The Health in the Americas+¹ country profiles are based on the interagency indicators available as of the dates referenced. The sources are referenced in this table. In some cases, the values of the indicators may differ from the most recent data available in the country.

Environmental and social determinants of health

In 2000 the total population of Ecuador was 12 689 206 inhabitants; by 2024 this figure had risen to 18 135 478, representing a 42.9% increase. Regarding the country’s demographic profile, in 2024 people over 65 years of age accounted for 8.3% of the total population, an increase of 3.6 percentage points compared to the year 2000. In 2024, there were 100.6 women per 100 men and 34.1 older people (65 years or older) per 100 children under 15 years of age, as can be seen in the country’s population pyramids, distributed by age group and sex (Figure 1). Considering the population between 15 and 64 years of age to be potentially active (i.e., potential participants in the labor force), this group represented 67.2% of the total population of the country in 2024 (12 187 069 people). When we add these figures to the potentially passive population (4 435 185 under 15 years of age and 1 513 224 over 65 years of age), the result is a dependency ratio of 48.8 potentially passive people per 100 potentially active people. This ratio was 66.9 in 2000.

Life expectancy at birth in 2024 was 77.6 years, higher than the average for the Region of the Americas and 5.5 years higher that in 2000 (72.1).

Between 2007 and 2022, the average number of years of schooling in Ecuador increased by 16.2%, reaching an average of 9.0 years in the latest year for which information is available. The unemployment rate in 2023 was 3.6%. Disaggregated by sex, the rate was 4.3% for women and 3.0% for men. The literacy rate was 96.4% in 2022. In men, this figure was 96.7%; in women, 96.1%. In addition, 25.2% of the population were below the national poverty line in 2022, a decrease from 36.7% in 2007. In 2022, 3.2% of the population was living in poverty, defined as the percentage of the population with an income of less than US$ 2.15 per day; this is below the regional average of 2.6%.

During the period 2000-2022, the country improved its score on the Human Development Index, with an increase of 11.8% (from a score of 0.684 to a score of 0.765); during the same period, the index rose 14.6% internationally and 11.2% in Latin America (Figure 2).

In 2021, public expenditure on health accounted for 5.28% of gross domestic product (GDP) (Figure 3) and 14.76% of total public expenditure, while out-of-pocket spending on health accounted for 30.62% of total health expenditure.

Digital coverage

In 2021, 76.2% of the population had an internet connection, representing a considerable increase from 2000, when 1.5% of the population had an internet connection.

Health situation

Maternal and child health

Between 2000 and 2020, infant mortality in Ecuador decreased from 15.5 to 7.8 deaths per 1000 live births, a decrease of 49.7% (Figure 4). The percentage of low-weight births (less than 2500 g) increased from 3.6% to 9.3% between 2000 and 2022, while exclusive breastfeeding in the child population up to 6 months of age was 79.26% in 2004 (the latest year for which information is available).

Regarding the immunization strategy, measles vaccination coverage was 74% in 2022, a decrease of 10 percentage points from 2000.

The maternal mortality ratio in 2020 was estimated at 65.7 deaths per 100 000 live births, representing a 45.3% reduction compared to the estimated value in 2000 (Figure 5). In relation to fertility, it is estimated that in 2024 women had an average of 1.8 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 39.6% decrease, from 89.9 live births per 1000 women aged 15 to 19 years in 2000 to 54.3 in 2024. In 2021, 97% of births were attended by skilled birth personnel. Between 2004 and 2013 the percentage of pregnant people who had four or more consultations for antenatal care increased from 57.5% to 79%.

Communicable diseases

In 2022, there were 38 new cases of tuberculosis per 100 000 population in Ecuador. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 3.5 (1.7 in women and 5.4 in men).

In 2022, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 28.8 per 100 000 population. The age-adjusted mortality rate for HIV was 3.7 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 74.5%. There were no reported cases of human rabies in the country in 2022.

Noncommunicable diseases and risk factors

In Ecuador in 2023, the prevalence of tobacco use among people aged 15 and older was 10.6%. In the same age group, the prevalence of overweight and obesity was 66.8% in 2022.

Also in 2016, 54.4% of the population reported insufficient physical activity.

In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 17.9%, a decrease of 2.7 percentage points compared to 2000 (20.6%). The prevalence of diabetes mellitus, which stood at 6.3% in 2000, increased to 8% in 2014.

Mortality

In 2019, the adjusted rate of potentially avoidable premature mortality in Ecuador was 194.2 deaths per 100 000 population, a decrease of 33% compared to the rate of 290 in 2000. This meant that, in 2019, the rate in the country was 14.3% lower than the average rate reported for the Region of the Americas as a whole. Among potentially preventable premature deaths, the rate for preventable causes was 102 per 100 000 population in 2019, which is 25.6% lower than the regional average rate; and the rate for treatable causes was 92.2 per 100 000 population, below the regional average of 89.6.

The overall age-adjusted mortality rate was 4.8 per 1000 population in 2019, a decrease of 22.8% compared to 2000 (6.2 deaths per 1000 population).

When deaths are categorized into three main groups, it is observed that, in 2019, the age-adjusted mortality rate from communicable diseases was 56 per 100 000 population (64.1 per 100 000 in men and 48.5 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 365.5 per 100 000 population (411.7 per 100 000 in men and 326.6 per 100 000 in women). The rate of age-adjusted mortality from external causes was 53.8 per 100 000 population (84.2 per 100 000 in men and 24.4 per 100 000 in women), including road traffic accidents (20.6 per 100 000 population), homicides (7.1 per 100 000 population) and suicides (7.7 per 100 000 population). In 2000, the percentage distribution of causes was 62.4% for noncommunicable diseases, 23.1% for communicable diseases, and 14.5% for external causes; in 2019, the percentages were 76.2%, 12.3%, and 11.5%, respectively (Figure 6).

Cancer mortality

Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 18.3 per 100 000 men; lung cancer, 6.7 per 100 000; and colorectal cancer, 6.8 per 100 000. In women, these values were 9.9 deaths per 100 000 for breast cancer; 5.6 per 100 000 for lung cancer; and 6.8 per 100 000 for colorectal cancer.

The sources of the interagency indicators used in this profile can be found in this table.