Child to Child Ecuador Launches Integrated School Health “Knapsack”


Spanish children's book

Centro Niño a Niño, based in Cuenca, Ecuador, recently launched a comprehensive educational toolkit to promote children’s health within the unique indigenous framework of Sumak Kawsay (“Good Living”) with a special focus on the invisible world of microbes. Consisting of activity guides incorporating Child to Child methodology, story books, videos and songs, the Alforja Educativa (“Educational Knapsack”) captures the unique Kichwa concept of Sumak Kawsay, which was incorporated into the Ecuadoran constitution in 2008 and calls for harmonious relationships among all living things. Sumak Kawsay recognises the interconnectedness and interdependency of humans and the natural world. The kit also includes a section on Alegremía (“happiness in the blood”) which delineates the six elements (all beginning with “A” in Spanish) needed for a full and healthy life: agua (water), aire (air), alimento (food), abrigo (clothing), arte (art), y amor (love).

Activities based on Child to Child methodology

The Alforja incorporates the active-learning step methodology of Child to Child, promoting child participation in issues that affect them. Through the process of identifying an issue, studying its root causes, planning an action, implementing that action, and evaluating the results, the children become active protagonists in improving the health and wellbeing of themselves, their families, and their communities. Unique to the Alforja is its grounding in the cultural richness of indigenous legends and encouragement of children to connect with nature in a more integrated way. In this manner, the children relate more intimately to the issue and hence become more committed to finding a solution.

Through an active partnership with researchers, teachers, artists, and children reaching out to 17 schools over four years, the team at Centro Niño a Niño created a series of child-focused videos, catchy songs, and colorful storybooks to accompany the two volume activity guide.  One of the books, De Los Más Pequeños a los Diminutos del Planeta (“From the Smallest to the Tiniest of the Planet”) is a series of stories written and illustrated by children about the importance of balance and harmony with the microbial world.

Part of an international effort to confront anti-microbial resistance

Children's book on bacteria

Centro Niño a Niño’s creation of the Alforja was sponsored by Sweden-based network ReAct International which works to reduce anti-microbial resistance and the creation of “super-bugs” due to the indiscriminate and improper use of antibiotics. As part of a worldwide network, Centro Niño a Niño was charged with developing an approach appropriate for children. Since children would not recognize anti-microbial resistance as an issue that affects them, placing the problem within the context of Sumak Kawsay – harmony among all living creatures, both visible and invisible – was key to the success of the Alforja. Through activities promoted through the Alforja, children have discovered the importance of microbes in their lives and in the production of foods they love to eat such as cheese and yogurt. In response, the children have carried that message through songs, puppet shows and rallies to call for proper use and respect for antibiotics both in health care and food production.

Alforja available on-line

The entire Alforja Educativa: Salud Escolar y el Mundo Microbiano is available for download via the Centro Niño-a-Niño website.  The Alforja is the most recent set of publications and videos created by the Centro Niño a Niño in its twenty year history of implementing Child to Child methodology to promote child participation in health and wellbeing. For more information contact  Silvina Alessio at or Celine Woznica, Director of Child to Child of the Americas, at

A Spanish version of this article is also available to view here.