I. introduction

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JULY 31ST, 2009.


Maternal and child undernutrition is the underlying cause of 3.5 million deaths annually, 35% of the disease burden in children younger than 5 years and 11% of total global disability-adjusted life-years (DALYs).1 Undernutrition encompasses stunting, wasting, and deficiencies of essential vitamins and minerals (collectively referred to as micronutrients) as one form of the condition known as malnutrition, with obesity or over-consumption of specific nutrients as another form.1 Poor fetal growth or stunting in the first 2 years of life leads to irreversible damage, including shorter adult height, lower attained schooling, reduced adult income, and decreased offspring birthweight. In addition, undernutrition in the first 2 years of life, along with rapid weight gain later in childhood and in adolescence, increases the risk of nutrition related chronic diseases.2

Two of the eight Millennium Development Goals (MDGs) can only be achieved if there is a reduction in child undernutrition. The MDGs state as the first goal “to halve between 1990 and 2015 the proportion of people who suffer from hunger.”3 One indicator used to monitor progress in reaching this target is the proportion of children who are underweight, i.e., low weight compared with that expected for a well-nourished child of that same age and gender. Reducing growth retardation and micronutrient deficiencies is also essential to achieve the MDG 4 related to child survival.1

The United Nations Children's Fund (UNICEF) framework outlines the basic and underlying causes of undernutrition, which include environmental, economic, and sociopolitical factors; whereby poverty plays a central role (Appendix 1).4 The negative effects of undernutrition on human capital and economic productivity2 are cause for concern among Mesoamerican governments. Eliminating undernutrition is one of the unmet objectives of the region’s health agenda; therefore, new efforts to strengthen the strategies for reducing undernutrition are required. Due to the irreversible nature of the damage caused by malnutrition in early infancy, pregnant mothers and children under 2 years of age need to be targeted by these strategies. This is particularly true for high vulnerable population such as indigenous, rural, and low-income populations, who usually have higher rates of malnutrition than the rest of the population.

The following document describes and analyses the main nutrition problems of the Mesoamerican region as well as their current nutrition programs and policies. This assessment will serve as the basis for developing a plan aimed at strengthening the capacities of both the region and its nations, by integrating other complementary actions with existing effective interventions to eliminate maternal and child undernutrition in Mesoamerica.


The Nutrition Work Group analyzed available information on the current nutrition problems, programs and policies in each of the eight countries in Mesoamerica. National surveys, developed for different purposes and in different years, were used to define the main nutrition problems in Central America. Since the 1980s, Mexico has completed three national nutrition surveys that were used for this assessment. In the 1960’s, a regional survey was implemented in Central America and, since the 1980´s, 26 nutrition surveys have been conducted. To document the nutritional problems specific to Mesoamerica, we analyzed data for the various indicators described in Appendix 2. Also, the country coordinators from Central America compiled and updated information on the nutrition policies and programs in Mesoamerica. For Mexico, we reviewed the National Institute of Public Health’s (INSP) publications on the performance of the nutrition programs and analyzed the nutrition survey data to determine the coverage and targeting of these programs.
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