Undernutrition in Guatemala: Overview & Evidence

Scope of the Problem

• Undernutrition is a global issue. In 2019, 20.3% of the population in Sub-Saharan Africa and 14.5% in South Asia were undernourished; Latin America & the Caribbean averaged 7.7%, but Guatemala’s rate was 16.8%. Ballard Brief

• In Guatemala, chronic child malnutrition (i.e. long-term growth failure) reached 49.3% in 2017. Ballard Brief+1

• As of 2020, 42.8% of Guatemalan children under 5 were classified as stunted, giving Guatemala the highest stunting rate in Latin America and the 7th-highest globally. Ballard Brief+2Open Knowledge FAO+2

• Guatemala ranks 121st out of 162 countries in progress toward SDG (Sustainable Development Goals) regarding hunger and nutrition. Ballard Brief

Who Is Most Affected?

• Young children (0–5 years) are especially vulnerable: early life (conception through age 2—the “first 1,000 days”) is critical for physical, cognitive, and neurological development. Ballard Brief+2IADB Publications+2

• Indigenous and rural populations bear a disproportionate burden:
  • Chronic malnutrition affects 58% of indigenous children versus 38% of non-indigenous children. Ballard Brief+2IADB Publications+2
  • In some indigenous-majority rural municipalities, stunting rates may reach or exceed 70%. FantaProject+2BioMed Central+2

• More than half of Guatemala’s population resides in rural areas, where access to health services, clean water, and varied food is limited. Ballard Brief+2IADB Publications+2

• In rural, indigenous regions, stunting prevalence has been observed at ~67% in some departments (e.g. Huehuetenango) vs. lower in urban districts. BioMed Central+2FantaProject+2

Historical Trends & Trajectory

• Between 1995 and 2015 in Guatemala:
  • Wasting (acute malnutrition) declined from ~3.8% to ~0.8%. Ballard Brief+2IADB Publications+2
  • Underweight fell from ~21.7% to ~12.4%. Ballard Brief+2IADB Publications+2
  • Stunting decreased from ~55.4% to ~46.7%. Ballard Brief+2FantaProject+2

• The pace of improvement is slow: over ~20 years, only a ~5 pp decline in chronic malnutrition has been achieved. Ballard Brief+1

• The majority of linear growth faltering (stunting) begins in utero (i.e., before birth) and in the first 6 months of life. IADB Publications+2PMC+2

• Guatemala has among the highest stunting rates globally—ranked 6th highest by some analyses—and the highest in Latin America. Ballard Brief+3BioMed Central+3FantaProject+3

Causes of Undernutrition in Guatemala

Food Insecurity & Macronutrient Deficits

• Approximately 16% of Guatemalans suffer from severe food insecurity. Ballard Brief+2World Food Programme+2

• Diets heavily rely on maize (corn) staples, especially tortillas, which provide calories but lack diversity in proteins, vitamins, and minerals. Scholars Crossing+2IADB Publications+2

• In rural households with severe food insecurity, dietary diversity is low and bean intake (a primary source of protein) is reduced. Ballard Brief+2IADB Publications+2

• Rising food prices complicate access to nutritious foods: maize and staple costs hinder purchasing of fruits, vegetables, meat, eggs, or dairy. Ballard Brief+2FantaProject+2

• The “depth of food deficit”—average calories missing per person—was ~101 kcal/day in 2016. Ballard Brief

Micronutrient Deficiencies

• Iron, zinc, folate, and other micronutrients are frequently deficient. UNICEF USA+3FantaProject+3IADB Publications+3

• In Guatemala, ~32% of children 6–59 months had anemia in 2017, with even higher rates in infants 6–11 months. FantaProject+2FantaProject+2

• Zinc deficiency is closely associated with anemia and increased susceptibility to infection and developmental delays. Ballard Brief+3PMC+3IADB Publications+3

Poverty, Inequality & Social Barriers

• Over half of Guatemalans live below the poverty line; 23% live in extreme poverty. Ballard Brief+2FantaProject+2

• Nutrition interventions and access to health services are uneven, especially in marginalized indigenous and rural communities. Ballard Brief+3BioMed Central+3FantaProject+3

• Cultural norms, limited maternal education, and lack of decision-making power over household resources also constrain dietary choices. BioMed Central+2Scholars Crossing+2

Climate, Environmental Shocks & Agricultural Risks

• Guatemala lies in Central America’s Dry Corridor, increasingly affected by droughts, floods, erratic rainfall, and climate-related crop failures. Ballard Brief+3World Food Programme+3FantaProject+3

• In 2024, a Reuters report emphasized that drought and crop failure remain constant threats to food security and nutrition in rural Guatemala. Reuters

• Many smallholder farmers lack irrigation, access to resilient seed varieties, or financial buffers; average plots are small (~0.5-0.6 hectares). IADB Publications+2FantaProject+2

Consequences of Undernutrition

Physical & Health Impacts

• Undernutrition is estimated to contribute to ~45% of deaths in Guatemalan children under 5. FantaProject+2Ballard Brief+2

• Weakening of the immune system increases vulnerability to diarrhea, respiratory infections, and other diseases. IADB Publications+2Ballard Brief+2

• Linear growth deficits (stunting) are linked to reduced adult height, poorer physical capacity, complications in childbirth, and lower productivity. FantaProject+3IADB Publications+3BioMed Central+3

Cognitive, Educational & Socioeconomic Effects

• Undernourished children may suffer reduced brain development, lower cognitive function, poorer school performance, and behavioral challenges. Scholars Crossing+3Ballard Brief+3IADB Publications+3

• In Guatemala, a child’s height at age 3 has been associated with later performance in literacy, numeracy, and general knowledge tests. Ballard Brief

• Stunted children miss more school (due to illness), are more likely to repeat grades or drop out, and have lower eventual earnings. IADB Publications+2Ballard Brief+2

• Undernutrition contributes to a generational cycle—malnourished girls become mothers with limited capacity to nourish their own children. IADB Publications+2FantaProject+2

Best Practices & Intervention Strategies

Maternal & Postnatal Nutrition Interventions

• Focus on the first 1,000 days (conception through age 2), as this window is essential for preventing irreversible deficits. IADB Publications+2Ballard Brief+2

• Promotion of exclusive breastfeeding (EBF) for the first 6 months is key; in Guatemala, only ~53% of infants 0–5 months are exclusively breastfed. Global Nutrition Report+2FantaProject+2

• Postnatal care provides opportunities to counsel mothers on proper infant feeding, sanitation, and hygiene. IADB Publications+2UNICEF USA+2

Nutrition Programs & Policies

• The government and partners launched a National Strategy for the Prevention of Chronic Malnutrition (ENPDC 2016–2020) aiming to reduce stunting among children under 2 by 10 percentage points. FantaProject+1

• Programs like PROCOMIDA (food-assisted maternal & child health interventions) target high-stunting areas. ScienceDirect+1

• Micronutrient fortification / home fortification (e.g. “Sprinkles”—micronutrient powder added to food) has been proposed to address widespread deficiencies in iron, zinc, folate, etc. UNICEF USA+2Ballard Brief+2

• Nutritional training and education through NGOs (e.g. USAID-supported programs) help mothers and community health workers adopt optimal feeding practices. Ballard Brief+1

Agricultural & Climate Resilience Measures

• Promote drought-resistant crops, improved irrigation, soil conservation, climate-smart agriculture, and crop diversification to strengthen resilience in the Dry Corridor. World Food Programme+2IADB Publications+2

• Support smallholder farmers with technical assistance, financing, and access to inputs so that crop failures (due to climate shocks) don’t translate into hunger. IADB Publications+2Reuters+2

Equitable Access & Systems Strengthening

• Expand health infrastructure, especially in rural and indigenous areas, to deliver maternal-child nutrition services. FantaProject+2IADB Publications+2

• Engage community-based models, peer education, and local leaders to overcome cultural or behavioral barriers to optimal feeding practices. BioMed Central+2IADB Publications+2

• Monitor, evaluate, and strengthen accountability systems to track progress in nutrition outcomes and service delivery. IADB Publications+1