Lessons Spread to Combat Malnutrition in Central America

Key Contact
Lucy Katherine Bassett
Start Date
End Date
Funding Amount
$ 49,480
Knowledge-providing Countries


Chronic malnutrition, or stunting, is a serious problem in Central America. Stunting rates in El Salvador, Guatemala, Honduras, Nicaragua, and Panama are greater than 20 percent and the cost of malnutrition in these countries is estimated to range from 2.3 to 11.4 percent of GDP.1  A growing number of studies show that community-based growth promotion (CBGP) programs can help reduce malnutrition rates.

Eager to learn and share their CBGP experiences, El Salvador, Guatemala, Honduras, Nicaragua, and Panama reached out to the World Bank for help connecting with other countries. In response, the World Bank coordinated a knowledge exchange using in-person workshops, video conferences and webinars, and an online community of practice space for exchanging resources and ideas.
The knowledge exchange strengthened the network of community-based nutrition practitioners in the region and provided countries with concrete options for improving program implementation. “Listening to those with experience helps” said José Renan De León, Head of Nutrition, Ministry of Health, Panama. “…[T]his experience has given us a guide and guidelines to strengthen the work in our country.”
Participants focused the exchange on four themes: 1) growth monitoring; 2) behavior change communication; 3) program monitoring and evaluation; and 4) additional services, like micronutrient powders and early childhood development (ECD) activities, that can enhance child development outcomes. “We gained a much better understanding of monitoring indicators and applied these to monitoring the quality of our communications materials,” Carina Ramirez, a Guatemalan Nutritionist, reflected,. “We also learned about the integrated model of nutrition and early stimulation and are applying for funds to do a similar pilot in Guatemala.”
The knowledge exchange helped many countries raise their awareness of successful solutions, It inspired many to enhance their own programs with increased knowledge of what works and what doesn’t in implementing CBGP programs. In the future, this enhanced network of practitioners can help bring the strongest programs to scale.

Beneficiaries / Participants

Malnutrition remains the single largest cause of child mortality in the world. Poor nutrition can permanently impair a child’s development and overall growth. Guatemala’s stunting rate, for example, is the third highest in the world at 54.5%.
Community-based growth promotion (CBGP) programs can help combat malnutrition and support children’s growth through regular growth monitoring and individualized counseling to parents about caring practices, feeding, disease treatment, and appropriate use of health services..
El Salvador, Guatemala, Honduras, Nicaragua, and Panama have been implementing CBGP programs based on a common model, Atención Integral en Nutrición Comunitaria (AIN-C). Each country spoke with the World Bank about their interest in meeting different implementers of CBGP programs from other countries. Building off the successful experience of a previous international conference in 2006 entitled “Combatiendo la desnutrición crónica en América Central,” the World Bank organized a regional workshop to discuss operational experiences, share knowledge on how to improve program models, and to provide technical guidance and ideas for innovations in monitoring and promoting child growth.