The Normalization of Childhood Disease: An Ethnographic Study of Child Malnutrition in Rural Guatemala

Abstract

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.

Mixed‐methods study identifies key strategies for improving infant and young child feeding practices in a highly stunted rural indigenous population in Guatemala

“…Previous research in Guatemala has described the normalisation of child stunting in high prevalence areas, where caregivers cannot recognise that their children are malnourished because it is ‘normal to have short children’ (Chary et al . , p. 94). A positive deviance model, which highlights children who are growing better than their peers, may generate enthusiasm for nutritional programming among caregivers and community leaders (Bisits Bullen ; Chary et al .…”

“…A positive deviance model, which highlights children who are growing better than their peers, may generate enthusiasm for nutritional programming among caregivers and community leaders (Bisits Bullen ; Chary et al . ).…”

“…The stunting prevalence for children 6–59 months is 71% (Chary et al . ). Xejuyu' contains approximately 230 families and 45% live on less than $2 USD per day.…”

Testing the water, challenging the narratives of sustainable development: student volunteer research promoting public health in rural Panama in the shadow of an "eco-playground"

“…Such "choices" and behaviors mean learning to live with illness. Along with inadequate funding of clinics and exposure to contaminated water in the community and within the clinic itself, they comprise a "normalized total experience" for both clients and caregivers where marginalized populations suffer disproportionately in society (Chary et al 2013). Providing clean water and subsequent education on water and water-related illnesses is a major preventative step toward better health.…”

Implications of gender and household roles in Indigenous Maya communities in Guatemala for child nutrition interventions

“…Although access to free government-sponsored health care is a right, geographic and linguistic barriers for rural Maya (Glei & Goldman, 2000;Shiffman & del Valle, 2006), as well as fears of mistreatment and discrimination (Berry, 2008;Chary, Messmer, Sorenson, Henretty, Dasgupta, & Rohloff, 2013), are obstacles with far-reaching health effects. This is most evident in the prevalence of chronic child malnutrition, or stunting, among Maya children.…”