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Government begins preparing strategy to fight chronic childhood malnutrition in Ecuador

Published on June 21, 2021

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The authorities of the Social Front of the Government formed a commission to fight chronic child malnutrition (DCI) that held its first meeting on the morning of Friday, June 18th, at the Carondelet Palace, with the presence of President Guillermo Lasso and the counselor Luis Enrique Coloma.

In addition, the ministers of Economic and Social Inclusion, Mae Montaño; the Minister of Health, Ximena Garzón; the Minister of Education, María Brown; the Secretary General of the Public Administration and Cabinet, Iván Correa; the Secretary of Communication, Eduardo Bonilla; and, the Vice Minister of Economy and Finance, Luis Fierro.

Lasso said that the reduction of the DCI index in the country will be an objective that arises from the collaboration between the public and private sectors; the plan is aimed at children from gestation to two years of age.

“At the center of this table we will have the well-being of the children who are going to be born, of children up to two years of age, to whom we are going to dedicate all our effort to reduce the DCI index in the next four years, which it is one of the highest in the region. We have this interesting task that we are going to carry out with great optimism and great joy,” said the President at the beginning of the two-hour meeting.

At the end of the meeting, Coloma said that the President has indicated that this issue is a priority in his government and will lead the linking of the different State portfolios to have an effective plan for the fight against DCI.

“This, possibly, is the biggest problem that Ecuador currently has, but it is also the greatest opportunity that the country has to improve the living conditions of all, and I believe that it is not only an issue in which the central government should be involved. We have decentralized autonomous governments in the fight against DCI, especially during the first thousand days of life: 270 days of gestation and two years of age, it’s essential to take care of their young brains,” said Coloma.

According to Executive Decree 31, signed on May 24th, within a period of sixty days, this commission must present a proposal on the normative and institutional reforms that allow the execution of the National Early Childhood Strategy for the Prevention and Reduction of Malnutrition Children’s Chronicle: Ecuador Crece sin Malnutrición Infantil or Ecuador Grows Without Child Malnutrition (ECSDI).

Montaño said that the strategy involves provincial, municipal, and parochial sectional governments for a work that allows to act in an integral way in a problem that is multi-causal.

According to the National Health and Nutrition Survey, Ecuador has the second highest prevalence of chronic childhood malnutrition (DCI) in Latin America, with the rate of DCI in children under 2 years of age of 27.2% (2018), almost 3 out of 10 children, against 24.8% in 2014.

Coloma will take the strategic lead on Ecuador Grows Without Child Malnutrition

With more than 20 years of experience in strategic planning and leading projects, Coloma is the President’s advisor in the fight against malnutrition.

As a government advisor to President Guillermo Lasso, Coloma is taking on the challenge of leading the implementation of the strategy for the prevention and reduction of chronic childhood malnutrition.

He says that it is his greatest challenge, and he comes prepared with the knowledge he has gained in his 28 years of business experience leading negotiations with international groups and by the completion of his master’s degrees in innovation and strategic planning.

The 52-year-old Industrial Distribution engineer has until July 23rd to comply with the proposal on regulatory and institutional reforms that allow the execution of the strategy. And for this, he has already made inroads with various ministries.


You have the task of advising the president, how did your approach with the president arise?

I met President Guillermo Lasso when he was President of the Bank of Guayaquil and perhaps in a couple of other forums, later when he was a candidate. The designation (of advisor) is not because of a friendship with me, the President asked for recommendations from civil organizations that are supporting the fight against chronic childhood malnutrition, and he wanted someone who can help in the articulation, and he received my recommendation.


Your position is an ad honorem, and therefore you do not receive an economic remuneration, but do you have a fixed tenure or not?

This is an honorable position; I do not receive a salary and I believe that the challenge of chronic childhood malnutrition needs a lot of articulation. My role is as an advisor to the President, as a recommendation in terms of strategy, inter-institutional and intersectoral articulation, measuring reports of results achieved and being able to influence things to happen. I do not execute; I do not have an execution function and for that we have the Technical Secretariat Ecuador Grows without Child Malnutrition. And I will be (for the time) that is necessary and what the President considers, that is, I do not have a specific deadline.


In a little more than 20 days in office, what have you done?

We have collected relevant information from all the parties that are contributing to this fight, that is, from what has been done in the past, from the best regional and global practices on the fight against chronic child malnutrition. We have had conversations with the Ministry of Economic and Social Inclusion, the Ministry of Public Health, Education and Finance. We have developed a first general framework of the strategy with the main elements that it should contain, and we are organizing the strategic planning that would start next Monday in a working session with teams from all ministries, and also assistance from international cooperation, and entities of civil society.


On June 21, four days after completing a month in office, will you have meetings with the ministries?

It formally begins on Monday with the work sessions. We will be working with various ministerial delegates.


What will the connection be like with Erwin Ronquillo, current technical secretary of the Toda Una Vida Plan, but who will become technical secretary of Ecuador Grows without Child Malnutrition?

I will be in charge of the part of articulating the strategy, of advising the President on public policy. And who will be the executing arm implementing those actions, organizing what things will be the Secretariat. So, we will cooperate more closely with Secretary Erwin Ronquillo.


And in that cooperation with secretaries and ministers, are there ways to meet the President’s goal of eradicating chronic child malnutrition?

There are several practices, techniques based on scientific evidence to combat chronic childhood malnutrition that have been applied worldwide and in the region. In Ecuador there are some elements of public policy, some decrees, legal frameworks that already establish mechanisms to implement initiative programs to combat chronic child malnutrition, which have been developed based on the best international practices. We already have a political framework that tells us what the actions are. We now have to expand this to implement and establish the mechanisms in the territory.


The executive decree, with which he you are assigned to the position, stipulates a period of 60 days to comply with the proposal on normative and institutional reforms that allow the execution of the strategy. Do you think you can meet that requirement?

We have a 60-day deadline in the decree to present the strategic plan and we hope to complete it sooner.


Has a budget been analyzed at the moment to comply with the strategy?

We do not have a planned amount; studies are still being carried out to determine how much the strategy that is being mounted and those recommendations and the regulations that already exist in Ecuador, will cost. Timely, sufficient resources must be allocated for this fight and the Ministry of Economy and Finance plays an important role.


Among your advice, is a public-private partnership planned, seeking international support?

International cooperation is helping a lot in the establishment of programs and strategies. The resources of multilateral organizations are important.


You currently have your own office, what is your day to day like?

I am now moving through various places; I prefer to be in the territory. I will be meeting in various ministries and spending more time in the Technical Secretariat Ecuador Grows without Child Malnutrition, where I have to do more articulation, coordination.


And your visits to the territory, who finances them?

In the case of my trips to the territory, I am going to finance them, I do not want there to be a burden to the Government, unless there are official functions where the President wants me to accompany him, then there he may have to use capacities or public resources. But in the movements that I am making to fulfill my mission of advising the President, I will cover him with expenses on my side.

Ronquillo will implement the plans

Erwin Rafael Ronquillo Coellar was appointed as Technical Secretary of the Todo Una Vida Plan, but in the first few days in office, the 44-year-old economist became the Technical Secretary of Ecuador Grows Without Child Malnutrition (Ecuador Crece sin Malnutrición Infantil).

Ronquillo has 22 years of experience in the public and private sector and has carried out consulting and advisory activities in several countries such as Colombia, Brazil, Argentina and El Salvador.


On June 7th, President Guillermo Lasso appointed you, through Executive Decree No. 60, as Technical Secretary of the Todo Una Vida Plan, a name that was given to social projects and programs in the government of former President Lenín Moreno. How did your relationship with Lasso come about?

I share values with President Lasso, a vision of the world regarding economic and social issues. We have had the opportunity to work around their different campaigns. I participated in the government plan workshops that were held before the 2017 campaign. I was in the workshops where the government plan was developed.


The position appointed by the Executive is temporary, according to the Communication Secretary of the Presidency, Eduardo Bonilla, because you will become the Technical Secretary of Ecuador Crece sin Malnutrición Infantil. But what actions have you taken so far from your current position?

Currently, the Technical Secretariat of the Todo Una Vida Plan was created to coordinate and articulate the social programs of the previous government. The task that has been entrusted to me is to transform this Secretariat by transferring the powers of social programs to each of the ministries that are already executing them.


What competencies?

The Las Manuelas program is currently being executed by the Ministry of Economic and Social Inclusion (MIES) and Las Manuelas, what they do is the work of approaching households to determine what the needs are of those who have people with disabilities, then this information is channeled to the respective ministries, especially the MIES, but it is not the only one and they make sure that this help arrives. That is the current work of the Secretariat. This competence is going to be transferred to the MIES so that the MIES is now the one who makes the visits and can meet the demands of the citizen.

Then, this Secretariat is going to transfer these powers to dedicate itself exclusively to the eradication and prevention of chronic child malnutrition.


With your new position as Technical Secretary, Ecuador Grows without Child Malnutrition, is there an armed work team?

What we are going to do in the coming weeks is to work with two teams, one for institutional transformation and a top-level team that will begin to work on the child malnutrition strategy.


Who will make it up?

In preparing the strategy, work will be done in conjunction with representatives of ministries, civil society and international cooperation.


Will you work jointly with other entities, such as, for example, with Mae Montaño, who chairs the MIES or Luis Enrique Coloma, ad honorem government advisor for public policies to combat child malnutrition?

In fact, counselor Coloma is the President’s delegate to coordinate all this joint action between the Government and civil society. Within the structure that has been envisaged, once the transformation process is completed, the Secretariat will be under the counselor or the counselor will be a point of contact with the President and with other ministries.


Is it to say that your management is going to be analyzed by Coloma and he in turn transmits it to the Executive?

Correct. It is a joint work with the counselor. It is not a separate or independent job. And likewise with ministries of the social sector.


Is there a roadmap or actions taken in your next work on child malnutrition?

We have already had the first contacts with Minister Montaño, the Miduvi, with the Ministry of Health. We have already made the first contacts and we have found absolute openness. The President’s vision is that the fight to eradicate chronic child malnutrition is a State policy, not just that of this government.


According to a report by the United Nations Economic Commission for Latin America (ECLAC), Ecuador ranks second in terms of chronic child malnutrition in children under 5 years of age in Latin America, behind Guatemala. Have you analyzed the panorama?

Currently, one out of every four children (under 2 years of age) in Ecuador suffers from chronic child malnutrition, according to 2018 data. Since that year a nationwide study has been carried out, but after the pandemic there is expert belief that Ecuador is going to be above 30%, that is, three out of every ten children. That is the challenge that we can not only get out of that situation as a country but that all those children who are suffering will be our focus in the coming years.


And how will they start?

It has been seen that the first battle against malnutrition is the home and a good nutrition culture. Unfortunately, access to food is not a guarantee of nutrition, we see that in the highest quintile of the country there is 15% of chronic child malnutrition, which is surprising because at that level there is no poverty, there is no lack of money, there is a lack of culture, then the first thing we must do is properly train and educate our mothers and fathers. The challenge is enormous because it is not only about delivering these foods but also changing the culture of citizens regarding nutrition.


And what means are going to be used?

At this moment we are beginning the transformation process of this Secretariat and the first thing we are going to do is by July 29th, which was the deadline that the president gave the counselor (Coloma) to present the strategy to prevent and eradicate the malnutrition. We are going to work together … to have a strategic plan that gives us the roadmap.


Is the budget being analyzed in that roadmap?

Once the plan is developed, we will submit the projects to the Planning Secretariat and the Ministry of Economy and have the resources.


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