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Published in: Globalization and Health 1/2006

Open Access 01-12-2006 | Debate

Globalization and local response to epidemiological overlap in 21st century Ecuador

Author: William F Waters

Published in: Globalization and Health | Issue 1/2006

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Abstract

Background

Third World countries are confronted by a complex overlay of two sets of health problems. Traditional maladies, including communicable diseases, malnutrition, and environmental health hazards coexist with emerging health challenges, including cardiovascular disease, cancer, and increasing levels of obesity. Using Ecuador as an example, this paper proposes a conceptual framework for linking epidemiologic overlap to emerging social structures and processes at the national and global levels.

Discussion

Epidemiologic trends can be seen as part of broader processes related to globalization, but this does not imply that globalization is a monolithic force that inevitably and uniformly affects nations, communities, and households in the same manner. Rather, characteristics and forms of social organization at the subnational level can shape the way that globalization takes place. Thus, globalization has affected Ecuador in specific ways and is, at the same time, intimately related to the form in which the epidemiologic transition has transpired in that country.

Summary

Ecuador is among neither the poorest nor the wealthiest countries and its situation may illuminate trends in other parts of the world.
As in other countries, insertion into the global economy has not taken place in a vacuum; rather, Ecuador has experienced unprecedented social and demographic change in the past several decades, producing profound transformation in its social structure. Examples of local represent alternatives to centralized health systems that do not effectively address the complex overlay of traditional and emerging health problems.
Literature
1.
go back to reference Evers B, Juárez M: Understanding the links: globalization, health sector reform, gender and reproductive health. In Globalization Committee Reproductive Health Affinity Group. New York: Ford Foundation; 2001. Evers B, Juárez M: Understanding the links: globalization, health sector reform, gender and reproductive health. In Globalization Committee Reproductive Health Affinity Group. New York: Ford Foundation; 2001.
2.
go back to reference Omran AR: The Epidemiologic Transition in the Americas. Washington: Pan American Health Organization; 1996. Omran AR: The Epidemiologic Transition in the Americas. Washington: Pan American Health Organization; 1996.
3.
go back to reference Omran AR: The epidemiologic transition: a theory of the epidemiology of population change. Milbank Memorial Fund Quarterly 1971, 49: 509-538.CrossRefPubMed Omran AR: The epidemiologic transition: a theory of the epidemiology of population change. Milbank Memorial Fund Quarterly 1971, 49: 509-538.CrossRefPubMed
4.
go back to reference Omran AR: The epidemiologic transition theory revisited thirty years later. World Health Statistics Quarterly 1998, 51: 1-42. Omran AR: The epidemiologic transition theory revisited thirty years later. World Health Statistics Quarterly 1998, 51: 1-42.
5.
go back to reference Rapley J: Globalization and Inequality: Neoliberalism's Downward Spiral. Boulder, CO: Lynn Rienner; 2004. Rapley J: Globalization and Inequality: Neoliberalism's Downward Spiral. Boulder, CO: Lynn Rienner; 2004.
6.
go back to reference Carroll TF, Ed: Construyendo Capacidades Colectivas: Fortalecimiento Organizativo de las Federaciones Campesinas-Indígenas en la Sierra Ecuatoriana. Quito: Soka University of America/World Bank Group Danish Trust Fund/PRODEPINE/World Bank Fondo Sociedad Civil/Oxfam America/Heifer Internacional; 2000. Carroll TF, Ed: Construyendo Capacidades Colectivas: Fortalecimiento Organizativo de las Federaciones Campesinas-Indígenas en la Sierra Ecuatoriana. Quito: Soka University of America/World Bank Group Danish Trust Fund/PRODEPINE/World Bank Fondo Sociedad Civil/Oxfam America/Heifer Internacional; 2000.
7.
go back to reference Hentschel J, Waters WF: Rural poverty in Ecuador: assessing local realities for the development of anti-poverty programs. World Development 2002, 30: 33-47. 10.1016/S0305-750X(01)00099-7CrossRef Hentschel J, Waters WF: Rural poverty in Ecuador: assessing local realities for the development of anti-poverty programs. World Development 2002, 30: 33-47. 10.1016/S0305-750X(01)00099-7CrossRef
8.
go back to reference Healy KJ: Llamas, weavings, and organic chocolate : multicultural grassroots development in the Andes and Amazon of Bolivia. Notre Dame, IN : University of Notre Dame Press; 2000. Healy KJ: Llamas, weavings, and organic chocolate : multicultural grassroots development in the Andes and Amazon of Bolivia. Notre Dame, IN : University of Notre Dame Press; 2000.
9.
go back to reference Broad R, Ed: Global Backlash: Citizen Initiatives for a Just World Economy. Lanham, Boulder, New York, and Oxford: Rowman & Littlefield Publishers; 2000. Broad R, Ed: Global Backlash: Citizen Initiatives for a Just World Economy. Lanham, Boulder, New York, and Oxford: Rowman & Littlefield Publishers; 2000.
10.
go back to reference Smith J, Johnston H: Globalization and Resistance: Transnational Dimensions of Social Movements. Lanham, Boulder, New York, and Oxford: Rowman & Littlefield Publishers; 2002. Smith J, Johnston H: Globalization and Resistance: Transnational Dimensions of Social Movements. Lanham, Boulder, New York, and Oxford: Rowman & Littlefield Publishers; 2002.
11.
go back to reference Sawyer S: The 1992 Indian mobilization in lowland Ecuador. Latin American Perspectives 1997, 24: 65-82.CrossRef Sawyer S: The 1992 Indian mobilization in lowland Ecuador. Latin American Perspectives 1997, 24: 65-82.CrossRef
12.
go back to reference Selverston-Scher M: Ethnopolitics in Ecuador: Indigenous Rights and the Strengthening of Democracy. Miami: North-South Center Press; 2001. Selverston-Scher M: Ethnopolitics in Ecuador: Indigenous Rights and the Strengthening of Democracy. Miami: North-South Center Press; 2001.
13.
go back to reference Leon D, Walt G, Eds: Poverty, Inequality and Health: An International Perspective. London: Oxford University Press; 2001. Leon D, Walt G, Eds: Poverty, Inequality and Health: An International Perspective. London: Oxford University Press; 2001.
14.
go back to reference Braveman PA: Monitoring equity in health and healthcare: a conceptual framework. Journal of Health, Population, and Nutrition 2003, 21: 191-192. Braveman PA: Monitoring equity in health and healthcare: a conceptual framework. Journal of Health, Population, and Nutrition 2003, 21: 191-192.
15.
go back to reference Larrea C, Freire W, Lutter C: Equidad desde el principio: Situación Nutricional de los Niños Ecuatorianos. Washington, DC: Pan American Health Organization/Ministerio de Salud Pública; 2001. Larrea C, Freire W, Lutter C: Equidad desde el principio: Situación Nutricional de los Niños Ecuatorianos. Washington, DC: Pan American Health Organization/Ministerio de Salud Pública; 2001.
16.
go back to reference Lasprilla E, Granda J, Obando C, Encalada E, Lasprilla C: Health system inequality and poverty in Ecuador. In Investigation in Health: Social and Economic Returns. Scientific and Technical Publication No. 582. Washington, DC: Pan American Health Organization; 2001:161-169. Lasprilla E, Granda J, Obando C, Encalada E, Lasprilla C: Health system inequality and poverty in Ecuador. In Investigation in Health: Social and Economic Returns. Scientific and Technical Publication No. 582. Washington, DC: Pan American Health Organization; 2001:161-169.
17.
go back to reference Stillwaggon E: Stunted Lives, Stagnant Economies: Poverty, Disease, and Underdevelopment. New Brunswick, NJ: Rutgers University Press; 1997. Stillwaggon E: Stunted Lives, Stagnant Economies: Poverty, Disease, and Underdevelopment. New Brunswick, NJ: Rutgers University Press; 1997.
18.
go back to reference Casas-Zamora JA, Gwatkin DR: Las muchas dimensiones de la equidad en la salud. Pan American Journal of Public Health 1998, 11: iii-iv. Casas-Zamora JA, Gwatkin DR: Las muchas dimensiones de la equidad en la salud. Pan American Journal of Public Health 1998, 11: iii-iv.
19.
go back to reference Lloyd-Sherlock P: Healthcare Reform & Poverty in Latin America. London: Institute of Latin American Studies; 2000. Lloyd-Sherlock P: Healthcare Reform & Poverty in Latin America. London: Institute of Latin American Studies; 2000.
20.
go back to reference Nárvez Guzmán R: Inequidades en el Estado de Salud, Acceso y Uso de los Servicios de Salud. Bolivia: 1998. La Paz: Unidad de Análisis de Políticas Sociales y Económicas; 1998. Nárvez Guzmán R: Inequidades en el Estado de Salud, Acceso y Uso de los Servicios de Salud. Bolivia: 1998. La Paz: Unidad de Análisis de Políticas Sociales y Económicas; 1998.
21.
go back to reference Wagstaff A: Pobreza y desigualdades en el sector de la salud. Pan American Journal of Public Health 2002, 11: 316-326.CrossRef Wagstaff A: Pobreza y desigualdades en el sector de la salud. Pan American Journal of Public Health 2002, 11: 316-326.CrossRef
22.
go back to reference Carolina MS, Gustavo LF, sic: Epidemlogical transition: model or illusion? A look at the problem of health in Mexico. Social Science & Medicine 2003, 57: 539-550. 10.1016/S0277-9536(02)00379-9CrossRef Carolina MS, Gustavo LF, sic: Epidemlogical transition: model or illusion? A look at the problem of health in Mexico. Social Science & Medicine 2003, 57: 539-550. 10.1016/S0277-9536(02)00379-9CrossRef
23.
go back to reference Rostow WW: The Stages of Growth: A Non-Communist Manifesto. Cambridge: Cambridge University Press; 1961. Rostow WW: The Stages of Growth: A Non-Communist Manifesto. Cambridge: Cambridge University Press; 1961.
24.
26.
go back to reference WHO (World Health Organization): Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series 2003. WHO (World Health Organization): Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series 2003.
27.
go back to reference Bacallao J: Epidemiologic and demographic transition: a typology of Latin American and Caribbean countries. In Obesity and Poverty: A New Public Health Challenge. Edited by: Peña M, Bacallao J. Washington, DC: Pan American Health Organization; 2000:77-84. Bacallao J: Epidemiologic and demographic transition: a typology of Latin American and Caribbean countries. In Obesity and Poverty: A New Public Health Challenge. Edited by: Peña M, Bacallao J. Washington, DC: Pan American Health Organization; 2000:77-84.
28.
go back to reference McMichael M, Ed: The Global Restructuring of Agro-Food Systems. Ithaca and London: Cornell University Press; 1994. McMichael M, Ed: The Global Restructuring of Agro-Food Systems. Ithaca and London: Cornell University Press; 1994.
29.
go back to reference Thrupp LA, Bergeron G, Waters WF: Bittersweet Harvests for Global Supermarkets: Challenges in Latin America's Agricultural Export Boom. Washington: World Resources Institute; 1995. Thrupp LA, Bergeron G, Waters WF: Bittersweet Harvests for Global Supermarkets: Challenges in Latin America's Agricultural Export Boom. Washington: World Resources Institute; 1995.
30.
go back to reference Kyle D: Transnational Peasants: Migrations, Networks, and Ethnicity in Andean Ecuador. Baltimore and London: The Johns Hopkins University Press; 2000. Kyle D: Transnational Peasants: Migrations, Networks, and Ethnicity in Andean Ecuador. Baltimore and London: The Johns Hopkins University Press; 2000.
31.
go back to reference Palast G: The Best Democracy Money Can Buy. New York: Penguin Books; 2003. Palast G: The Best Democracy Money Can Buy. New York: Penguin Books; 2003.
33.
go back to reference World Bank: World Development Report 1990: Poverty. New York: Oxford University Press; 1990.CrossRef World Bank: World Development Report 1990: Poverty. New York: Oxford University Press; 1990.CrossRef
34.
go back to reference World Bank: World Development Report 2006: Equity and Development. New York: World Bank and Oxford University Press; 2005.CrossRef World Bank: World Development Report 2006: Equity and Development. New York: World Bank and Oxford University Press; 2005.CrossRef
35.
go back to reference Waters WF: The road of many returns: rural bases of the informal economy in Ecuador. Latin American Perspectives 1997, 24: 50-64.CrossRef Waters WF: The road of many returns: rural bases of the informal economy in Ecuador. Latin American Perspectives 1997, 24: 50-64.CrossRef
37.
go back to reference Larrea C: Pobreza, Dolarización y Crisis en el Ecuador. Quito: ILDIS-FES/Instituto de Estudios Ecuatorianos/FLACSO/Abya Yala; 2004. Larrea C: Pobreza, Dolarización y Crisis en el Ecuador. Quito: ILDIS-FES/Instituto de Estudios Ecuatorianos/FLACSO/Abya Yala; 2004.
38.
go back to reference INEC (Instituto Ecuatoriano de Estadística y Censo): Pobreza y extrema pobreza urbana en el Ecuador. Quito: INEC 2005. INEC (Instituto Ecuatoriano de Estadística y Censo): Pobreza y extrema pobreza urbana en el Ecuador. Quito: INEC 2005.
39.
go back to reference PAHO (Pan American Health Organization): Health in the Americas. Scientific Publication No. 569. Washington, DC: Pan American Health Organization; 2002. PAHO (Pan American Health Organization): Health in the Americas. Scientific Publication No. 569. Washington, DC: Pan American Health Organization; 2002.
40.
go back to reference Breilh J, Campana A, Costales P, Granda E, Páez R, Yépez J: Deterioro de la Vida: Un Instrumento Para Análisis de Prioridades Regionales en lo Social y la Salud. Quito: Centro de Estudios y Asesoría en Salud/Corporación Editora Nacional 1990. Breilh J, Campana A, Costales P, Granda E, Páez R, Yépez J: Deterioro de la Vida: Un Instrumento Para Análisis de Prioridades Regionales en lo Social y la Salud. Quito: Centro de Estudios y Asesoría en Salud/Corporación Editora Nacional 1990.
41.
go back to reference WHO (World Health Organization): World Health Report 1999: Making a Difference. Geneva, WHO; 1999. WHO (World Health Organization): World Health Report 1999: Making a Difference. Geneva, WHO; 1999.
42.
go back to reference Guthmann JP: Epidemic cholera in Latin America: spread and routes of transmission. Journal of Tropical and Medical Hygiene 1995, 98: 419-427. Guthmann JP: Epidemic cholera in Latin America: spread and routes of transmission. Journal of Tropical and Medical Hygiene 1995, 98: 419-427.
43.
go back to reference Larrea C, Freire W: Social inequality and child malnutrition in four Andean countries. Pan American Journal of Public Health 2002, 11: 356-364.CrossRefPubMed Larrea C, Freire W: Social inequality and child malnutrition in four Andean countries. Pan American Journal of Public Health 2002, 11: 356-364.CrossRefPubMed
44.
go back to reference MSP/INEC (Ministerio de Salud Pública/Instituto Nacional de Estadística y Censo): Indicadores básicos de salud. Ecuador 2005. Quito: MPS/INEC MSP/INEC (Ministerio de Salud Pública/Instituto Nacional de Estadística y Censo): Indicadores básicos de salud. Ecuador 2005. Quito: MPS/INEC
45.
go back to reference Freire W, Bacallao J, Carrasco F: Desnutrición y Condiciones Socioeconómicas en el Ecuador. Quito: Consejo Nacional de Desarrollo/UNICEF/Pan American Health Organization-World Health Organization 1990. Freire W, Bacallao J, Carrasco F: Desnutrición y Condiciones Socioeconómicas en el Ecuador. Quito: Consejo Nacional de Desarrollo/UNICEF/Pan American Health Organization-World Health Organization 1990.
46.
go back to reference Freire W, Dirren H, Mora JO, Arenales P, Granda E, Breilh J, Campana A, Páez R, Darquea L, Molina E: Diagnóstico de la Situación Alimentaria, Nutricional y de Salud de la Población Ecuatoriana Menor de Cinco Anos-DANS. Quito: Consejo Nacional de Desarrollo/Ministerio de Salud Pública 1988. Freire W, Dirren H, Mora JO, Arenales P, Granda E, Breilh J, Campana A, Páez R, Darquea L, Molina E: Diagnóstico de la Situación Alimentaria, Nutricional y de Salud de la Población Ecuatoriana Menor de Cinco Anos-DANS. Quito: Consejo Nacional de Desarrollo/Ministerio de Salud Pública 1988.
47.
go back to reference CEPAR (Centro de Estudios de Población y Paternidad Responsable): ENDEMAIN: Encuesta demográfica y de salud materna e infantil, 2004. 2005. CEPAR (Centro de Estudios de Población y Paternidad Responsable): ENDEMAIN: Encuesta demográfica y de salud materna e infantil, 2004. 2005.
48.
go back to reference Rodriguez A, Guaman G, Nelson DP: Vitamin A status of children in five Ecuadorian provinces. Bulletin of the Pan American Health Organization 1996, 30: 234-241.PubMed Rodriguez A, Guaman G, Nelson DP: Vitamin A status of children in five Ecuadorian provinces. Bulletin of the Pan American Health Organization 1996, 30: 234-241.PubMed
49.
go back to reference Aguilar HM, Abada-Franch F, Racines J, Paucar A: Epidemiology of Chagas disease in Ecuador: a brief review. Memorias del Insituto Oswaldo Cruz 1999, (suppl. 1):387-393. Aguilar HM, Abada-Franch F, Racines J, Paucar A: Epidemiology of Chagas disease in Ecuador: a brief review. Memorias del Insituto Oswaldo Cruz 1999, (suppl. 1):387-393.
50.
go back to reference Braguinsky J: Prevalencia de obesidad en América Latina. Ana Del Sistema Sanitaria Navar 2002, (Suppl. 1):109-115. Braguinsky J: Prevalencia de obesidad en América Latina. Ana Del Sistema Sanitaria Navar 2002, (Suppl. 1):109-115.
51.
go back to reference Jacoby E: The obesity epidemic in the Americas: making health choices the easiest choices. Pan American Journal of Public Health 2003, 15: 278-284. Jacoby E: The obesity epidemic in the Americas: making health choices the easiest choices. Pan American Journal of Public Health 2003, 15: 278-284.
52.
go back to reference Peña M, Bacallao J, Ed: Obesity and Poverty: A New Public Health Challenge. Washington, DC: Pan American Health Organization; 1999. Peña M, Bacallao J, Ed: Obesity and Poverty: A New Public Health Challenge. Washington, DC: Pan American Health Organization; 1999.
53.
go back to reference Anselmi M, Avanzini JF, Moreira JM, Montalvo G, Arman D, Prandi R, Marquez M, Caicedo C, Colombo F, Tognoni G: Treatment and control of arterial hipertension in a rural community in Ecuador. The Lancet 2003, 361: 1186-87. 10.1016/S0140-6736(03)12918-2CrossRef Anselmi M, Avanzini JF, Moreira JM, Montalvo G, Arman D, Prandi R, Marquez M, Caicedo C, Colombo F, Tognoni G: Treatment and control of arterial hipertension in a rural community in Ecuador. The Lancet 2003, 361: 1186-87. 10.1016/S0140-6736(03)12918-2CrossRef
54.
go back to reference Bocciolone L, la Vecchia C, Levi F, Lucchini F, Franceschi S: Trends in uterine cancer mortality in the Americas, 1955–1988. Gynecological Oncology 1993, 51: 335-344. 10.1006/gyno.1993.1300CrossRef Bocciolone L, la Vecchia C, Levi F, Lucchini F, Franceschi S: Trends in uterine cancer mortality in the Americas, 1955–1988. Gynecological Oncology 1993, 51: 335-344. 10.1006/gyno.1993.1300CrossRef
55.
go back to reference Hurtig AK, San Sebastian MJ: Geographical differences in cancer incidence in the Amazon basin of Ecuador in relation to residence near oil fields. International Journal of Epidemiology 2002, 31: 1021-1027. 10.1093/ije/31.5.1021CrossRefPubMed Hurtig AK, San Sebastian MJ: Geographical differences in cancer incidence in the Amazon basin of Ecuador in relation to residence near oil fields. International Journal of Epidemiology 2002, 31: 1021-1027. 10.1093/ije/31.5.1021CrossRefPubMed
56.
go back to reference Arrosi S, Sankaranarayanan R, Parkin DM: Incidence and mortality of cervical cancer in Latin America. Salud Pública de México 2003, (suppl. 3):S306-S314. Arrosi S, Sankaranarayanan R, Parkin DM: Incidence and mortality of cervical cancer in Latin America. Salud Pública de México 2003, (suppl. 3):S306-S314.
57.
go back to reference Freire AX, Benitez S, Briones K, Freire NV: Duration of the diagnostic process for lung cancer versus other solid tumors at the National Oncology Institute of Ecuador. Arch Bronconeeumol 2003, 39: 167-170. 10.1157/13045950CrossRef Freire AX, Benitez S, Briones K, Freire NV: Duration of the diagnostic process for lung cancer versus other solid tumors at the National Oncology Institute of Ecuador. Arch Bronconeeumol 2003, 39: 167-170. 10.1157/13045950CrossRef
58.
go back to reference Robertson RL, Castro CE, Gomez LC, Gwynne G, Tinajero CL, Zschock DL: Primary health services in Ecuador: comparative costs, quality, and equity of care in Ministry of Health and rural social security facilities. Social Science and Medicine 1991, 32: 1327-1336. 10.1016/0277-9536(91)90192-FCrossRefPubMed Robertson RL, Castro CE, Gomez LC, Gwynne G, Tinajero CL, Zschock DL: Primary health services in Ecuador: comparative costs, quality, and equity of care in Ministry of Health and rural social security facilities. Social Science and Medicine 1991, 32: 1327-1336. 10.1016/0277-9536(91)90192-FCrossRefPubMed
59.
61.
go back to reference Puertas B, Schlesser M: Assessing community health among indigenous populations in Ecuador with a participatory approach: implications for health reform. Journal of Community Health 2001, 26: 133-147. 10.1023/A:1005281314274CrossRefPubMed Puertas B, Schlesser M: Assessing community health among indigenous populations in Ecuador with a participatory approach: implications for health reform. Journal of Community Health 2001, 26: 133-147. 10.1023/A:1005281314274CrossRefPubMed
62.
go back to reference Sola J: Una desconcentración incomplete: la reforma de la salud en el Ecuador. Ecuador Debate 2004, (No. 61):117-131. Sola J: Una desconcentración incomplete: la reforma de la salud en el Ecuador. Ecuador Debate 2004, (No. 61):117-131.
63.
go back to reference El Comercio: El seguro metropolitano de salud seneficia a más de 5000 afiliados. 2004. El Comercio: El seguro metropolitano de salud seneficia a más de 5000 afiliados. 2004.
64.
go back to reference Diario Hoy: Programa de Aseguramiento Popular. 2006, . Diario Hoy: Programa de Aseguramiento Popular. 2006, .
65.
go back to reference Puertas EB, Starr J: Descentralización en salud y seguros de salud comunitarios: alcances y desafíos en el Ecuador. Revista Iberoamericana de Educación Médica Continuada 2003, 22: 39-48. Puertas EB, Starr J: Descentralización en salud y seguros de salud comunitarios: alcances y desafíos en el Ecuador. Revista Iberoamericana de Educación Médica Continuada 2003, 22: 39-48.
66.
go back to reference Hinrichsen D: Taking health to the high Sierra. Millennium Trailblazers 4: Jambi Huasi. People Planet 1999, 8: 21-22.PubMed Hinrichsen D: Taking health to the high Sierra. Millennium Trailblazers 4: Jambi Huasi. People Planet 1999, 8: 21-22.PubMed
67.
go back to reference Velasco N: Social participation and health promotion in Cotacachi: an experience in progress. Correo de Población y Salud 1996, 5: 37-40. Velasco N: Social participation and health promotion in Cotacachi: an experience in progress. Correo de Población y Salud 1996, 5: 37-40.
68.
go back to reference Mutre P: Campaña de salud comunitaria 2005. Intag 2005.,5(37): Mutre P: Campaña de salud comunitaria 2005. Intag 2005.,5(37):
69.
go back to reference Anselmi M, Moreira JM, Caicedo C, Guderian R, Tognoni G: Community participation eliminates yaws in Ecuador. Tropical Medicine and International Health 2003, 8: 634-638. 10.1046/j.1365-3156.2003.01073.xCrossRefPubMed Anselmi M, Moreira JM, Caicedo C, Guderian R, Tognoni G: Community participation eliminates yaws in Ecuador. Tropical Medicine and International Health 2003, 8: 634-638. 10.1046/j.1365-3156.2003.01073.xCrossRefPubMed
70.
go back to reference Yanni VF: Women with self-esteem are healthy women': community development in an urban settlement of Guayaquil. Gender and Development 1996, 4: 39-44.CrossRefPubMed Yanni VF: Women with self-esteem are healthy women': community development in an urban settlement of Guayaquil. Gender and Development 1996, 4: 39-44.CrossRefPubMed
71.
go back to reference Aguirre-Molina M, Molina CW, Zambrana RE, Eds: Health Issues in the Latino Community. San Francisco: Jossey-Bass; 2001. Aguirre-Molina M, Molina CW, Zambrana RE, Eds: Health Issues in the Latino Community. San Francisco: Jossey-Bass; 2001.
72.
go back to reference Ojeda L: ¿Por qué la descentralización no avanza? Ecuador Debate 2004, (No. 61):95-116. Ojeda L: ¿Por qué la descentralización no avanza? Ecuador Debate 2004, (No. 61):95-116.
Metadata
Title
Globalization and local response to epidemiological overlap in 21st century Ecuador
Author
William F Waters
Publication date
01-12-2006
Publisher
BioMed Central
Published in
Globalization and Health / Issue 1/2006
Electronic ISSN: 1744-8603
DOI
https://doi.org/10.1186/1744-8603-2-8

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