Guatemala has one of the highest rates of child stunting in the world; the indigenous Maya population, who constitute a majority, are disproportionately affected in comparison to the general population. Nevertheless, research on the social dynamics of malnutrition in Maya communities is lacking. To address this deficiency, we present here an ethnographic study of caregivers' experiences of child malnutrition in two rural indigenous towns, supplemented by quantitative data collection on rates of child malnutrition in both study sites. Our research documents the ways in which child malnutrition is a "normalized" total experience for communities and caregivers, heavily influenced by local and structural inequalities, and we explore the policy implications of our findings for effective child nutrition programming.
In Guatemala over the last decade, the small Non-Governmental Organization (NGO) sector has grown dramatically. However, there is a critical lack of data examining the impact of this sector growth on target communities. We utilize ethnographic case studies from the Guatemalan health care sector to examine the community-side effects of health care NGO proliferation. We demonstrate how the constraints of "doing business" and serving as proxy agents for government have restricted the sector's flexibility and capacity for local engagement. We consider how these factors, together with competition for limited funds and service duplication, create community burnout and fuels resource shopping. We conclude with a consideration of some recent promising developments in community-based development and call for a return to greater reflexivity in the sector.
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