, Chemonics International, 2006 Aug. [32] p. (USAID Contract No. GEW-I-00-02-00016-00USAID Development Experience Clearinghouse Doc ID / Order No. PN-ADH-204)
Abstract: In June 2005, Ecuador was ranked a Tier 3 country by the annual U.S. State Department Trafficking in Persons Report (TIP). The report declared that Ecuador is a country of origin, transit, and destination in human trafficking for the commercial sexual exploitation and forced labor of adults and children. In September 2005, as a result of the U.S. Government's national interests in sustaining political stability and economic development in Ecuador, the country received a waiver from sanctions aimed at countries classified as failing to comply with the minimum standards to combat human trafficking. Since the release of the 2005 TIP report, the Government of Ecuador has taken significant steps towards responding to its human trafficking problem. The Government of Ecuador has recently passed domestic legislation criminalizing trafficking in persons in its various forms of exploitation. Ecuador's civil society has stepped up efforts to fight trafficking through their involvement in nationwide awareness-raising campaigns and grassroots safe migration education, and by developing more targeted shelter services for trafficking victims. In addition to the recent efforts mentioned above, in 2004, the Government of Ecuador, by presidential decree, formed an inter-institutional committee , mandated with fighting trafficking in persons through a national action plan that is currently pending presidential approval. Several key government partners, such as the National Council on Children and Adolescents and the National Council on Women, are also working on action plans outlining their participation in fighting human trafficking. (excerpt)
Language: English
Keywords:
ECUADOR | SUMMARY REPORT | WOMEN | TECHNICAL ASSISTANCE | CHILD LABOR | LABOR FORCE | SEXUAL TRAFFICKING | SEXUAL EXPLOITATION | LITIGATION | CRIME | PREVENTION AND CONTROL | SOCIAL PROTECTION | Developing Countries | South America, Western | South America | Latin America | Americas | Demographic Factors | Population | Programs | Organization and Administration | Human Resources | Economic Factors | Social Problems | Sociocultural Factors | Behavior | Political Factors | Diseases
Document Number: 311535

28.

Title: Constructing a secure safety net for mothers and children through guaranteed access to basic health care. State of the practice brief.
Author: John Snow [JSI]. DELIVER
Source: Arlington, Virginia, JSI, DELIVER, 2006 Oct. [5] p. (Ecuador State of the Practice BriefUSAID Contract No. HRN-C-00-00-00010-00USAID Development Experience Clearinghouse DocID / Order No. PN-ADI-968)
Abstract: Ecuador, located in northwestern South America, has a population of 13 million and is growing each year by 1 percent. Ecuador dollarized its economy in the 2000's. In 2004, its gross national income (GNI) per capita was estimated at U.S.$3,768. In addition, about 37 percent of the population is living below the international poverty line of U.S.$2 a day. Ecuador has experienced a steady decrease in total fertility rate (TFR), from 5.4 children per woman in 1979 to 3.3 in 2004. Moreover, during the last two decades, Ecuador has more than doubled its contraceptive prevalence rate (CPR), from 34 percent in 1979 to 73 percent in 2004 for all methods, suggesting that Ecuadorian women have increasingly embraced the importance of planning their families. The method mix among women in union is 33 percent voluntary sterilization, 19 percent oral contraceptives, 14 percent IUDs, 8 percent injectables, 6 percent condoms, 18 percent traditional, and 2 percent other methods. The increase in CPR over the last few years has been solely due to growth in modern method use. Additionally, unlike several countries in the Latin American and Caribbean (LAC) region, unmet need remained low and even decreased slightly, from 6 percent in 1999 to 5 percent in 2004. (excerpt)
Language: English
Keywords:
ECUADOR | SUMMARY REPORT | WOMEN'S GROUPS | MOTHERS | CHILD | MATERNAL-CHILD HEALTH SERVICES | TOTAL FERTILITY RATE | CONTRACEPTIVE PREVALENCE | SAFETY | REPRODUCTIVE HEALTH | FAMILY PLANNING | NEEDS | FUNDS | PROGRAM ACCESSIBILITY | South America, Western | South America | Latin America | Americas | Developing Countries | Interest Groups | Political Factors | Sociocultural Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Fertility Rate | Birth Rate | Fertility Measurements | Fertility | Population Dynamics | Contraceptive Usage | Contraception | Public Health | Economic Factors | Financial Activities | Program Evaluation | Programs | Organization and Administration
Document Number: 318848

29.

Title: Comparison of two methods for determining provider attendance during normal labor and delivery: results from Benin, Ecuador, Jamaica, and Rwanda.
Author: Burkhalter B; Jennings L
Source: Bethesda, Maryland, University Research Company, Quality Assurance Project, 2006 Apr. [20] p. (Operations Research ResultsUSAID Development Experience Clearinghouse DocID / Order No: PN-ADF-971USAID Contract No. GPH-C-00-02-00004-00)
Abstract: The Quality Assurance Project (QAP) compared two data collection methods used to determine the number and type of providers who attended 245 obstetric cases in hospitals in Benin, Ecuador, Jamaica, and Rwanda. Each case was viewed as having four phases (labor, intrapartum, postpartum-mother, and postpartum-newborn) resulting in 980 possible phases, referred to as "phase-cases." In all, 801 phase-cases were observed and assessed using both data collection methods. In the first method, an observer recorded the names or identification number of all providers attending the case in a table on the first page of a pre-printed data collection form (the "Page 1 method"). In the second method, the same observer recorded the identity of the provider next to each required task on the form as the provider performed the task (the "Task-by-task method"). The form is appended to Burkhalter et al. (2006). This report discusses the number of providers recorded by each method and addresses the problem generated by the fact that the two methods resulted in identical lists of providers in only 46% of the 245 obstetric cases. To address this problem, we present an analysis that generates a best ("Combined") method from the two original methods (Page 1 and Task-by-task). The average number of providers recorded was 3.65 by the Task-by-task method, 3.44 recorded by the Page 1 method, and 4.02 when the data from both methods were combined. An estimated 2% of providers were not recorded by either method. Over all countries, the Task-by-task method missed fewer providers than the Page 1 method in the intrapartum (12% compared to 51%), postpartum-mother (27% compared to 38%), and postpartum-newborn phases (14% compared to 40%), but missed more providers in the labor phase (36%) than the Page 1 method (22%). Based on the Combined data, the labor phase had the highest average number of attending providers at 2.8; intrapartum had 1.8 attending providers, postpartum mother had 1.7, and postpartum-newborn had 1.6. The labor phase was also most likely to be attended by at least one skilled provider (doctor, nurse, or midwife): 96% of the time. This rate for intrapartum was 90%, for postpartum-mother 84%, and postpartum-newborn 79%. Among all attending teams and phases, 88% included at least one skilled provider. Skilled provider attendance varied by country, ranging from 73% to 99%. (author's)
Language: English
Keywords:
BENIN | ECUADOR | JAMAICA | RWANDA | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | PROVIDERS WITH CLIENTS | CHILDBIRTH | OBSTETRICS | QUALITY OF HEALTH CARE | MATERNAL HEALTH SERVICES | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | South America, Western | South America | Latin America | Americas | Caribbean | Africa, Central | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Health Services | Delivery of Health Care | Health | Pregnancy Outcomes | Pregnancy | Reproduction | Medicine | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Maternal-Child Health Services | Primary Health Care
Document Number: 305483

30.

Title: Quality of obstetric care observed in 14 hospitals in Benin, Ecuador, Jamaica, and Rwanda.
Author: Burkhalter B; Edson W; Harvey S; Boucar M; Djibrina S
Source: Bethesda, Maryland, University Research Company, Quality Assurance Project, 2006 Mar. [44] p. (Operations Research ResultsUSAID Development Experience Clearinghouse DocID / Order No: PN-ADF-970USAID Contract No. GPH-C-00-02-00004-00)
Abstract: Trained clinical observers used a structured checklist at referral and district/regional hospitals in four developing countries to monitor care provided to 245 women during labor, delivery, and postpartum and their newborns during postpartum. The countries were Benin, Ecuador, Jamaica, and Rwanda. Observation periods were either continuous and lasted 72 hours or noncontinuous and lasted 12 hours over 4--6 days; all such periods included a weekend day and night. Observers marked the checklist to record the times when healthcare providers performed certain tasks and whether each had been done according to standard. Certain circumstances--such as a woman giving birth before arrival--required rigorous data cleaning. The quality of care for the different tasks is reported here by country, by hospital type, and overall. The frequency of labor monitoring was well below the rates recommended in all four countries, regardless of hospital type. Fetal heart rate (FHR) was monitored the most frequently at 1.3 times per hour, although its recommended rate in all countries is twice an hour. Other labor