Between 2002 and 2004, the Pedro Moncayo Cantonal Health Council, in collaboration with the MIRT program at the University of Washington, conducted a participatory assessment to identify health needs at the community, parish, and cantonal levels. This work led to the creation of the Community Local Information System (SILC), a georeferenced system of households and families, updated in 2009 and 2017.

During this period, cantonal assemblies were organized to develop territorial planning and development plans. These participatory spaces revealed concerns about the intensive use of pesticides in flower plantations, which was linked to an increased incidence of cancer in the region. This highlighted the need to investigate the health effects of pesticide exposure.

In 2008, Fundación Cimas, together with the University of Minnesota and with funding from the U.S. National Institutes of Health, launched the ESPINA Project, a study focused on secondary pesticide exposure in children and adolescents.

Later, in collaboration with the University of California, San Diego, the project evolved into a longitudinal study with a cohort of 500 participants. This work, which continues today, is projected to extend through 2026, generating valuable data to understand the long-term health impacts of pesticide exposure.