Connecting Ecuador’s indigenous communities to health care through training in native languages

Rosalina Guamán, a member of the Kañari People of the Kichwa Nationality of Ecuador, helped develop a training curriculum for the Universidad Católica de Cuenca and Project HOPE.

An innovative training program is boosting the capacity of health workers to meet the needs of Ecuador’s indigenous people

In Ecuador, there are approximately two doctors for every 1,000 people. That makes community health workers a critical lifeline, particularly for geographically isolated indigenous communities who often have limited access to public health services.

Today, thanks to an innovative program designed by the Universidad Católica de Cuenca in partnership with Project HOPE, a global health and humanitarian assistance organization, hundreds of newly trained health workers are delivering accurate information about how to promote health and stop the spread of COVID-19 in the native languages of Kichwa and Shuar.

And this model holds promise for addressing health needs far beyond the pandemic.

“This project is crucial for the rural communities of my province of Cañar since it allows us to carry a clear message in our native language. This is one of the most critical aspects of the program,” said Rosalina Guamán, a student who worked on the curriculum and is a member of the Kañari People of the Kichwa Nationality of Ecuador.

As Ecuador became an early epicenter for the pandemic in South America, hospitals were overwhelmed with COVID-19 patients and fear of infection spread. Today, the country’s infection rates are spiking again, with nearly 6,000 new cases reported by the World Health Organization in one 24-hour period at the end of April.

The pandemic also disrupted the flow of health information, at a time when simple, clear information about mask wearing, social distancing, hand washing, and isolating those with symptoms could save lives. Universidad Católica de Cuenca and Project HOPE launched their virtual community health worker training program to fill this gap.

Based on the university’s positive experience with an online COVID-19 training developed in 2020 by Project HOPE and Brown University, the new community health worker program focuses on health promotion and disease prevention with an emphasis on stopping the spread of COVID-19.

All the training materials have been specifically produced for easy downloading and printing — key in areas with low internet bandwidth. And the training has a simultaneous audio translation feature so participants from indigenous communities can immediately receive the training in the native languages of Kichwa or Shuar, in addition to Spanish.

After completing the training, participants will form health brigades to educate at least 2,000 community leaders in a cascade approach. By working in direct collaboration with local leaders, they can help prevent the spread of COVID-19 while respecting languages, cultures, and traditions.

The health brigades could also address other health issues affecting these communities that existed before the pandemic and will be there when the pandemic is over. Ecuador’s community health outreach workers typically care for patients through educational talks, workshops, health fairs and home visits developing trusted relationships with the community and creating a critical linkage to existing health services. Beyond addressing hygiene and getting out good information about COVID-19, the health brigades hold the potential to help administer standard childhood vaccines, conduct prenatal consultations with mothers, and provide treatment for common ailments, much of which has been placed on hold during the pandemic lockdowns.

Carmen del Rocío Parra Pérez, a nursing graduate working on a master’s degree in health management for local development at the university, is one of the more than 800 participants enrolled in the program now. She feels an urgency to create more resilient communities.

“We must strengthen the first level of medical care to prevent more people from becoming infected and dying, and to prevent the high demands on the hospitals so they do not collapse,” she stressed. “With this platform, we will get to train more people, especially in more remote communities, to prevent disease and promote healthy lifestyles.”


Abby Henson, a senior director on Project HOPE’s Development and Communications team, was moved to share a story about Project HOPE’s work in Ecuador after learning about Protecting Global Gains. She felt the creative collaboration between Project HOPE and the Universidad Católica de Cuenca was uniquely innovative by simply taking a best practices approach: to reach more marginalized communities, translate materials into native languages and make them easily accessible. Protecting Global Gains amplifies important work in the field and reminds implementers that the solution to tackling new challenges might involve going back to the basics.

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Celena Unkuch, a student at the Universidad Católica de Cuenca, translated training materials into the Shuar language.

Rosalina Guamán, a member of the Kañari People of the Kichwa Nationality of Ecuador, helped develop a training curriculum for the Universidad Católica de Cuenca and Project HOPE.

Health workers participating in the training curriculum developed by the Universidad Católica de Cuenca and Project HOPE walk to the community.

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Read how Project HOPE is Addressing the Global Shortage of Health Care Workers and The Global Health Care Worker Shortage: 7 Numbers to Note to learn more.

The World Health Organization estimates we will need 80 million health workers by 2030 to meet the global population — a number we are currently on track to miss by 15 million. Learn why the WHO says health workers are vital for building resilient communities.

This health worker training program was funded by support from AstraZeneca. Learn more about their approach to improve access to health care and increase health equity.

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