Risk analysis of poor health and growth failure of children in the central highlands of Guatemala.

Child morbidity and growth failure are multidimensional phenomena. An assessment was undertaken of the food and nonfood risk factors of poor health and growth failure in children of different age groups in the central highlands of Guatemala. The aim was to identify high risk factors in under-five and school-age children. Under-five children at high risk of being ill tended to come from households with: high needs of child care, a lack of access to a private well or piped water, and no sewage connection. Women's illiteracy constituted an additional risk factor for diarrheal disease in under-five children. Growth failure in under-five children was mainly due to chronic factors: 74% were stunted, 6% were wasted and 44% were weight deficient. These prevalence rates were lower among school-age children. Low per capita food availability, and particularly the absence in the household of self-produced staple foods, was the most significant risk factor of growth failure in under-five children, followed by high risk of being ill, and participation by women in farm production. The latter was particularly a risk factor of wasting. Nonfood risk factors were most important for growth failure in school-age children. These factors included: sanitation, housing conditions, women's literacy status, and adult women's body mass index. Participation in farm production by school-age children was associated with a higher risk of growth failure in younger siblings. It is concluded that multisectoral programs need to reduce the impact of various risk factors of poor health and growth failure in children, and be careful not to introduce new risk factors. Depending on which age group is targeted, such programs should either prioritize improvements in household food availability, or nonfood interventions that reduce women's illiteracy and improve sanitary and housing conditions.