The Power of Community: Volunteers keep watch over children’s immunization
Maria Ortencia Catucuago is one of 500 volunteers helping to promote the health of families in communities in Ecuador.
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After a morning of tending her dairy farm and delivering milk, María Ortencia Catucuago switches gears: She puts on a vest and backpack and begins her daily rounds to neighborhood homes in her role as a community health volunteer.
“I feel passionate about helping others,” Catucuago said. “For many years, I have been involved in community activities that promote the well-being and health of families.” Catucuago cares for Turucucho community, which is nestled in the foothills of the northeastern highlands of Ecuador.
She is part of a corps of indigenous members who volunteer to keep watch over the health and well-being of children under the age of 5 and pregnant women.
On a recent morning, Catucuago started rounds as a community health volunteer at the home of Fernanda Valdivieso and her two-year-old daughter, Aysel Yanez. Aysel was born premature and struggled with chronic malnutrition. The little girl had recently missed a diphtheria, tetanus, and pertussis (DTP) booster and a check-up on her weight and height.
“One of my responsibilities is reporting to health center colleagues so they can quickly respond,” Catucuago said. “I called the health personnel, then they came and gave her the vaccine she lacked.”
For Valdivieso, Catucuago’s visit provided a critical reminder. “Next time, I won’t forget her check-up,” Valdivieso said.
Catucuago’s volunteer work is part of a community health monitoring strategy in 137 communities of indigenous peoples and nationalities in the Imbabura and Pichincha Provinces and in the Monte Sinai part of Guayaquil, Ecuador’s largest city.
Operated in coordination with the Ministry of Public Health and UNICEF, the community health monitoring strategy was implemented to empower communities to actively prevent the spread of COVID-19. Since it was effective in the pandemic, the strategy was expanded to encourage routine immunization and keep track of the health of pregnant women and children under age 5.
Part of the aim of the community health monitoring strategy is to tackle chronic malnutrition, which affects four out of ten indigenous children under the age of 2. Essential to the effort to curb malnutrition are vaccines including pneumococcal and rotavirus. However, in 2020 and 2021, a vaccine shortage and low attendance at health centres led to a drop in coverage. In 2021, the rates of complete rotavirus vaccination in Ecuador was 60.5 per cent and 62.2 per cent for pneumococcus vaccination. Now that the vaccine shortage has ended, the health ministry aims to achieve coverage over 95 per cent.
The monitoring strategy has allowed the community to alert public health officials where there are difficulties with services, said Pacha Cabascango the technical coordinator of the Community-based Epidemiological Surveillance programme at the Ecuadorian Society for Public Health.
Volunteers such as Catucuago work with an average of 25 families in their communities. The corps of about 500 volunteers have reached about 8,200 children younger than 5 years since the programme began in 2020, and it is one of the country’s more successful models of community outreach, Cabascango said.
“Through their work, we have seen that families, especially the new generations, have less resistance to vaccination and recognize its importance in the health and development of children,” he said.
Catucuago was invited to become a community health volunteer at a community-wide meeting in 2020.
After a long day of visits, calls and conversations with neighbours in the community, Catucuago returns home to her farm. The work of helping Aysel get a check-up and her DTP vaccine brings her a great sense of purpose, she said.
“I want all the children in my community to grow up healthy, happy and with the same opportunities,” Catucuago said.
