What is Chronic Childhood Malnutrition?

Guatemala has the fourth highest rate of chronic malnutrition in the world and the highest in Latin America and the Caribbean. Nearly half of all Guatemalan children under the age of five (48.9 percent, according to the World Food Programme) are chronically malnourished. This already devastating problem is nearly twice as severe among indigenous children, 8 of every 10 of whom suffer from chronic malnutrition, according to UNICEF. In the primarily rural, indigenous Department of Chimaltenango, where ALDEA works, about 70 percent of children suffer from chronic malnutrition.

Together with our partners, we implement programs in nutrition and health, environment, and empowerment for a community-led integrated approach to the complex problem of chronic childhood malnutrition.

What Malnurishment looks like

Chronic childhood malnutrition is a debilitating consequence of poverty. Stunting is the telltale sign of chronic malnutrition, but its consequences are far more dire than poor physical growth. Chronically malnourished children are more susceptible to disease and infection, causing high rates of infant and child mortality. Chronic malnutrition also causes cognitive impairments, which are often irreversible. Children who suffer from these impairments are more likely to drop out of school and grow up to have less potential for economic success later in life.

How does chronic malnutrition happen?

Chronic malnutrition happens over time and is the result of multiple factors. We can group these factors into three constellations:

Nutrition and Health

This set of factors focuses on the period we call the “first 1000 days” – the short window that includes pregnancy and the first two years of a child’s life. In rural Guatemala, low birth weight is associated with poor nutrition during pregnancy. Other factors that influence health and nutrition outcomes in an infant or toddler include breast feeding practices, whether the child suffers frequent bouts of disease, and the quality of their diet and nutritional intake through age two.


The lack of clean water and poor sanitation in most homes leads to high rates of diarrheal disease. Indoor air pollution causes a high incidence of respiratory disease. Young children spend large quantities of time with their mothers in closed, unventilated kitchens where food is cooked over open fires. Respiratory and diarrheal diseases compromise children’s immune systems and reduce nutrient absorption. Other environmental factors include limited access to productive agricultural land, and the adverse effects of climate change on production regulating in crops destruction and pre- and post-harvest losses.


Centuries of social, economic, and political exclusion have left Mayan communities in a disadvantaged situation of chronic, grinding poverty. As people organize, they become agents of change in their communities: they can create effective relationships with their local governments, address their lack of access to basic health services, and stimulate environmental changes that impact their health and well-being. The ability of women to control the number and spacing of their children is an example of powerful decision-making that results in autonomy for women and creates healthier families. However, there is a dearth of access to family planning in these communities. 

Root Causes of Malnutrition

The graphic below illustrates the problem of malnutrition and its root causes on a global scale. These same issues are part of the public health context of Guatemala. To reduce chronic malnutrition over the long term, our work needs to address these fundamental issues—poverty and the status of women.

How does ALDEA address chronic childhood malnutrition?

Our evidence-based programs are informed by decades of experience and designed to ensure long-term improvements in health and well-being. Together with our partners, we implement programs in nutrition and health, environment, and empowerment for a community-led integrated approach to the complex problem of chronic childhood malnutrition that builds a better future for generations to come. 

Further Resources on Chronic Malnutrition in Guatemala