CFAs: Strengthening Maternal and Child Health in Guayas and Chimborazo (Ecuador)

UNICEF has launched a Call for Expression of Interest to strengthen maternal, newborn, child health, and nutrition services in Guayas and Chimborazo, Ecuador. The initiative will improve healthcare quality, support ESAMYN standards, strengthen HIV prevention services, promote breastfeeding, and improve care during the first 1,000 days of life.

The programme seeks an implementing partner to provide technical assistance, health worker training, community engagement, and support for sustainable maternal and child health networks.

Overview of the UNICEF Maternal and Child Health Initiative

The United Nations Children’s Fund (UNICEF) has launched a Call for Expression of Interest to identify an implementing partner that can strengthen maternal and child health and nutrition networks in Ecuador.

The initiative focuses on improving healthcare services in:

• Guayas Province
• Chimborazo Province

The programme aims to improve health outcomes for mothers, newborns, infants, and young children through stronger health systems, better-quality care, and community participation.

A major focus area is the first 1,000 days of life, which covers pregnancy through a child’s first two years. This period is critical for nutrition, brain development, disease prevention, and long-term health.

Key Areas of Focus

The programme will support several priority health areas, including:

Maternal and Newborn Health

Activities will focus on:

• Improving prenatal care access and continuity
• Strengthening institutional childbirth services
• Supporting emergency obstetric care
• Improving newborn healthcare practices
• Enhancing counselling for mothers and caregivers

Child Nutrition and Early Development

The initiative will promote:

• Prevention of child malnutrition
• Exclusive breastfeeding
• Improved infant and young child feeding practices
• Early childhood development support
• Family counselling during the first 1,000 days

HIV and Infection Prevention

The programme will strengthen prevention of mother-to-child transmission of infections, including:

• HIV
• Syphilis
• Chagas disease
• Hepatitis B

Health facilities will receive support to improve screening, prevention, treatment pathways, and counselling services.

WASH and Environmental Health

The initiative includes support for hygiene and environmental health through the WASH-FIT strategy.

Key areas include:

• Safe water access
• Sanitation improvement
• Hygiene practices
• Infection prevention measures in healthcare facilities

Why This Programme Matters

Maternal and child health remains a major priority in Ecuador due to ongoing challenges affecting vulnerable populations.

Key concerns include:

• Maternal and infant mortality
• Child malnutrition
• Adolescent pregnancy
• Gaps in prenatal care
• Limited access to quality healthcare
• Early childhood development challenges

The COVID-19 pandemic increased these challenges by disrupting:

• Prenatal consultations
• Facility-based childbirth support
• Parenting counselling
• Child development services

This initiative aims to rebuild stronger and more resilient healthcare systems.

Geographic Focus Areas

Guayas Province

Guayas faces challenges related to:

• High population density
• Urban security concerns
• Barriers to healthcare access

The programme will strengthen services in Guayaquil through improved health facility capacity and community-based approaches.

Chimborazo Province

Chimborazo requires targeted approaches due to:

• Geographic barriers
• Rural access challenges
• Intercultural healthcare needs

The programme will support health services in Riobamba and surrounding communities.

What Is ESAMYN?

ESAMYN stands for Ecuador’s standards for health facilities that support mothers and newborns.

The ESAMYN framework promotes:

• Quality maternal care
• Safe childbirth practices
• Newborn protection
• Breastfeeding promotion
• Respectful healthcare services
• Family involvement in care

UNICEF will support selected health facilities in preparing for ESAMYN accreditation and long-term sustainability.

Role of the Implementing Partner

The selected partner will provide technical assistance and capacity building to healthcare facilities and professionals.

Responsibilities include:

• Assessing health service gaps
• Developing improvement plans
• Supporting ESAMYN preparation
• Training healthcare workers
• Strengthening community health networks
• Improving quality-of-care systems

Expected Programme Activities

The implementing partner will conduct:

Health Facility Assessments

Assessments will review:

• Quality indicators
• Infrastructure conditions
• Healthcare processes
• Equipment requirements
• Patient safety systems
• Security considerations
• Cultural relevance of services

Development of Intervention Plans

Facilities will receive customized improvement plans focused on:

• Maternal health
• Newborn care
• Nutrition services
• Infection prevention
• WASH improvements
• Family counselling

Training and Technical Support

Health workers will receive training on:

• Maternal and neonatal healthcare
• Emergency obstetric care
• Continuous quality improvement
• Infection prevention
• HIV prevention
• Patient safety
• Breastfeeding counselling
• Child development support

ESAMYN Implementation and Health Facility Strengthening

The programme aims to strengthen hospitals and primary healthcare facilities through technical assistance plans.

At least 17 health facilities will be supported to prepare for external evaluation and ESAMYN certification.

The initiative will help facilities improve:

• Clinical quality standards
• Staff capacity
• Service delivery
• Family-centred care approaches

Community Participation and Health Networks

Community involvement is a key part of the programme.

The initiative will support:

Maternal and Neonatal Networks

These networks will improve:

• Communication between communities and health facilities
• Referral systems
• Continuity of maternal care

Breastfeeding Support Groups

These groups will encourage:

• Exclusive breastfeeding
• Parent education
• Infant nutrition support

Community Surveillance Systems

Local monitoring systems will help identify:

• Maternal health risks
• Child nutrition concerns
• Healthcare access barriers

Who Is Eligible to Participate?

The Call for Expression of Interest is intended for organizations with experience in health system strengthening and community-based programmes.

Potential partners may include:

• Non-governmental organizations
• Public health institutions
• Technical assistance organizations
• Civil society organizations with health expertise

Eligible organizations should have experience in:

• Maternal and child health
• Nutrition programmes
• Healthcare capacity building
• Community engagement
• Monitoring and evaluation

How the Programme Will Work

Step 1: Selection of Implementing Partner

UNICEF will assess organizations based on:

• Technical expertise
• Operational capacity
• Experience in health programmes
• Ability to work with communities and healthcare providers

Step 2: Facility Assessment

The selected partner will identify:

• Existing service gaps
• Training needs
• Infrastructure challenges
• Quality improvement priorities

Step 3: Implementation of Support Plans

The programme will provide:

• Technical assistance
• Healthcare worker training
• Facility improvement support
• Community engagement activities

Step 4: Long-Term Sustainability

The initiative will strengthen local systems through:

• Health worker capacity development
• Community ownership
• Sustainable management models
• Continued quality improvement

Common Challenges and Implementation Tips

Common Challenges

The programme may need to address:

• Difficult access to remote communities
• Cultural differences in healthcare practices
• Limited healthcare resources
• Urban security risks
• Staffing capacity gaps

Best Practices

Successful implementation requires:

• Community participation
• Culturally appropriate approaches
• Strong coordination with health authorities
• Regular training and supervision
• Data-based decision-making

Frequently Asked Questions (FAQ)

What is the UNICEF Call for Expression of Interest about?

It is an opportunity for qualified organizations to partner with UNICEF to strengthen maternal, newborn, child health, and nutrition services in Ecuador.

Which provinces are included in the programme?

The programme focuses on Guayas and Chimborazo provinces, including Guayaquil and Riobamba.

What are the first 1,000 days of life?

The first 1,000 days refer to pregnancy through a child’s first two years, a critical period for nutrition, development, and health.

What does ESAMYN mean?

ESAMYN refers to Ecuador’s standards for health facilities that promote safe maternal care, newborn protection, breastfeeding, and quality healthcare.

How many health facilities will be supported?

The initiative aims to prepare at least 17 health facilities for ESAMYN evaluation and certification.

What health topics are covered?

The programme covers:

• Maternal health
• Newborn care
• Nutrition
• HIV prevention
• Infection control
• WASH and hygiene
• Child development support

Can programme activities change during emergencies?

Yes. The cooperation agreement includes a contingency clause allowing UNICEF and its partner to adapt activities and activate resources during emergency situations.

Conclusion

UNICEF’s maternal and child health initiative in Ecuador aims to improve healthcare quality and reduce inequalities affecting mothers, newborns, and children.

By strengthening ESAMYN standards, improving health services, supporting nutrition, expanding community participation, and building healthcare capacity, the programme will create stronger and more sustainable maternal and child health systems in Guayas and Chimborazo.