Guatemala Baseline Study
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Baseline Study for the Title II Development Food Assistance Programs in Guatemala Contract #: AID-OAA-M-12-00009 March 12, 2014 This publication was produced at the request of the U.S. Agency for International Development, Office of Food for Peace. It was prepared independently by ICF International, Inc. Baseline Study for the Title II Development Food Assistance Programs in Guatemala March 12, 2014 The Baseline Study of Title II Development Food Assistance Programs in Guatemala was implemented by ICF International and its subcontractor, Aragon y Asociados, from January through June 2013. This study was made possible by the generous support of the American people through the support of the Office of Food for Peace (FFP) of the U.S. Agency for International Development (USAID). The contents of this report are the responsibility of ICF and do not necessarily reflect the views of USAID or the U.S. Government. Information about Title II emergency and development food assistance programs may be obtained from USAID’s Office of Food for Peace at http://www.usaid.gov/what-we-do/agriculture-and-food- security/food-assistance. ii Baseline Study for the Title II Development Food Assistance Programs in Guatemala March 12, 2014 Contents List of Acronyms ......................................................................................................................................... vi Executive Summary .................................................................................................................................... vii 1. Introduction ............................................................................................................................................... 1 2. Methodology ............................................................................................................................................. 2 2.1 Methods for Population-based Household Survey ........................................................................... 2 A. Study Design and Objectives..................................................................................................... 2 B. Sample Design ........................................................................................................................... 2 C. Questionnaire............................................................................................................................. 4 D. Field Procedures ........................................................................................................................ 5 E. Data Analysis ............................................................................................................................ 8 2.2 Methods for Qualitative Study ....................................................................................................... 10 A. Study Design and Objectives................................................................................................... 10 B. Study Sample ........................................................................................................................... 10 C. Instruments .............................................................................................................................. 12 D. Data Collection ........................................................................................................................ 13 E. Data Preparation, Coding, and Analysis .................................................................................. 13 2.3 Study Limitations and Issues Encountered .................................................................................... 14 3. Overview of the Food Security Situation in the Western Highlands of Guatemala................................ 16 4. Findings .................................................................................................................................................. 18 4.1 Characteristics of the Study Population ......................................................................................... 18 4.2 Household Indicators ...................................................................................................................... 21 A. Household Hunger Scale (HHS) ............................................................................................. 21 B. Household Dietary Diversity Score (HDDS) .......................................................................... 23 C. Household Poverty Levels ....................................................................................................... 25 D. Household Sanitation Practices ............................................................................................... 28 4.3 Agricultural Indicators ................................................................................................................... 31 A. Types of Farming and Techniques .......................................................................................... 33 B. Roles, Responsibilities, and Decision Making in Agriculture................................................. 35 C. Challenges in Agricultural Production .................................................................................... 36 4.4 Women’s Health and Nutrition Indicators ..................................................................................... 37 A. Community Health Issues and Health Care Services .............................................................. 37 B. Women’s Health and Nutrition ............................................................................................... 37 C. Health Care for Women .......................................................................................................... 39 4.5 Children’s Health and Nutrition Indicators .................................................................................... 41 iii Baseline Study for the Title II Development Food Assistance Programs in Guatemala March 12, 2014 A. Stunting, Underweight, and Wasting ....................................................................................... 41 B. Diarrhea and Oral Rehydration Therapy (ORT) ..................................................................... 46 C. Minimum Acceptable Diet (MAD) ........................................................................................... 47 D. Breastfeeding ........................................................................................................................... 48 E. Childhood Illness ..................................................................................................................... 50 5. Conclusions ............................................................................................................................................. 50 5.1 Household Hunger ......................................................................................................................... 51 5.2 Household Dietary Diversity ......................................................................................................... 51 5.3 Poverty Levels ............................................................................................................................... 51 5.4 Water, Sanitation, and Hygiene ..................................................................................................... 52 5.5 Agriculture ..................................................................................................................................... 53 5.6 Women’s Health and Nutrition ...................................................................................................... 53 5.7 Children’s Health and Nutrition ..................................................................................................... 54 Annexes 1 Sampling Plan for Title II Baseline Studies 2a Household Survey Questionnaire in Spanish 2b Household Survey Questionnaire Back-translated to English 3 Indicator Definitions 4 Methods for Poverty Indicators 5 Qualitative Study Sampled Communities 6a Qualitative Study Instruments in English 6b Qualitative Study Instruments in Spanish 7 Tabular Summary of Indicators 8 Multivariate Model Results 9 Bivariate Analysis Results 10 Scope of Work for Baseline Study: Title II Development Food Assistance Programs in Guatemala, Niger, and Uganda iv Baseline Study for the Title II Development Food Assistance Programs in Guatemala March 12, 2014 List of Tables Table 2.1 Sampled Communities and Households for Each Title II Program .............................................. 3 Table 4.1a Total Population in the Title II Survey Area by Program Area ............................................. 18 Table 4.1b Household Characteristics by Program Area ......................................................................... 19 Table 4.2a Food for Peace Indicators – Household Hunger Score (HHS) .............................................. 22 Table 4.2b Food for Peace Indicators – Household Dietary Diversity Score (HDDS)............................ 24 Table 4.2c Food for Peace Indicators – Poverty ...................................................................................... 26 Table 4.2d Food for Peace Indicators – Water, Sanitation and Hygiene (WASH) .................................. 29 Table 4.3a Food for Peace Indicators – Agriculture ................................................................................ 32 Table 4.4a Food for Peace Indicators – Women’s Nutritional Status and Dietary Diversity