Mixed‐methods study identifies key strategies for improving infant and young child feeding practices in a highly stunted rural indigenous population in Guatemala |
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| Authors: | Kelley Brown Nicole Henretty Anita Chary Meghan Farley Webb Heather Wehr Jillian Moore Caitlin Baird Anne Kraemer Díaz Peter Rohloff |
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| Affiliation: | 1. World Vision US, Federal Way, Washington, USA;2. Edesia Inc., Providence, Rhode Island, USA;3. School of Medicine & Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA;4. Department of Anthropology, University of Kansas, Lawrence, Kansas, USA;5. Harvard Medical School, Boston, Massachusetts, USA;6. Department of Anthropology, University of Florida, Gainesville, Florida, USA;7. Wuqu' Kawoq, Santiago Sacatepéquez, Guatemala;8. Brigham and Women's Hospital, Boston, Massachusetts, USA |
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| Abstract: | Guatemala's rural indigenous population suffers from one of the highest rates of chronic child malnutrition (stunting) in the world. Successfully addressing stunting requires defining the barriers to and opportunities for new behaviour‐change initiatives. We undertook a mixed‐methods assessment of feeding practices and food purchasing behaviours around infants and young children aged 6–36 months in two rural indigenous Guatemalan communities. We found that most caregivers were aware only of acute forms of child malnutrition and that they greatly underestimated the local prevalence of malnutrition. Despite moderate adherence to exclusive breastfeeding and timing of complementary food introduction, diets had poor diversity and inadequate meal frequency. Furthermore, perceptions of food insecurity were high even in the presence of land ownership and agricultural production. Although fortified foods were highly valued, they were considered expensive. At the same time, proportionally equivalent amounts of money were spent on junk foods or other processed foods by most participants. Biological mothers often lacked autonomy for food purchasing and nutritional decisions because of the power exerted by husbands and paternal grandmothers. Our findings suggest several creative and community‐based programming initiatives including education about the acute vs. chronic malnutrition distinction, engaging landowners in discussions about domestic food consumption, engaging with caregivers to redirect funds towards fortified foods rather than junk food purchases and directing behaviour‐change initiatives towards all household stakeholders. |
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| Keywords: | multidisciplinary approaches child nutrition complementary foods cultural issues ethnicity low‐income countries |
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