In many of the world’s cuisines, there is a holy trinity of food—the three basic ingredients that most closely reflect that country’s gastronomic soul, the flavor base of the cuisine. In Guatemala, those foods are maize (mostly in the form of tortillas), black beans, and rice.
However, a diet consisting mainly of these staple foods does not contain the full complement of nutrients required for optimal health and growth. Pregnant and lactating women and young children are especially susceptible to micronutrient deficiencies if they do not eat a diverse diet that includes foods such as meat, fruits, and vegetables in addition to staple foods. In Guatemala, infants and young children are at further risk for nutrient deficiencies because the primary complementary foods they eat are often thin porridges or soups and tortillas.
As a result, Guatemala’s malnutrition rate is the highest in Latin America and the fourth highest in the world, according to the World Food Programme. Nearly half of Guatemalan children younger than age five are chronically malnourished, a situation that is likely due to a combination of factors such as limited access to adequate food, illness, and suboptimal care and feeding practices. Says IFPRI Research Fellow Deanna Olney, “To grow well, you need good food, good health, and good care.”
The challenge in Guatemala is to find how best to address this complex set of factors and improve the growth of children during the 1,000-day window of opportunity from conception through the first two years of life. To do that, Olney and her colleagues in IFPRI’s Poverty, Health, and Nutrition Division—Jef Leroy and Susan Richter—and Division Director Marie Ruel are currently evaluating a food-assistance program by the United States Agency for International Develoment (USAID) that uses an innovative approach aimed at preventing malnutrition in children younger than two years of age (PM2A). Under the program, approximately 44,000 pairs of Guatemalan mothers and children receive a package of preventive interventions: food rations, quality preventive healthcare, and health and nutrition education. While all beneficiaries have access to similar preventive healthcare and health and nutrition education, they have been randomly assigned to receive one of three types of family rations (full ration, half ration, or no ration) and one of three types of individual rations, which are offered to the women from pregnancy through 6 months postpartum and to the children from 6 to 24 months of age. The types of individual rations include:
- Lipid-based nutrient supplement: This contains fat, protein, and micronutrients. Similar in consistency to peanut butter, it can be mixed into or spread on other foods.
- Sprinkles: These are micronutrient powders that can be mixed with food.
- Corn–soy blend: This flour fortified with micronutrients can be used to make porridge, tortillas, or other foods.
As part of the evaluation of the USAID program, IFPRI researchers will measure child nutritional status, child development, maternal nutrition and health knowledge, infant and young child feeding practices, and household food security and consumption among 4,000 of the mother–child pairs. The study will help inform USAID and other policymakers and program implementers about (1) the impact and cost effectiveness of the program on child nutritional status, (2) the need for and optimal size of the family ration offered, and (3) what type of fortified individual ration confers greatest benefits for child growth.