Advancing maternal and child health and nutrition in Ecuador: a call for research

Maternal and child health and nutrition (MCHN) remain critical public health priorities across Latin America. Poor MCHN is linked to higher child mortality, impaired cognitive development, increased risk of chronic diseases, adverse maternal outcomes, and significant economic and social costs. Despite some important regional improvements in the past decades, many countries in the region still bear stagnant or worsening scenarios for malnutrition indicators and unequal access to prenatal care.

Ecuador is among the countries in the Americas that need to improve MCHN to achieve Global Nutrition Targets proposed by the WHO/UNICEF. Approximately 23% of Ecuadorian children under five experience stunting, contrasting to 1.6% in Chile and nearly double the regional average of 11%.^1,2 Those rates are markedly higher in the Central Highlands and Amazon regions and approach ∼40% among Indigenous children.³ 20% of children under two suffer from chronic malnutrition in Ecuador, and 11.2% of infants are of low weight at birth.¹ Data on exclusive breastfeeding from Ecuador is incomplete but suggests only 39.6% of infants aged 0–5 months are exclusively breastfed.¹ Over 90% of Ecuadorian pregnant women typically receive at least four antenatal care visits, as defined in older WHO guidelines, but quality and equity gaps persist. Data from 2012 showed that Indigenous women in Ecuador have a lower prevalence of antenatal care, skilled birth attendance, institutional delivery, and modern contraceptive use compared with the majority population,⁴ reflecting long-standing structural disadvantages tied to geography, ethnicity, and poverty.

Accelerating progress in MCHN is, therefore, intrinsically associated with addressing geographical and ethnic inequalities. Rural residence, low maternal education, and poverty amplify disparities, while food insecurity and fragile food systems further undermine maternal diets and child feeding practices. These intersections highlight the need for equity-grounded research that centeres populations experiencing the greatest disadvantage, interrogates structural barriers, disaggregates data by ethnicity and geography and produces guidance to integrated interventions addressing nutrition, health care quality, and social and political determinants of health.

As a trusted voice for the region, The Lancet Regional Health – Americas is committed to publishing the highest-quality research to inform evidence-based decisions. In this context, we are pleased to support the Scientific Research in Maternal and Child Health and Nutrition project,⁵ an initiative of the Ecuador Crece Contigo Foundation, which aims to generate and disseminate robust evidence on MCHN in Ecuador. We encourage Ecuadorian researchers working on projects supported by this initiative to submit their work to the journal. It is important to emphasise, however, that while we recognise the importance of the Ecuador Crece Contigo Foundation's research initiative, as an independent scientific journal, we are not involved in any of their funding decisions; decisions made by their grant holders to write and submit papers to the journal; along with any other aspects of the Foundation's operational activities. Authors may submit their manuscripts to the journal for consideration, subject to the journal's standard editorial processes, which include editorial evaluation and external peer review. Acceptance for publication will be based solely on scientific merit and will be an independent editorial decision by the journal's editorial team.

While this Comment focuses on Ecuador, MCHN is a regional challenge. We hope our public support for the work of the Ecuador Crece Contigo Foundation will foster greater collaboration across Latin America and the Caribbean, driving innovation, shared learning, and the generation of new evidence to inform policies and programmes that improve maternal, child, and newborn health across the continent.

Declaration of interests

TV and OW are editors of The Lancet Regional Health – Americas.