Ecuador and Peru: Lessons for fighting chronic malnutrition in children

Did you know that 700 new neural connections are generated every second in the first 24 months of life, precisely the period when major disparities tend to arise? 

Did you also know that for every dollar invested in early childhood, the rate of return is between four and nine dollars?

The responses to these questions are key for achieving change in any country, and it is something that Peru has come to understand. Its investment in its youngest citizens has produced impressive results: chronic malnutrition in children declined 14 percentage points over the past seven years to 13 percent in 2019, among the lowest in Latin America.

Peru’s progress was an incentive for four ministers of social issues in Ecuador to recently visit the country to find out how it was done and discuss how to address the problem of malnutrition  back home. The Peruvian Ministry of Development and Social Inclusion hosted the delegation with support from the World Bank, which facilitated the exchange and organized a three-day agenda of meetings, visits, and discussions.

Peru’s success was for many reasons, but I believe the three most important were political will, civil society commitment, and public policy coordination at all levels of government.

A number of tools were developed to put this inter-institutional coordination into practice. One was the creation of a permanently updated nominal register of children and pregnant women, which enables the individualized monitoring of nutritional status and the main interventions of the program and service. Another tool was the Performance Stimulation Fund (FED by its Spanish acronym), which provides incentives to encourage local governments to fight against chronic malnutrition. 

Ecuador can adopt several of these tools to reduce chronic malnutrition in children, a challenge in that country. 

A problem for both countries is how to implement strategies for the productive and labor inclusion of vulnerable families who receive cash transfers through state programs such as Juntos in Peru and BDH in Ecuador. Peru has also developed innovative programs like Haku Wiñay, which promotes the development of rural productive and entrepreneurial capacities. In Ecuador, the government has implemented the Human Development Credit program to encourage financial inclusion. The latter program still requires more evidence for learning, however.

The visit provided valuable lessons for both countries, and it also led to commitments to:

• Advance in the construction of a nominal register to enable individual monitoring to prevent chronic malnutrition;  
• Develop a pilot for a model of incentives to achieve results or improve performance; 
• Exchange innovative experiences and organize discussion sessions on economic and social inclusion.

We must make a commitment to learn from other countries and facilitate the exchange of experiences to combat the scourge of child chronic malnutrition and promote productive and labor inclusion in vulnerable households.