Wuqu' Kawoq (Maya Health Alliance): Early Development and Child Nutrition in Mayan Communities in Rural Guatemala
When children receive food that contains essential nutrients during their first 1,000 days of life, we can be certain that they can develop to their physical and cognitive potential. In Guatemala, where many children in rural communities still do not have access to a nutritional diet, the Wuqu' Kawoq (Maya Health Alliance) Early Development and Child Nutrition Program provides care for children under 2 years of age and monitors their growth. This initiative is innovative because it adapts successful strategies to the context of rural Mayan communities, and combines the delivery of micronutrients with training for caregivers.
Problematic
Guatemala has one of the highest levels of chronic child nutrition in LAC and in the world: one of two children under 5 years of age suffers from chronic malnutrition. The statistics are even more worrying in certain rural regions that are home to Mayan communities, where chronic malnutrition levels can reach as high as 80 percent. This urgent situation increases the risk that children will contract illnesses and limits their capacity to learn and their cognitive development. It also results in inadequate preparation for primary school and negatively affects the children’s academic performance. The causes of child malnutrition in Guatemala include high levels of poverty, lack of training for caregivers, mothers, and fathers on best practices for nutrition, and low content of essential nutrients in traditional diets. There is a need for comprehensive solutions that address these aspects together, with a particular emphasis on indigenous populations.
Solution
This initiative has an integral nutritional focus for a vulnerable indigenous population. The program consists of community workers making monthly visits to households with malnourished children (between 6 and 24 months of age) during a period of six months. The household intervention includes growth monitoring, provision of micronutrients, de-worming, and consultations on nutritional topics. In addition, classes are offered in the community’s native language on food preparation. An innovative aspect of the program is that community agents conduct interviews with caregivers about children’s nutritional practices. The main caregivers and the community workers review different information about breastfeeding, complementary foods, frequency of meals, and the diversity of foods. The community workers also ask the caregivers about their perceptions regarding whether the children’s diet is adequate. The workers highlight positive changes in practices and set goals for the next visit.
Evaluation and Impact
A random assignment experiment was conducted to understand the effect of the interviews on nutritional practices. The experiment involved 296 children considered to be emaciated (loss of more than 10 percent of body weight). Of those children, 145 were assigned to a treatment group and 151 to a control group. The control group received monthly household visits during which community workers carried out growth monitoring, delivered supplements and micronutrients, and shared generic messages about nutritional practices. The treatment group received the same standard care as the control group as well as a monthly visit from a different group of community workers who conducted interviews about nutritional practices during the past 24 hours, based on which they set goals for the next visit. The results showed that the interviews had positive effects on family practices. An improvement was observed in the diversity of foods in the treatment group compared to the control group.