Building on and expanding the Amazon Indigenous Health Route

March 31, 2021

Thanks to the financial support of The Rockefeller Foundation, this initiative will improve access to Covid-19 care for 339,000 inhabitants from 23 Indigenous peoples and local communities in the Ecuadorian, Peruvian and Brazilian Amazon.

In the Amazon, COVID-19 represents an increasing threat. The lack of access to health services and the limited response to the pandemic add to the pressures that Indigenous peoples and local communities and their territories have historically faced. Furthermore, the effects of COVID-19 and its response measures have exacerbated their vulnerabilities to the impacts of deforestation, logging, illegal mining, oil extraction and the constant violation of their human and territorial rights.

To face this reality, in mid-2020, Hivos, through the All Eyes on the Amazon program, began the implementation of the “Amazon Indigenous Health Route”, a step-by-step model to answer to the spread of COVID-19 by improving the access to health for Amazonian Indigenous peoples in Ecuador. This initiative has been developed in coordination with CONFENIAE (Confederation of Indigenous Nationalities of the Ecuadorian Amazon), civil society organizations and the Ministry of Public Health, and the technical support of the Pan American Health Organization (PAHO).

In Ecuador, some of the results obtained so far include:

  • The development of an integrated health care network.
  • The design of access routes to health centers to facilitate access for the Waorani, Shuar, A’i Kofán, Siona and Achuar nationalities.
  • Training activities in prevention, health and community care measures aimed at health professionals, community health promoters and Indigenous leaders.
  • The development of a friendly and easy-to-use protocol with prevention and care measures with four lines of action: Family, Community, Health Promoters and Health Professionals.
  • The production and dissemination of health education materials.
  • The provision of 2,000 COVID-19 PCR tests to support testing campaigns in Indigenous communities of the Amazon.
  • First place in the SDSN Amazonia 2020 Award (Sustainable Development Solutions Network).

Since December 2020, thanks to the financial support of The Rockefeller Foundation, Hivos has been working on the consolidation of the Amazon Indigenous Health Route in Ecuador and its adaptation and expansion to the Madre de Dios region (Peru) and the state of Maranhao (Brazil), through intercultural knowledge dialogues and the collaborative work with Indigenous organizations (CONFENIAE in Ecuador, FENAMAD in Madre de Dios – Peru and CTI in Maranhao – Brazil) and the public health systems in the three countries.

By adapting the response strategies to COVID-19 so that they are relevant, pertinent and appropriate for their territorial and cultural realities, the initiative aims to improve access to health and the response to COVID-19 of 339,000 people from 23 Indigenous peoples and local communities in the Amazon.

To do so, the project is organized around four strategies:

Strategy 1 – Placing the needs and rights of Indigenous peoples at the center of the diagnostic and primary healthcare and telehealth networks

Strategy 2 – Adapting health promotion and disease prevention approaches and materials to be culturally relevant and effectively foster behavioral change, in target Indigenous communities

Strategy 3 – Developing capacities of indigenous Community Health Promoters (CHP)

Strategy 4 – Expanding digital surveillance capacity in Indigenous communities and linking data to the formal health system.

Thus, Hivos and its partner organizations seek to promote structural changes in health systems and networks to reduce the impact of COVID-19 on the lives, organizations and territories of Indigenous populations in the Ecuadorian, Peruvian and Brazilian Amazon, by equipping Indigenous organizations and health facilities in the Amazon with tools and capacity building to improve the access to care, prevention and protection measures by placing the rights and cultures of Indigenous peoples at the core of public health systems. 

Learn more about the route at: www. and stay updated on its implementation through Hivos Latin America and Hivos Amazonia social media channels.


For more information:

Daniel de la Torre

COVID-19 Strategy Leader


Nora Sánchez

AIR Communications Officer