Can community health workers deliver complex nutrition education, individualized for each family, and have significant positive results on growth and diet? Our new publication on child malnutrition and community health care workers shows that they can! Plus, we managed to grab a quick word with Dr. Boris Martinez, author of the case study, for a short interview.
Why did you decide to research this topic?
There are a few events in my life that lead me to this research. I grew up in rural Guatemala, so since early childhood, I’ve seen many people struggling to afford even basic necessities. In my village malnutrition is ubiquitous, and access to education and health care is extremely limited. Later I learned that Guatemala has the highest rate of stunting in the Western Hemisphere, and that the indigenous-Maya is one of the world’s most stunted populations. With this in mind, during my last year of medical school, I volunteered at a nutrition rehabilitation center in rural Guatemala, where I cared for hundreds of severely malnourished indigenous children. I witnessed the devastating effects of malnutrition in growth and neurodevelopment. I began to understand the real need for evidence to improve outcomes for these high-risk populations.
What new information does your study contribute?
The study compared standard approaches for children’s growth and diet to an intensive, individualized intervention for caregivers. Community health workers managed the intervention, and we found that the individualized approach resulted in significant improvements in children’s dietary quality (adequate number of food groups consumed per day) and overall dietary adequacy (composite of dietary quality and meal frequency). In other words, the intensive intervention better engaged caregivers in problem-solving and creative resource utilization, leading to improved feeding practices for children.
What will the implications of your findings be for Wuqu’ Kawoq and for other organizations fighting malnutrition?
Other organizations fighting malnutrition in Guatemala and similar contexts, can benefit from our findings by implementing culturally, linguistically, and resource appropriate individualized nutrition education approaches. At Wuqu’ Kawoq we are already redesigning all of our caregiver nutrition counseling from the ground up to be more collaborative and empowering for caregivers, and less based on generic messaging and one-size-fits-all approaches.
What are the next steps?
We are currently in the process of publishing this trial’s developmental outcomes. We are planning a re-enrollment study of this cohort to see if greater impacts in growth emerge with extended follow-up. In the long-term we plan to combine our individualized nutrition education with individualized early childhood development interventions. Our overall goal is that every child grows and develops at their fullest potential.