DecilionAcción Pública
Care and Health Observatory
ESEN

Ecuador

A caregiver-support standard makes burden and emotional wellbeing measurable, while local community initiatives and national time-use accounts show different parts of the care landscape.

National profile

Sources reviewed 13 November 2026

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Three distinct windows on care

Ecuador’s April 2026 technical standard for the Servicio de Atención y Fortalecimiento a Personas Cuidadoras (AFPC) treats caregivers as direct recipients of support. Its focus is caregivers linked to disability services of the Ministry of Human Development, rather than all people performing unpaid work.

INEC’s national accounts and Quito’s neighborhood initiatives add context at different scales. They should be read alongside the service standard, without treating either as a measure of AFPC coverage.

Measuring wellbeing

The AFPC admission and results protocol requires the Zarit burden scale and Goldberg anxiety/depression scale at baseline and annually. A perception questionnaire covering the service’s dimensions repeats every six months; assessment of nearby support networks repeats annually.

These are concrete tools for following caregiver wellbeing. The standard supplies instruments and records, but no completed cohort with repeated scores, attrition or a comparison group from which to estimate health effects.

Who the AFPC standard includes

The standard prioritizes family or community caregivers of dependent people linked to ministry services. Entry criteria include being at least 18, voluntary participation, willingness to join a caregiver committee and residence in the intervention territory.

The listed documents include identity, proof that the person receiving care uses ministry services, participant registration and consent, and an admission form signed with the support-network technician. This describes the prescribed entry process; it does not provide a verified open appointment channel or waiting-time guarantee.

Committees and territorial accompaniment

AFPC is designed around periodic accompaniment by support-network technicians. The operational model assigns one technician to an attention unit with 20 committees of 30 caregivers; committee size may range from 15 to 40 according to technical judgment and local circumstances.

These are staffing and organization parameters. Assessing delivery requires actual staff in post, active committees, attendance and completed health assessments, rather than multiplying the model’s ratios into a national beneficiary total.

Unpaid work is broader than direct care

INEC estimates that in 2023 women doing unpaid work devoted 28.7 hours per week to it, compared with 11.4 for men. The denominator is people aged 12 or older who performed unpaid work; the numerator covers 66 activities. These estimates include domestic work and are not hours spent exclusively caring for dependent people.

The satellite account is a national statistical synthesis with provisional figures. Its methods combine source surveys and population projections, adjusting and estimating activities not fully observed in the 2023 module. It does not measure caregiver depression or evaluate AFPC.

Weekly unpaid-work hours, 2023
PopulationHours
Women aged 12+ doing unpaid work28.7
Men aged 12+ doing unpaid work11.4

INEC satellite account, provisional estimates; 66 activities, not direct-care hours alone.

Quito: neighborhood care networks

Quito’s municipality reports that Vecindades de Cuidado has operated since 2025 with zonal administrations and support from UN Women. Its Escuela de Cuidados covers rights, gender and masculinities, community leadership and protection routes against violence.

The January 2026 account identifies participation by women leaders in the rural parish of Pacto. It provides a concrete territorial example of community organization, but no measured change in burden or mental health and no basis to identify it as AFPC delivery.

Read standards, data and local reports separately

The official register confirms the AFPC publication date and title; the full gazette contains the operational rules and annexes. INEC’s results should be read with its methods, while the Quito article is a municipal report of activities.

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