i 2ª Calle 20-92, Zona 11 Col. El Mirador 1, 01011 Cel.: (502) 5202 1982 Casa: (502) 2472 8501 
Guatemala, Guatemala E-mail: jmatute@bigfoot.com 
  
Jorge Matute, October 2011
Title II Food Security Program 
PROMASA 
 Save the Children 
 
MYAP 2006-2011 
Endline Report 
MYAP Endline 2011
Executive Summary
i 
Executive Summary
Save the Children is a non‐profit organization with no political or religious affiliations.   It has been
working in Guatemala since 1999, implementing health, education, and food‐  and nutrition‐security
programs aimed at achieving positive and lasting changes in the lives of vulnerable boys and girls.
It is a member and presides over the International Save the Children Alliance, a global network
constituted by 28 organizations that implement programs in 110 countries around the world to ensure
the welfare of 25 million girls and boys.
One of the programs being executed by Save the Children in Guatemala is the Maya Food Security
Program (PROMASA), which is a Title II PL 480  Multi‐Year Assistance Program (MYAP) funded by the
United States Agency for International Development (USAID).  This program responds to the objectives
established by USAID’s Food for Peace Office for Title II PL 480 programs, which is to reduce food
insecurity in vulnerable populations and to respond to emergencies and natural disasters.
Within this framework, PROMASA undertakes activities that promote good practices in health and
nutrition, livelihoods, natural resources, and risk management, and whose goal is to reduce food
insecurity and chronic malnutrition in boys and girls from 0 to 3 years old in 123 communities within 6
municipalities of the Department of Quiché (San Gaspar Chajul, Santa María Cunén, San Juan Cotzal,
Santa María Nebaj, Sacapulas, and San Miguel Uspantán), benefitting more than 11,600 families.
The Program, which started in 2006 and is set to end in 2011, has worked with local partners, among
them, Cooperativa Todos Nebajenses (COTONEB), Génesis Empresarial, Kiej de los Bosques, and relevant
municipalities.   Other important partners that have contributed to implementing program activities
include the Peace Corps, the School of Nutrition, and the School of Veterinary Medicine and Zootechnics
at the Universidad de San Carlos.  Coordination with government institutions such as SESAN, the Ministry
of Agriculture, and the Ministry of Health has also been fundamental.
Since the program will soon end, a Final Evaluation was performed with two aims:  To establish the reach
of Program objectives and the extent to which they were achieved by measuring impact and process
indicators– and to comply with donor requirements.
MYAP Endline 2011
Executive Summary
ii 
The process used to that end was a Statistical Sampling Survey, whose parameters are in line with FANTA
II guidance and outlined in depth in its design document.  The sample size is based on estimates of the
chronic malnutrition rate (height [length] for age under two standard deviations) in children under 5
years old.   This estimate was 1163 children living in 775 families, distributed in 31 communities (or
clusters).  A total of 807 interviews were performed, during which anthropometrical measurements of
1184 children were taken.  The result of the sampling design determined a stratification that combined
communities’ geographical location and the Program’s agricultural/livestock activity.   In the 11 strata
that were defined, a random sample was selected with selection probabilities proportional to size (PPS
sampling) in 2 to 7 clusters or communities.
Data was gathered by means of an instrument agreed‐on by the three organizations executing Title II
programs in Guatemala:   Catholic Relief Services (CRS), SHARE, and Save the Children.   Quality was
controlled both internally and externally during this phase.  These controls helped to solve systematic
errors during the interviews.  It is also important to mention that a as a result of this accompaniment,
translators were easily found whenever they were needed.
Except for the anthropometrical indicators from 1184 boys and girls, the rest of the health and nutrition
and agricultural/livestock indicators were measured during the 807 interviews that were undertaken.  
Another exception is the commercial‐activity indicators measured in a sub‐sample of participants in that
activity.
The data‐processing and data‐analysis phase started by entering all data into the computer, using a
double‐entry method and the EPI INFO software.   In order to perform the statistical analysis, the EPI
INFO CSAMPLE analysis model was used.  This model contemplates a sampling design, stratification, and
selection by clusters.  Lastly, the weight that would be assigned to each observation was determined by
means of its inverse probability selection, which assigns equal selection probability to all observations.
Following are the most relevant results of the evaluation:
MYAP Endline 2011
Executive Summary
iii 
A Comparative Table of Main Indicators  
PROMASA, Save the Children
2007‐2011
Area Indicators Baseline
Programmed
GOAL
LOA
Endline
2011
Anthropometry in
children under 5
years old
Percentage of children under 5 years old with
chronic malnutrition (Z < ‐2SD height/age), WHO 78.2% 75.2% 70.3%
(64.6, 76.0)
Percentage of children under 5 years old with
overall malnutrition (Z < ‐2SD weight/age), WHO 26.3% 20% 25.0%
(21.0, 29.1)
Percentage of children under 5 years old with
chronic malnutrition (Z < ‐2SD height/age),  NCHS 71.6% 69% 63.0%
(57.4, 68.5)
Percentage of children under 5 years old with
overall malnutrition (Z < ‐2SD weight/age), NCHS 34.2% 28% 30.5%
(26.7, 34.2)
Family dietary
diversity and family
food scarcity  
Average dietary diversity score 4.6
Food groups
6
Food groups
8.0
Food groups
Children’s feeding
practices
Percentage of infants under 6 months of age who
were exclusively breastfed during the past 24 hours 65.6% 74% 80.1%
Danger signs in
mothers’,
newborns’, and
children’s health
Percentage of mothers and caregivers of children
under 36 months of age who recognize at least two
danger signs of childhood illnesses that indicate the
need to seek health services  
50.0% 75% 80.6%
Agricultural/livestock
practices
Percentage of producers adopting at least two
good agricultural practices 11.0% 30% 65.5%
This table shows the difference between the baseline indicator values and the values established for
each indicator by the Final Evaluation of the Program.   This difference determines the impact of the
program.  Examples of this are the 8.6% decrease in chronic malnutrition rates (length/height for age
under less than two standard deviations) in children under five years old, according to the NCHS
reference and the 7.9% decrease in those rates according to the WHO reference (P<0.05).   The 3.7%
decrease in overall malnutrition rates (weight for age under less than two standard deviations),
according to the NCHS reference (P<0.05) is another such example.  In addition to this, the table shows
that proposed goals were achieved.
Another factor that must be underscored is the significant difference in the overall malnutrition rates
among the population of boys and girls under 36 months old and the population of boys and girls from
36 to less than 60 months old (P<0.05).  In this case, rates were higher in the older group (73.4%) versus
the younger group (57.9%).   These values correspond to estimates developed according to NCHS
references, and it is worth noting that this difference remained the same when estimates according to
WHO references were developed.
MYAP Endline 2011
Executive Summary
iv 
In regard to dietary diversity, results show that it surpassed the baseline value.  From a consumption of
an average of 4.6 food groups, the value increased to an average of 8.01 food groups.  This exceeded the
proposed goal of 6 groups (P<0.05).  The food group most eaten by all families is cereals and the food
group that is less eaten is fish and seafood (2.9%), as well as dairy products (29.5%).   The average
number of Months of Adequate Household Food Provisioning was 10.5 months, which is higher than the
baseline value, but slightly underneath the goal of 11 months.  
Another positive result is the improvement in exclusive breastfeeding practices, which showed a
significant change (P<0.05) with respect to the baseline, changing from 65.6% to 80.1%.   This result
surpassed the established goal.
In regard to recognizing the danger signs in pregnant women, newborns, and children, results show that
the percentage of women who acquired this knowledge amply exceeded the established goal.  
At present, 84.5% of women recognize danger signs during pregnancy; 69.9% recognize danger signs in
newborns, and 80.6% recognize danger signs in children.   Among the women who mentioned
recognizing some danger sign, either during pregnancy or in newborns and children, around 50% of them
stated that they had experienced at least one sign during their pregnancy or with one of their children.  
The significance of this is that nearly all of them (over 95%) sought qualified personnel to help them (a
hospital, a health center/post, or a private clinic).
Good agricultural and good livestock practices also improved.   Results show that they are over the
baseline and that they also surpassed established goals (P<0.05).  65.5% of producers stated that they
had adopted at least two good agricultural practices and 81.3% of them stated that they have adopted
good livestock practices.  These results show a significant positive difference in malnutrition rates among
the population receiving aid from the Program’s agricultural and livestock components (significantly
lower rates [P<0.05]) compared to the population who did not receive such aid.
MYAP Endline 2011
Table of Contents
v 
Table of Contents
I Introduction ..............................................................................................................................1
I.1 Contextual Framework....................................................................................................1
I.2   Justification and Survey Objectives...............................................................................2
I.3 MYAP Indicators..............................................................................................................3
II Methodology ............................................................................................................................ 1
I.  Survey Design
I.1 Sample Size (Sample Selection).......................................................................................3
I.2 A List of Selected Community Clusters ...........................................................................4
Table M2...................................................................................................................................5
Selected and Visited Community Clusters...............................................................................5
II. Updating and Adapting Instruments to Gather Information...............................................6
III.   Selecting and Training Field Personnel..............................................................................7
III.1   Selecting and Integrating Field Personnel...................................................................7
III.2 Training and Standardization ........................................................................................8
IV.   Executing Field Work.........................................................................................................9
IV. 1   Field Phase..................................................................................................................9
a.     Presenting the Survey and Requesting Cooperation from the Community...........9
b.    Managing the Survey Team...................................................................................10
c.     Linguistic Issues.....................................................................................................10
d.   Managing Information in the Field.........................................................................11
IV.2   Quality Control in the Field .......................................................................................11
IV.3 Products......................................................................................................................12
IV.3.1.   Health and Nutrition, and Livelihood Components........................................12
IV.3.2. Marketing and Commercialization Component ...............................................12
IV.3.3. Risk Management and Sentinel Sites................................................................13
V   Analyzing Data and Writing the Report ............................................................................13
III Results .................................................................................................................................... 15
III.A    MYAP Indicators.......................................................................................................16
III.B    2011 Results. ............................................................................................................20
III.B.1 Anthropometry in Children under 5 Years Old ..................................................20
III.B.2 Family Dietary Diversity and Family Food Scarcity ............................................26
III.B.3 Information, Education and Communication in Health and Nutrition ..............33
III.B.4 Children Feeding Practices.................................................................................36
III.B.5 Danger Signs in Mothers’, Newborns’ and Children’s Health............................41
III.B.6 Water Treatment ...............................................................................................44
III.B.7 Agricultural/Livestock Practices.........................................................................46
III.B.8 Improved Income (Formal Marketing)...............................................................51
III.B.9 Community Risks................................................................................................54
IV Conclusions ............................................................................................................................. 56
V Annexes .................................................................................................................................. 57
ANNEX 1:  Effects of the Design of 2011 MYAP Indicators....................................................58
MYAP Endline 2011
Table of Contents
vi 
ANNEX 2 .................................................................................................................................59
A Summary of Surveys by Communities, in the Nutrition and Health and the
Agricultural/Livestock Components...................................................................................59
ANNEX 3 .................................................................................................................................61
A Summary of Surveys by Community Sentinel Sites........................................................61
MYAP Endline 2011
vii 
Glossary
COCODES Spanish acronym for Community Development Councils
CRS Catholic Relief Services
ENSMI    Spanish acronym for National Mother‐Child Health Survey
FANTA    Food and Nutrition Technical Assistance
MoH    Ministry of Health
MYAP    Multi‐Year Assistance Program
NCHS National Center for Health Statistics
Odds Ratio A statistical chance ratio that measures the connection between illness
and exposure to a certain factor
WHO World Health Organization
PPS sampling    Probability Proportional to Size Sampling
PVO    Private Voluntary Organization
SAM     Spanish acronym for Improved Food Security  
SHARE SHARE of Guatemala
USAID    United States Agency for International Development
MYAP Endline 2011
Introduction
1 
I Introduction
The Maya Food Security Program (PROMASA), implemented by Save the Children in 123
communities within 6 municipalities located in Quiché, is now in its last year of execution.  In
order to establish the reach and the achievement of its goals, a Final Evaluation was
performed, seeking to measure the impact and process indicators for Health and Nutrition,
Livelihoods, Natural Resources, and Risk Management components.  
The execution of these components helped to reduce food insecurity and chronic malnutrition
in boys and girls from 0 to 3 years old in 123 communities located in 6 municipalities in the
Department of Quiché (San Gaspar Chajul, Santa María Cunén, San Juan Cotzal, Santa María
Nebaj, Sacapulas, and San Miguel Uspantán), benefitting more than 11,600 families.
This Final Evaluation has been performed in order to comply with one of the commitments of
the FFP‐A‐00‐07‐00001‐00 Agreement executed by Save the Children and the United States
Agency for International Development (USAID), which establishes that a report verifying
compliance with program indicators must be presented.   To that end, Save the Children
contracted the services of JMatute‐CIENSA as an external consultant.
I.1 Contextual Framework1
Guatemala is presently facing significant challenges in order to attain its social and economic
development.  Illiteracy, malnutrition, and mother‐child death rates are among the highest in
Latin America, except for Haiti.
A civil war that lasted thirty‐six years and a historical legacy of social, political, and economic
exclusion of the indigenous population (41%) are factors that have resulted in the lack of health
services, economic opportunities, and education among most rural inhabitants.   These
circumstances have hampered the country’s development.
 
1 Information provided by Save the Children Guatemala
MYAP Endline 2011
Introduction
2 
Save the Children USA is a non‐profit organization with no political or religious affiliations.  It
has been working in Guatemala since 1999, implementing health, education, food‐  and
nutrition‐security, and emergency‐response programs aimed at achieving positive and lasting
changes in the lives of vulnerable boys and girls.
At present, it is a member and presides over the International Save the Children Alliance, a
global network constituted by 28 organizations that implement programs in 110 countries
around the world to ensure the welfare of 25 million girls and boys.
One of the programs being executed by Save the Children in Guatemala is the Maya Food Security
Program (PROMASA), which is a Multi‐Year Assistance Program (MYAP) within the Title II PL 480
Program funded by the United States Agency for International Development (USAID).   This program
responds to the objectives established by USAID’s Food for Peace Office for Title II PL 480 programs,
which is to reduce food insecurity in vulnerable populations and to respond to emergencies and natural
disasters.
Within this framework, PROMASA undertakes activities that promote good practices in health and
nutrition, livelihoods, natural resources and risk management, and whose goal is to reduce food
insecurity and chronic malnutrition in boys and girls from 0 to 3 years old in 123 communities within 6
municipalities of the Department of Quiché (San Gaspar Chajul, Santa María Cunén, San Juan Cotzal,
Santa María Nebaj, Sacapulas, and San Miguel Uspantán), benefitting more than 11,600 families.
The Program, which started in 2006 and will end in 2011, has worked with local partners,
among them, Cooperativa Todos Nebajenses (COTONEB), Génesis Empresarial, as well as the
Ministry of Health and the Ministry of Agriculture, the Food and Nutritional Security Secretariat
(SESAN), the President’s Planning and Programming Secretariat (SEGEPLAN), and
municipalities, among others.   
I.2   Justification and Survey Objectives
In the Terms of Reference provided to the Consultant, the objectives that were sought with this
evaluation or survey were defined as follows:
MYAP Endline 2011
Introduction
3 
Objectives of the Evaluation
1. To establish the reach and the achievement of Program’s goals by measuring
impact and process indicators for each of the components established for the
Program
2. To describe program performance during its term of execution in terms of the
results and objectives achieved in target groups.
3. To determine the effect that interventions and strategies have had on
decreasing food insecurity.
4. To determine the effect of interventions in chronic and overall malnutrition in
boys and girls under 5 years old.
5. To identify good Food and Nutrition Security practices, as opportunities and
alternatives that can yield significant results in household income,   health
conditions and mother/child nutrition, natural‐resource management, and food
security that can be incorporated into the design of other programs to be
implemented.
I.3 MYAP Indicators
The MYAP initiative has established the following main indicators to measure its effects.   They were
measured by means of the instruments especially devised for that purpose.
Area Indicators
Anthropometry
in children under
5 years old
Percentage of children under 5 years old with chronic malnutrition (Z < ‐2SD height/age),  NCHS
Percentage of children under 5 years old with chronic malnutrition (Z < ‐2SD height/age), WHO
Percentage of children under 5 years old with overall malnutrition (Z < ‐2SD weight/age), NCHS
Percentage of children under 5 years old with overall malnutrition (Z < ‐2SD weight/age), WHO
Family dietary
diversity and
family food
scarcity
Average dietary diversity score
Average number of months of adequate household food provisioning
Children’s
feeding practices Percentage of infants from 0 to <6 months who were exclusively breastfed during the past 24 hours.   
Danger signs in
mothers’,
newborns’, and
children’s health
Percentage of women who recognize at least two danger signs during pregnancy
Percentage of women who recognize at least two danger signs in newborns (under 28 days of birth)
Percentage of women who recognize at least two danger signs indicating that a child needs treatment when
he/she is sick.
Agricultural/
livestock
practices
Percentage of producers adopting at least two good agricultural practices
Percentage of producers adopting at least two good livestock practices
Improved
income Percentage of producers adopting at least two formal marketing practices
MYAP Endline 2011
Introduction
4 
MYAP Endline 2011
Methodology
1 
II Methodology
The survey was performed in five main stages:
1. Designing the survey
2. Updating and adapting instruments to gather information
3. Selecting and training field personnel
4. Executing field work and entering data into the computer
5. Analyzing information and writing the report
I. Designing the Survey
The size of the sample that was estimated for this survey was based on the following parameters, which
are contained in the document on the survey design.  The estimate was made according to FANTA II
indications.
1) Confidence Level:  It was set at 95% (Z = 1.96).
2) P(1‐P):  FANTA’s recommendation to use P(1‐P)=0.25 was adopted
3) Effect of Sample Design:  the value suggested by FANTA was used:  2
4) Error of Estimation:   Since the above values are constant within the equation, it is the error of
estimation that ultimately conditioned the sample size.  This value was set at 4% of error.
Estimate on sample size for the target population; that is, children under 5 years old:
According to baseline information, there were children under 5 years old in each one of the selected
households.  There was an average 1.5 children/household in these selected households.  Thus, to find
1,163 children under 5 years old, 775 households had to be visited (1,163/1.5 = 775 households with
children under 5 years old).  In the field, the number of households where information was gathered,
which in this case are the same as surveyed families, was 809; that is, 34 above the programmed
number, as a result of the random‐selection process performed in the field.
5) Field Selection:   In order to find children under 5 years old in the communities, the following
process was undertaken:
MYAP Endline 2011
Methodology
2 
a. Household selection.  35 households were randomly selected per community was made
using maps or sketches.  This value is higher than the 25 households per community that
were expected, in order to achieve the size of the estimated sample (25 is the size of the
sample estimated per primary cluster).  The reason for this is that it was not expected that
all the households would include children under five years old.   Therefore, the over
sampling of 35 households is a result of an adjustment in the selection, considering the
loss of households in which there were no children under five years old.  
b. Case Confirmation.  The first step when arriving at a selected household was to confirm
that it met the inclusion criteria:  That there was at least one child under 5 years old in the
household.  After confirming that there was, the next step was to establish if there was
more than one family with children under 5 years old in the household.  If there were two
or more families in a household, one family was randomly selected.  Once a family was
selected, their informed consent to perform the survey was obtained.
Summary of estimated sample size:
 CHILDREN UNDER 5 YEARS OLD:  1,163  (a 4% error of estimation in chronic malnutrition)
The number of children in the sample is conditioned by:
 The baseline considers that there are 1.5 children under 5 years old per family
 The selection of one family per household (a household is equal to a family)
 The minimum number of families to obtain the sample is 1,163/1.5= 775
 HOUSEHOLDS:  775
 The 775 households are distributed into 31 clusters (25 households/cluster)
 775 households, adjusted to accommodate possible losses, equals a total of 1,302
households
 When dividing 1,302 households by the 31 clusters, the result is 1,302 / 31 = 42
household clusters, which is the number of households that must be selected and visited
in each community.  However, as previously mentioned, in practice, only 35 households
–not 43– were selected, based on the experience of the consulting team.  This number
proved to be sufficient.
MYAP Endline 2011
Methodology
3 
I.1 Sample Size (Sample Selection)
The Sample Design responds to the measurement of the impact indicator:    Rate (percentage) of
children with low length/height for age (chronic malnutrition defined by Z score:  malnourished = Z < ‐
2SD).  A stratified sample design by clusters in three stages was used.   
Stratification considered two characteristics in population clusters:
 The first one consisted of the geo‐political division of the country into municipalities.   The
communities that were selected for this survey belong to six municipalities in the department of
Quiché:  Chajul, San Juan Cotzal, Nebaj, Uspantán, Cunén, and Sacapulas
 The second one considered the agricultural/livestock activity that the program implemented in
certain communities.   Thus, there are two divisions:   With and without agricultural/livestock
activity.
The conjunction between geo‐political divisions and the presence of agricultural activity generates
stratification.  The following are the strata identified for Save the Children:
Table M1
Strata and Number of Primary Clusters to be Sampled
Save the Children*
Stratum
# Municipality
Agricultural
Activity
Total
Population
in Stratum
Number of Community Clusters to be Sampled
Proportional
Distribution
Adjusted
Distribution *
1 Sacapulas
Quiché
YES 7,668 2 2
2 NO 7,769 3 2
3 Cunén
Quiché
YES 16,369 5 4
4 Uspantán
Quiché
YES 11,112 4 3
5 NO 1,745 1 2
6 Nebaj
Quiché
YES 24,038 8 7
7 NO 651 0 1
8 San Juan
Cotzal
Quiché
YES 9,446 3 2
9 NO 1,182 0 2
10 Chajul
Quiché
YES 14,744 5 4
11 NO 1,430 0 2
Total Population 96,154 31
* Table taken from the document "Evaluation of Title II Food Security Program in Guatemala, MYAP 2006‐2011.  “Endline Sample Design”.
MYAP Endline 2011
Methodology
4 
Within each stratum, a sample of clusters was made in three stages, as follows:
 First Selection Level:  Communities  
A community cluster is a group of the population living in the same sector, geopolitically
defined and quite homogenous.   Thus,
community clusters refer to communities or
human settlements such as:  villages, parajes
(isolated inhabited areas), caseríos (groups of
houses), towns, cities, etc.  These community
clusters were selected through Probability
Proportional to Size (PPS sampling).  See the
list of selected clusters below.   Community
clusters are under the statistical concept of
primary clusters.
 Second Selection Level:  Households  
Within each selected community cluster, a
random sampling of households was
performed.  The selection in this case took into account the only factor that was required to
be part of the survey sample:  That there are children under 5 years old in the household.
 Third Selection Level:  Families   
There were a few households (68) that included more than one family that met the previously‐
mentioned inclusion criteria.  Therefore, one family was randomly selected.  The term “family”
includes the “nuclear family” composed of the father, the mother, and their children 2
.
I.2 A List of Selected Community Clusters  
Table M2 shows a list of selected clusters submitted to Save the Children in the design document.  Based
on this list, Save the Children’s Monitoring and Evaluation personnel analyzed the feasibility of visiting
the selected sites considering risks such as natural disasters (impassable access routes) and rejection
from communities.
Thus, Save the Children, after having evaluated the risks, replaced some communities with substitutes.
 
2 It is important to note that for the endline, information on a nuclear family unit was measured, while a slightly
different unit was used for the baseline:  a HOUSEHOLD (the latter includes the nuclear family as well as any other
member of the household “who eats from the same pot”).
PPS Sampling
Sampling with Selection Probabilities
Proportional to Size
A random selection process is used for this
methodology.  It uses cluster population sizes
to select samples, by means of a process that
is similar to systematic sampling in which
individuals from a population are selected
(each individual in the cluster has the same
probability of being selected, but this
probability is different in the various clusters).  
Thus, communities with the most population
are more likely to be selected.
MYAP Endline 2011
Methodology
5 
Table M2
Selected and Visited Community Clusters
Dept.
Stratum
Municipality
Total Population in
Stratum
Selected Cluster/
Community
Visited
Communities
Quiché
1
Sacapulas
7,668
1 CHACAGUEX YES
2 TRAPICHITOS YES
Substitute Community 3 SALINAS MAGDALENA NO
2 7,769
4 PARRAXTUT NO
5 1er CENTRO DE RIO BLANCO YES
Substitute Community 6 PATULUP YES
3 Cunén 16,369
7 SAN ANTONIO YES
8 CHIUL YES
9 BATZULA YES
10 LA HACIENDA YES
Substitute Community 11 MEDIA LUNA NO
4
Uspantán
11,112
12 EL PINAL YES
13 TIERRA BLANCA PERICÓN YES
14 EL PALMAR YES
Substitute Community 15 EL CARACOL YES
5 1,745
16 JACUBI YES
17 QUIZACHAL NO
Substitute Community 18 SICACHE NO
6
Nebaj
24,038
19 XEXUXCAP YES
20 SALQUIL GRANDE YES
21 PALOP YES
22 VILLALÁ YES
23 RÍO AZUL YES
24 ACTXUMBAL YES
25 PULAY YES
Substitute Community 26 VICALAMÁ YES
7
651 27 LAS VIOLETAS NO
Substitute Community 28 NONE
8
San Juan
Cotzal
9,446
29 SANTA AVELINA YES
30 EL PINAL YES
Substitute Community 31 BICHIBALÁ YES
9
1,182
32 TIXELAP NO
33 PAMAXÁN YES
Substitute Community 34 NONE
10 Chajul 14,744
35 SANTA CLARA YES
36 XEMAC YES
37 ILOM YES
MYAP Endline 2011
Methodology
6 
Dept.
Stratum
Municipality
Total Population in
Stratum
Selected Cluster/
Community
Visited
Communities
38 XOLUCAY YES
Substitute Community 39 JUIL NO
11 1,430
40 SOTZIL YES
41 CHONCHOLA YES
Substitute Community 42 NONE
The original design document is attached to this report.
II. Updating and Adapting Instruments to Gather Information
Because the MYAP is a program executed by three organizations, –Save the Children, CRS, and SHARE–
the instruments to gather information for the baseline and the endline evaluation measurements were
developed jointly by the three organizations, which defined the instruments to gather information from
the onset.
Therefore, the instruments to gather the information required to estimate indicators had already been
validated and amply tested by said organizations for the baseline study.  However, as a result of each
institution’s executing the program, and before the endline was executed, technical personnel from
these institutions met to review the baseline instruments.  With the experience gained in executing the
program, they made changes in the instruments whenever they considered it pertinent.   Changes,
though, were very few and relatively insignificant with respect to the original structure of the
instruments.  
Therefore, the Consultant already had an information‐gathering instrument with questions that had
been validated and tested by the three institutions, so there was no need to validate the instrument.
In order to streamline the data‐gathering and data‐entry processes, the Consultant divided the original
instrument into several sections or forms, without altering the original questions.   This allowed for
increased efficiency in gathering data and entering it into the computer.
The following instruments, attached as annexes, were used:
1. Form 1 Cover Sheet (filter).docx             (one page)
2. Form 2 Family Structure (FORM A).docx             (one page)
MYAP Endline 2011
Methodology
7 
3. Form 3 Health 0‐60 (FORM B).docx    (0 to  <60 months)   (six pages)
4. Form 4 Health 0‐6 (FORM C).docx   (0 to  <6 months)   (two pages)
5. Form 5 Health 6‐24  (FORM D).docx   (6 to  <24 months)   (two pages)
6. Form 6 SHAVE Production (FORM E).docx         (six pages)
7. Form 7 Marketing Cover Sheet (filter‐M).docx          (one page)
8. Form 8 Marketing Family Structure (FORM F).docx           (one page)
9. Form 9 Marketing (FORM G).docx            (three pages)
10. Form 10 Anthropometry (FORM antropometry).docx         (one page)
11. Form 11a Risk Management (FORM H1).docx    (Situation Room) (three pages)
In the Annex "First Progress Report:  Training" instruments are further detailed.
III.   Selecting and Training Field Personnel
When field surveys are performed, it is important to consider the elements that directly affect the
quality of the information being gathered and which will subsequently condition results.  Among these
aspects is selecting and training personnel, as well as the training and standardization activities required
to accomplish this.
III.1   Selecting and Integrating Field Personnel
Field personnel, totaling 21 individuals divided into three work groups, was recruited in accordance with
the following basic characteristics:   That they have a secondary‐school diploma, previous experience,
time availability according to the work chronogram that was developed at the onset, a positive attitude
toward the activities involved in a quantitative survey such as this one.
In order to constitute surveyor work groups, efforts were made to include at least one member of the
group who spoke one of the Mayan languages spoken in the geographical areas that would be surveyed.  
Thus, there was someone who spoke the local language in every group.
The method used to document interviewees’ responses in the field was filling out printed instruments.  
Consequently, in each of the three groups of surveyors there was an individual whom we identified as
MYAP Endline 2011
Methodology
8 
the “editor”.  The role of the editor was to ensure that the instruments were correctly filled out, and to
verify that all the relevant forms were available.
III.2 Training and Standardization
The group of surveyors was trained by means of a five‐day workshop (August 8‐12, 2011).  Generally, in
similar consultancies, the Consultant is responsible for training and standardization.   In this case,
however, both SHARE and Save the Children directly participated in training personnel, and they
substituted their role as observers (generally the case) to an executing role.
In practice, interview or “face‐to‐face” techniques and dynamics were used to fill out the instruments,
since this is the methodology used in the field.  
The training workshop was structured according to three important sections:
 First portion:   Presenting each one of the Programs and reviewing topics pertaining to the
indicators being measured.   This was undertaken by SHARE and Save the Children technical
personnel.  
 Second portion:  Learning about, handling and filling out data‐gathering instruments, aimed at
acquainting surveyors with the order and sequence of questions and the correct way to record
information (coding gathered information).  SHARE and Save the Children were in charge of this
activity.
 Third portion:   Executing practical exercises and standardizing the way in which
anthropometrical measurements are taken.  Technical aspects on face‐to‐face interviews were
addressed (in pairs and systematized) and the corresponding practical exercises were
performed.  There were two main purposes for this stage:   
a) To introduce personnel to the process of applying data‐gathering instruments
b) To evaluate how much each workshop participant knew about handling the instruments
adequately.  It was possible to determine trainees’ knowledge on this subject and thus made
it easier to provide timely and immediate feedback on how to apply each data‐gathering
instrument correctly.
MYAP Endline 2011
Methodology
9 
Three exercises to standardize weight and length/height were performed with boys and girls
under five years old3
, with the purpose of ensuring that adequate standardized personnel
will be available to take and record these anthropometrical measurements.  During these
exercises, “Salter” hanging scales, with a 25‐kilogram capacity and 100‐gram sensitivity,
were used, since they are the ones being used in this field phase, as well as height rods that
allow measuring children while standing or lying down.  Measurement standardization was
evaluated by means of the Habicht4 method.
During the last two days of the workshop the basic survey terms in Mayan languages (K´iche, Ixil, Mam,
K'aqchikel) were standardized.   All gathering instruments were applied in those languages, using a
systematized interview to achieve a standardization level similar to the one shown during the
application of the Spanish instruments.
IV.   Executing Field Work
At the end of the training workshop, field logistics were reviewed and defined according to survey
requirements and field schedules or work routes were developed in accordance with selected
communities.
IV. 1   Field Phase
Field activities were executed according to the schedule established in the training and logistics phase.
a.     Presenting the Survey and Requesting Cooperation from the Community
Before starting to gather information in each community, personnel in each work team sought the
support from local authorities and/or local leaders, COCODES members and assistant mayors, as well as
Save the Children’s technical personnel and volunteers.   These individuals provided their support as
facilitators during the field phase to provide guidance within the community, to locate households,
translate, and/ or contact translators.
 
3 This practice was performed with the assistance of the Comprehensive Care Center Program, which allowed our
personnel to come to their center located in Zone 13.  (See Annex 5, a copy of the letter requesting their
cooperation.)
4 This standardization was aimed at determining surveyors’ level of precision and accuracy when weighing and
measuring boys and girls under five years old.
MYAP Endline 2011
Methodology
10 
b.    Managing the Survey Team
The team started their field work on August 20 in Quiché.  Information was gathered in communities
within the Chajul, San Juan Cotzal, and Nebaj municipalities before the teams recessed on August 25.  
Data‐gathering for the survey was accomplished simultaneously by three field‐surveyor groups (Groups
1, 2, and 3), and thus, were able to visit three communities per day.
After their recess, the teams started their field and data‐gathering activities in the Nebaj, Quiché
municipality on August 30.   Information on communities in the Uspantán, Cunén, and Sacapulas
municipalities was gathered.  Field work was performed in the Primer Centro de Río Blanco, Uspantán,
and Quiché.
c.     Linguistic Issues
An essential factor to assigning personnel to their work area was to gain previous knowledge of the
geographical areas and the language spoken there.  As previously mentioned, it was determined that at
least one surveyor in each work group should speak one of the four main languages spoken in the area
being surveyed.  In so doing, it was guaranteed that at least one surveyor who could speak the local
language was part of each work group.  However, in some cases, translators had to be hired, since the
surveyor speaking the local language was not able to handle so much work.  It is important to mention
that before seeking and hiring translators, and to establish if they were needed, local authorities were
asked their opinion on the linguistic preferences of those mothers being surveyed.
Save the Children’s technical team provided their support to contact the translators according to
established needs.   The persons hired to translate were people living in the community, community
facilitators, mother leaders, agricultural/livestock leaders, COSAN members and, in some cased,
members of Save the Children’s technical team.  They were all provided with a brief introduction to the
instruments that were being used, so that they became acquainted with them and understood them.  
The methodology used by teams in each household was to introduce themselves and to ask what
language the interviewee spoke.  Subsequently, she was given the chance to choose what language she
preferred to be interviewed in.  The supervisor for each group was in charge of assigning translators, and
paid special attention to their needs.  He/she accompanied his/her group at all times during field work.    
MYAP Endline 2011
Methodology
11 
c.   Managing Information in the Field
The first step in each community was to select the households that would be surveyed, according to the
total number of households in the community and the 35‐household sample size that had been defined.  
Samples for each community were obtained through systematic random sampling, based of sampling
frames (diagram).   Once surveyors and anthropometric specialists were established in selected
communities, the supervisor located them in the assigned households according to the selected sample.
In the field, all the information was gathered through home visits.  Each interview lasted between forty‐
five minutes and one hour and a half.  This included the presentation, the instruments that would be
used (which depended on the number of children in the household and their ages), as well as the need
to use a translator in the household.
In most communities, local personnel provided support.  They provided guidance and accompaniment,
significantly contributing to making work more effective.  
IV.2   Quality Control in the Field
IV.2.1 Internal Quality Control  
During the whole phase of field work several quality‐control mechanisms were applied.  Among them,
the following should be underscored:  
a. The direct supervision in the households where surveys were made, by means of a random
sample among selected households, generated by the supervisor as the work was progressing.
b. Thoroughly reviewing each one of the filled‐out forms (edition), which was an activity performed
by group editors and done while still in the communities.
IV.2.1 External Quality Control  
During the whole field‐work phase, Save the Children personnel accompanied the three groups of
surveyors.   Accompanying Save the Children personnel included:   Monitoring and Evaluation
Coordinator, Norberto Enríquez; Health Coordinator, Viviana Rendón; Agricultural Coordinator, Héctor
Lara, as well as community volunteers (mother leaders, agricultural/livestock leaders, COSAN members).  
They supervised the work and contributed to improving the performance of groups by providing
feedback when they noted that there was a mistake in the field work being performed.
MYAP Endline 2011
Methodology
12 
IV.3 Products
IV.3.1.   Health and Nutrition, and Livelihood Components   
The total products corresponding to the surveys in each community are presented included in the Table
in Annex 2, according to the order in which communities were visited.
It is important to mention that during the dates in which field work was being undertaken, there were
several events within and outside the communities that sometimes limited information‐gathering
actions, such as political rallies, religious activities (activities before and during the Day of Our Lady of
the Assumption, and other community religious events), Independence Day, activities related to the
social program “Mi Familia Progresa”, among other social events.  These events kept mothers outside
their homes during most of the day and thus limited the number of effective interviews and delayed
anthropometric measurements.   
It is also important to mention that there were frequent constraints to gather survey information in peri‐
urban communities, as interviewees were not usually in their homes and there were a considerable
number of rejections to the survey.
IV.3.2. Marketing and Commercialization Component
Information gathering corresponding to the Marketing and Commercialization component was random
in selected communities identified by Save the Children as those in which this component was
developed.   Because it was agreed with FANTA and the three PVOs that the indicators for this
component would only be measured among participants, individual interviewees were not selected
randomly, but rather all the participants in the Marketing and Commercialization component in the
community were summoned.   Participants were coordinated and summoned by Save the Children
through its technical team.
All the products from the surveys in each selected community are included in Annex 3, in accordance
with the order in which communities were visited during the field‐work phase.
The communities sampled for this component were three, and a total 43 surveys were performed.
MYAP Endline 2011
Methodology
13 
IV.3.3. Risk Management and Sentinel Sites
Form H1‐Sentinel Sites was applied to selected communities where this activity is being implemented.  
The field supervisor for each group was responsible for coordinating and summoning participants in this
component, supported by Save the Children’s technical team.  This activity took place in the facilities
established by community leaders to that end (Sentinel Sites).  Information on community activities and
their organization and planning was reviewed, as well as the materials they have and the training
activities in which they have participated.  The communities where information on this component was
gathered are mentioned in Annex 3.
Each group’s field supervisor was in charge of completing this form, with support from community
leaders.  
The progress report on the field work performed is attached in an Annex.
V   Analyzing Data and Writing the Report
The information gathered in the field was entered into the computer by means of the EPI INFO software,
DOS 6.04d.  Data contained in each of the forms or instruments were entered using a double entry
method.  Each entry was performed by a different typist.  As part of the quality‐control mechanisms for
data entry, EPI INFO has a CHECK module that was activated and that allowed detecting errors such as
mistaken “skips” in variables, extreme or invalid values (for example, there are only two codes for sex:  
1=male and 2=female, any other value cannot be entered into the software program).  
After both entries have been completed independently, data were checked by a process known as
validation (using the software module:  VALIDATE).  Discrepancies between files or errors in them were
identified, and they were corrected in both entry files (first and second).  Once files were corrected, they
were validated again, and if there were new inconsistencies, they were again identified and corrected.  
This process was repeated as much as necessary, until identical files were achieved (no inconsistencies
or errors).   
Anthropometric values were estimated by means of the EPI INFO EPINUT module, which provides Z‐
scores according to NCHS references.  Z‐Scores were also estimated using WHO references, by means of
the WHO ANTHRO software, version 3.2.2.  It is important to mention that when the information in both
MYAP Endline 2011
Methodology
14 
software programs was processed, very extreme cases or “outliers” were eliminated.   ANTHRO
eliminates the values estimated for these children, and in the case of NCHS, they were eliminated
manually by the Consultant, by means of programs developed for that purpose.  These programs do not
eliminate the cases, themselves; rather, they eliminate extreme values, so that a child with an extreme
value in height might still keep his/her information for weight/age, but not for height/age.  This results
in unequal sample sizes among the same anthropometric indicators, and additional differences among
the same indicators measured by different software programs, due to the difference in the references
on which they are based.
When errors had been eliminated from the databases, programs were created to develop indicators
(see annexes on databases for these programs, which have a PGM extension and can be accessed
through WORD).   EPI INFO CSAMPLE module was used for the statistical analysis.   It estimates
percentages, averages, and variability measurements (including confidence intervals) taking into
account the sample design.   Three variables were considered in this case:   STRATUM, CLUSTER, and
WEIGHTING.
The strata are the ones defined in the design document, so that each survey can be easily located within
the corresponding stratum.  Similarly, the CLUSTER corresponds to the primary or community cluster, in
other words, the community.  WEIGHTING was estimated taking into account selection probability (in
the same way in which the baseline was estimated):
Weighting = 1 / selection probability  
In which:
Selection Probability = Prob. Selecting community X Prob. Selecting household within community  
To develop this report, a draft was submitted to SHARE and Save the Children personnel with its format
which mainly identified the tables containing the indicators that would be reported.
MYAP 2011 Endline
Results
15 
III Results
This section contains the results yielded by this survey for each one of the program indicators.   This
information is presented by means of tables5 and graphs.   Tables contain information for the total
population as well as disaggregated information on the population from communities where there
was/was not an agricultural/livestock program intervention.
Tables present the values established for the sample (percentages or averages) and the values for the
population (at a 95% confidence interval), as well as the size sample used to estimate each indicator and
the number of subjects in the sample that conform to the indicator.   It is important to note that,
because the statistical analysis was performed taking into account the sampling design (stratified by
clusters), it was necessary to weight each observation with its inverse selection probability.  Thus the
percentages that are presented do not respond to a mere division of cases or subjects that conform to
the indicator and the sample size.  For example:  61.1% from a sample size of 911 children under five
years old has been reported for the indicator “Percentage of children under 5 years old with chronic
malnutrition (Z < ‐2SD height/age) for the population with an agricultural/livestock intervention” (under
less than two standard deviations).  When dividing 541 by 911 the result is 59.4%, which is not the same
as 61.1%.  The difference, as previously mentioned, is due to the 61.1% value having been estimated by
taking into account the sample design, while the 59.4% value was estimated not taking the design into
account, and thus, it is a skewed value (by analysis).
Results are presented in four different sections within this document:
III.A MYAP Indicators.   This section contains a table summarizing the results of the main Program
indicators, the values that contrast with goals, and the values obtained for the baseline.
III.B    2011 Results.   The detailed indicator results, both for the total population and for the
disaggregation:   Population in which there was/was not an agricultural/livestock intervention.  
Additionally, the main findings are included at the end of each table (a discussion of the results).  
III.C   Effects of the Design.  This section corresponds to one of the Annexes and it contains the effects
of the sample design on each one of the eleven main indicators.
III.D 2011 Results by Municipality.  This section corresponds to the disaggregation of indicators by
municipality.  This section IS NOT PRESENTED as part of this report, but rather as an attached document
containing analysis output with EPI INFO.   This disaggregation was requested by Save the Children,
which will use it with programmatic purposes.
 
5 Containing indicators pertaining to the same topic
MYAP 2011 Endline
Results
16 
III.A MYAP Indicators
Table III.A.1 MYAP Indicators and Their Goals
Area Indicators   Baseline
Programmed
GOAL
LOA
Endline  
2011
Anthropometry
in children
under 5 years
old
Percentage of children under 5 years old with chronic malnutrition
(Z < ‐2SD height/age),  NCHS 71.6% 69% 63.0%
(57.4, 68.5)
Percentage of children under 5 years old with chronic malnutrition
(Z < ‐2SD height/age), WHO 78.2% 75.2% 70.3%
(64.6, 76.0)
Percentage of children under 5 years old with overall malnutrition
(Z < ‐2SD weight/age), NCHS 34.2% 28% 30.5%
(26.7, 34.2)
Percentage of children under 5 years old with overall malnutrition
(Z < ‐2SD weight/age), WHO   26.3% 20% 25.0%
(21.0, 29.1)
Family dietary
diversity and
family food
scarcity
Average dietary diversity score 4.6
Food groups
6
Food groups
8.0
Food groups
(7.76, 8.26)
Average number of months of adequate household food
provisioning   9.1 months 11 months
10.49
months
(10.30, 10.69)
Children’s
feeding
practices
Percentage of infants under 6 months of age who were exclusively
breastfed during the past 24 hours 65.6% 74% 80.1%
(73.4, 86.8)
Danger signs in
mothers’,
newborns’,
and children’s
health
Percentage of mothers of children under 36 months of age who
recognize at least two danger signs during pregnancy that indicate
the need to seek health services  
30.0% 50% 84.5%
(78.1, 91.0)
Percentage of mothers of children under 36 months of age who
recognize at least two danger signs in newborns  (<28 days) that
indicate the need to seek health services
26.0% 41% 69.9%
(64.3, 75.4)
Percentage of mothers and caregivers of children under 36
months of age who recognize at least two danger signs of
childhood illnesses that indicate the need to seek health services
50.0% 75% 80.6%
(76.0, 85.3)
Agricultural/
livestock
practices
Percentage of producers adopting at least two good agricultural
practices 11.0% 30% 65.5%
(57.9, 73.1)
Percentage of producers adopting at least two good livestock
practices 12.0% 30% 81.3%
(72.2, 90.4)
Improved
income
Percentage of producers adopting at least two formal marketing
practices
15.4% 30%
99.2%
(98.5, 99.9)
Not
comparable
to Baseline
MYAP 2011 Endline
Results
17 
III.A.1 MYAP Indicators and Their Goals
Main Findings:
Table III.A.1 shows that populations in which Save the Children is implementing PROMASA show positive
signs in indicators as compared to those prevalent before starting the program, as they show
improvement.
Chronic malnutrition rates (height for age under less than two standard deviations) in children under
five years old decreased by 8.6% according to the NCHS reference and by 7.9% according to the WHO
reference (P<0.05).   So did overall malnutrition rates (weight for age under less than two standard
deviations), which decreased by 3.7% according to the NCHS reference (P<0.05).  In this sense, results
also show that established goals to decrease chronic and overall malnutrition were achieved.
Graph II.A.1:  Chronic Malnutrition (Height for Age) in Children under 5 Years Old
MYAP 2011 Endline
Results
18 
Graph III.A.2: Overall Malnutrition (Weight for Age) in Children under 3 Years Old and
Children under 5 Years Old
In regard to dietary diversity, results show that it surpassed the baseline value, increasing average
consumption from 4.6 to 8 food groups.  This result surpassed the 6‐group established goal (P<0.05).
The average number of Months of Adequate Household Food Provisioning was 10.5 months, which is
higher than the baseline value, but slightly underneath the goal of 11 months.  
In general, knowledge on the danger signs in pregnant women, newborns, and children has exceeded
baseline values and the goals established (P<0.05).  Results show that the percentage of women who
learned about danger signs easily doubled when compared to baseline values.   Thus, there are now
84.5% of women who recognize danger signs during pregnancy; 69.9% who recognize danger signs in
newborns, and 80.6% who recognize danger signs during childhood.
Good agricultural and livestock practices also improved compared to the baseline and they also
surpassed established goals (P<0.05).   Now, there are 65.5% of producers using good agricultural
practices and 81.3% of producers using good livestock practices.  These results appear to be the reason
for the significant difference in malnutrition rates among the population participating in the Program’s
agricultural/livestock intervention, which show significantly lower rates (P<0.05), compared to those of
the population in which there was no intervention.
MYAP 2011 Endline
Results
19 
In regard to adopting at least two formal marketing practices, results show that at the baseline, 15.4% of
producers engaged in these practices and, thus, a 30% goal was established.  Because Save the Children
implemented this activity with a limited group of producers, it was considered that the impact on the
whole population would be minor and that, therefore, the indicator would not show program efforts
and achievements with participants.  Thus, the sample for this indicator is a sub‐sample of the overall
survey sample6
, which is still representative due to the random selection of communities.  In this case,
there is a sample of 49 participants, which shows that the program has caused 99.2% of them to adopt
at least two formal‐marketing practices, and that this percentage among total participants is not below
98.5% (this value corresponds to the lower limit of the confidence interval for this indicator).
 
6 In their July 2011 meeting, FANTA and the three PVOs –SHARE, Save the Children, and CRS– agreed that this
indicator would be measured by means of a sub‐sample of participants and not a population sample, as the rest of
the indicators were measured.
Confidence interval
The value found for the indicator (% or average) is included in the tables, and
underneath, its confidence interval is shown.  This interval corresponds to the
lower and higher limits estimated with a 95% confidence level and they show
the range of values in which the population value is located.
MYAP 2011 Endline
Results
20 
III.B 2011 Results.
III.B.1 Anthropometry in Children under 5 Years Old
A sample of 1,184 children under five years old was used. Because some of them presented extreme values in their weight and/or length‐height
for age and/or weight for length‐height measurements, these girls and boys are identified as extreme‐value cases ("outliers") and software
programs identify them with a variable (flag), and in the particular case of the ANTHRO software, it eliminates the values. Thus, the total sample
size is not 1,184 boys and girls; it is smaller, depending on whether a child had an extreme value or not. Consequently, there are different‐size
samples for the various indicators.
Table III.B.1 Anthropometry in Children under 5 Years Old Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample
Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Anthropometry according to NCHS References
1a
Percentage of children under 5 years old with chronic
malnutrition (Z < ‐2SD height/age)
911
(541)
61.1%
(54.8, 67.4)
260
(188)
77.5%
(72.4, 82.6)
1,171
(729)
63.0%
(57.4, 68.5)
1a1
Average height/age Z‐score in children under 5 years old 911 ‐2.20 SD
(‐2.33, ‐2.56)
260
‐2.56 SD
(‐2.69, ‐2.43) 1,171
‐2.24 SD
(‐2.37, ‐2.11)
2a
Percentage of children under 5 years old with overall
malnutrition (Z < ‐2SD weight/age)
917
(275)
28.9%
(24.8, 33.1)
263
(103)
42.7%
(41.6, 43.8)
1,180
(378)
30.5%
(26.7, 34.2)
2a1
Average weight/age Z‐score in children under 5 years old 917 ‐1.42 SD (‐1.53, ‐1.31) 263 ‐1.77 SD (‐1.89, ‐1.64) 1,180 ‐1.46 SD (‐1.57, ‐1.64)
3a
Percentage of children under 5 years old with acute
malnutrition (Z < ‐2SD weight/height)
911
(39)
3.9%
(1.3, 6.5)
261
(2)
0.3%
(0.6, 0.2)
1,172
(41)
3.5%
(1.2, 4.8)
3a1 Average weight/height Z‐score in children under 5 years 911 ‐0.04 SD 261 ‐0.21 SD 1,172 ‐0.06 SD
MYAP 2011 Endline
Results
21 
Table III.B.1 Anthropometry in Children under
5 Years Old
Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample
Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
old (‐0.16, 0.08) (‐0.27, ‐0.15) (‐0.17, 0.05)
Anthropometry according to WHO References
1b
Percentage of children under 5 years old with chronic
malnutrition (Z < ‐2SD height/age)
919
(616)
68.6%
(64.6, 76.0)
263
(206)
84.0%
(82.3, 85.7)
1,182
(822)
70.3%
(64.6, 76.0)
1b1 Average height/age Z‐score in children under 5 years old 919 ‐2.46 SD (‐2.61, ‐2.31) 263 ‐2.84 SD (‐2.98, ‐2.69) 1,182 ‐2.50 SD (‐2.65, ‐2.36)
2b
Percentage of children under 5 years old with overall
malnutrition (Z < ‐2SD weight/age)
919
(228)
23.5%
(19.1, 28.0)
263
(83)
36.9%
(35.4, 38.4)
1,182
(311)
25.0%
(21.0, 29.1)
2b1 Average weight/age Z‐score in children under 5 years old 919 ‐1.29 SD (‐1.41, ‐1.17) 263 ‐1.67 SD (‐1.82, ‐1.53) 1,182 ‐1.33 SD (‐1.45, ‐1.21)
3b
Percentage of children under 5 years old with acute
malnutrition (Z < ‐2SD weight/height)
916
(46)
5.0%
(2.5, 7.5)
263
(3)
1.6%
(0.0, 5.3)
1,179
(49)
4.7%
(2.5, 6.9)
3b1 Average weight/height Z‐score in children under 5 years old 916 0.21 SD (0.07, 0.35) 263 ‐0.01SD
(‐0.09, 0.08) 1,179 0.19 SD (0.06, 0.31)
MYAP 2011 Endline
Results
22 
Table III.B.2 Anthropometry in Children under
5 years old by Age Group Results
Indicator
0 a < 36 Months 36 Months a < 60 Months
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Anthropometry according to NCHS References
1a
Percentage of children under 5 years old with chronic malnutrition (Z < ‐2SD
height/age)
784
(445)
57.9%
(52.1, 63.7)
387
(284)
73.4%
(66.7, 80.1)
1a1
Average height/age Z‐score in children under 5 years old 784 ‐2.10 SD (‐2.24, ‐1.96) 387 ‐2.52 SD (‐2.66, ‐2.34)
2a
Percentage of children under 5 years old with overall malnutrition (Z < ‐2SD
weight/age)
793
(247)
30.8%
(26.4, 35.3)
387
(131)
29.7%
(21.9, 37.4)
2a1
Average weight/age Z‐score in children under 5 years old 793 ‐1.39 SD (‐1.53, ‐1.25) 387 ‐1.61 SD (‐1.75, ‐1.47)
3a
Percentage of children under 5 years old with acute malnutrition (Z < ‐2SD
weight/height)
786
(16)
2.3%
(0.8, 3.8)
386
(25)
6.0%
(1.5, 10.6)
3a1
Average weight/height Z‐score in children under 5 years old 786 ‐0.02 SD (‐0.15, 0.10) 386 ‐0.14 SD (‐0.30, 0.03)
Anthropometry according to WHO References
1b
Percentage of children under 5 years old with chronic malnutrition (Z < ‐2SD
height/age) 795 (520) 66.6% (60.8, 72.5) 387 (302) 78.1% (70.7, 72.5)
1b1 Average height/age Z‐score in children under 5 years old 795 ‐2.43 SD (‐2.59, ‐2.27) 387 ‐2.65 SD (‐2.79, ‐2.51)
2b
Percentage of children under 5 years old with overall malnutrition (Z < ‐2SD
weight/age)
795
(196)
24.5%
(21.0, 27.9)
387
(115)
26.2%
(18.1, 34.3)
2b1 Average weight/age Z‐score in children under 5 years old 795 ‐1.25 SD (‐1.40, ‐1.11) 387 ‐1.49 SD (‐1.65, ‐1.33)
3b
Percentage of children under 5 years old with acute malnutrition (Z < ‐2SD
weight/height)
792
(22)
3.8%
(2.2, 5.3)
387
(27)
6.6%
(1.6, 11.5)
3b1 Average weight/height Z‐score in children under 5 years old 792 0.20 SD 387 0.16 SD
MYAP 2011 Endline
Results
23 
(0.05, 0.35) (‐0.06, 0.37)
Table III.B.3 Anthropometry in Children Under 5 Years Old by Sex Results
Indicator
Boys Girls
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Anthropometry according to NCHS References
1a
Percentage of children under 5 years old with chronic malnutrition (Z < ‐2SD
height/age) 600 (362) 61.2% (54.7, 67.7) 571 (367) 64.9% (57.7, 72.1)
1a1
Average height/age Z‐score in children under 5 years old 600 ‐2.20 SD (‐2.34, ‐2.05) 571 ‐2.28 SD (‐2.45, ‐2.12)
2a
Percentage of children under 5 years old with overall malnutrition (Z < ‐2SD
weight/age)
604
(176)
27.0%
(22.6, 31.5)
576
(202)
34.1%
(29.7, 38.5)
2a1
Average weight/age Z‐score in children under 5 years old 604 ‐1.42 SD (‐1.56, ‐1.28) 576 ‐1.50 SD (‐1.62, ‐1.37)
3a
Percentage of children under 5 years old with acute malnutrition (Z < ‐2SD
weight/height)
602
(20)
3.1%
(1.0, 5.1)
570
(21)
4.0%
(0.8, 7.1)
3a1
Average weight/height Z‐score in children under 5 years old 602 ‐0.09 SD
(‐0.2, 0.03)
570
‐0.03 SD
(‐0.18, 0.12)
Anthropometry according to WHO References
1b
Percentage of children under 5 years old with chronic malnutrition (Z < ‐2SD
height/age) 606 (424) 70.3% (63.4, 77.4) 576 (398) 70.4% (634, 77.4)
1b1 Average height/age Z‐score in children under 5 years old 606 ‐2.50 SD (‐2.66, ‐2.34) 576 ‐2.50 SD (‐2.68, ‐2.32)
2b
Percentage of children under 5 years old with overall malnutrition (Z < ‐2SD
weight/age)
606
(159)
24.7%
(20.4, 29.0)
576
(152)
25.4%
(20.1, 30.7)
2b1 Average weight/age Z‐score in children under 5 years old 606 ‐1.31 SD
(‐1.45, ‐1.17)
576
‐1.36 SD
(‐1.49, ‐1.22)
3b
Percentage of children under 5 years old with acute malnutrition (Z < ‐2SD
weight/height)
605
(24)
4.4%
(2.1, 6.7)
574
(25)
5.0%
(1.8, 8.1)
3b1 Average weight/height Z‐score in children under 5 years old 605 0.19 SD 574 0.17 SD
MYAP 2011 Endline
Results
24 
(0.03, 0.36) (0.02, 0.33)
III.B.1 Anthropometry in Children under 5 Years Old
Main Findings:
According to NCHS references (Table III.B.1), these results show that chronic malnutrition rates (length/height for age) are 16.4% lower in boys
and girls under five years old in the population with agricultural/livestock interventions versus the population without these interventions
(77.5% versus 61.1% respectively, P < 0.05). A child under five years old who lives in a community where there is an agricultural/livestock
intervention has 2.2 times less probability (odds ratio) of being malnourished than a child who lives in a community without these interventions.
There are similar results for overall malnutrition (weight for age), in which the difference between both groups is 13.8% (P < 0.05), and the
probability of NOT being malnourished is 1.8 times (odds ratio) when living in communities with agricultural/livestock interventions.
Nevertheless, it is interesting to note that these results also show that acute malnutrition (weight for length/height) was higher in the group with
agricultural/livestock interventions (P < 0.05). This was detected in 39 cases that exhibit wasting or extreme thinness, probably as a result of a
very severe food crisis. From these 39 cases found with the NCHS reference, 147 have some degree of severe malnutrition (under or equal to
less than three standard deviations), indicating children who are in serious danger.
Results are similar when they are analyzed according to WHO references. However, when WHO growth references are applied instead of the
NCHS references, there is an increase in chronic malnutrition rates. Thus, malnutrition rates are higher with those references than with NCHS
references. Results show lower malnutrition rates for the first two anthropometric indices (height for age and weight for age) in the group in
which livelihoods interventions have been implemented (P < 0.05), while acute malnutrition rates (weight for length/height) are higher. The
National Mother‐Child Health Survey 2008‐2009 (ENSMI in Spanish) shows malnutrition results according to the WHO reference, which in the
specific area of Quiché are: 72.2% of chronic malnutrition and 21.5% of overall malnutrition. These values are confirmed by the children who
live in communities with agricultural/livestock activities, while communities without agricultural/livestock interventions have higher rates.
7 With both the NCHS reference and the WHO reference, the total number of boys and girls with severe acute malnutrition is 20. The list of these children was
shared with Save the Children, and from those 20, only two of them are children whose families are participating in the Program.
MYAP 2011 Endline
Results
25 
When results are disaggregated by age groups (Table III.B2), they show that there are higher chronic malnutrition rates among older girls and
boys (from 36 to < 60 months old), according to the length/height for age (73.4% to 57.9%, P<0.05) (NCHS). In this case, it can also be said that a
child who is over 36 months has 2 times more probability (odds ratio) of being chronically malnourished than does a younger child. Acute
malnutrition (NCHS) in children from 36 to < 60 months is three times the rate of younger children, and the difference between both groups is
statistically significant (P<0.05).
On the other hand, the results included in Table III.B3 show that the percentages of boys and girls with chronic, overall, and acute malnutrition
(WHO) were similar when the sex of these children was considered.
MYAP 2011 Endline
Results
26 
III.B.2 Family Dietary Diversity and Family Food Scarcity
Table III.B.2 Family Dietary Diversity and Family
Food Scarcity Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Family Dietary Diversity and Family Food Scarcity
4
Average dietary diversity score (average food groups
eaten) 635 8.11 groups (7.86, 8.36) 172 7.04 groups (6.87, 7.21) 807 8.01 groups (7.76, 8.26)
4a Percentage of families that ate from the following
groups:
4a1 A: Cereals
635
(635)
100%
(‐)
172
(172)
100%
(‐)
807
(807)
100%
(‐)
4a2 B: Roots and tubers
635
(415)
66.3%
(59.7, 73.0)
172
(79)
39.7%
(21.7, 57.6)
807
(494)
63.8%
(57.4, 70.2)
4a3 C: Vegetables
635
(366)
56.2%
(50.5, 62.0)
172
(76)
54.5%
(36.3, 72.7)
807
(442)
56.0%
(50.6, 61.5)
4a4 D: Fruits
635
(517)
80.6%
(75.7, 85.5)
172
(109)
63.6%
(46.2, 80.9)
807
(626)
79.0%
(74.2, 83.8)
4a5 E: Meat, chicken, innards
635
(323)
48.2%
(40.0, 56.3)
172
(70)
39.7%
(66.5, 13.4)
807
(393)
47.4%
(39.7, 55.0)
4a6 F: Eggs
635
(434)
70.7%
(67.4, 74.1)
172
(112)
59.0%
(49.4, 68.6)
807
(546)
69.6%
(66.4, 72.9)
4a7 G: Fish and seafood
635
(25)
3.2%
(1.6, 4.8)
172
(0)
0%
(‐)
807
(25)
2.9%
(1.5, 4.3)
4a8 H: Legumes /nuts 635 (502) 79.5% (75.7, 83.3) 172 (144) 86.1% (80.8, 91.4) 807 (646) 80.1% (76.7, 83.5)
4a9 I: Milk and dairy products 635 31.1% 172 14.2% 807 29.5%
MYAP 2011 Endline
Results
27 
Table III.B.2 Family Dietary Diversity and Family
Food Scarcity Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
(195) (26.1, 36.2) (18) (7.5, 20.8) (213) (25.0, 34.7)
4a10 J: Oils/fats 635 (569) 90.7% (88.1, 93.3) 172 (137) 79.0% (69.9, 88.2) 807 (706) 89.6% (87.0, 92.2)
4a11 K: Sugar/honey 635 (630) 99.4% (98.6, 100) 172 (170) 99.6% (99.4, 99.8) 807 (800) 99.4% (98.7, 100)
4a12 L: Various foods
635
(532)
85.1%
(80.6, 89.7)
172
(131)
68.6%
(55.1, 82.1)
807
(663)
83.6%
(79.1, 88.0)
Family Food Scarcity
5
Average number of months of adequate household
food provisioning 635
10.48
months
(10.27, 10.68)
172
10.66
months
(10.28, 11.04)
807 10.49 months (10.30, 10.69)
5a Most scarce foods:
5a1 A: Corn
635
(313)
50.2%
(43.5, 56.9)
172
(57)
43.0%
(38.9, 47.1)
807
(370)
49.5%
(43.4, 55.6)
5a2 B: Beans
635
(270)
43.9%
(37.6, 50.3)
172
(44)
34.8%
(30.0, 39.5)
807
(314)
43.1%
(37.3, 48.8)
5a3 C: Horticultural products
635
(72)
12.5%
(7.2, 17.8)
172
(17)
10.8%
(4.5, 17.1)
807
(89)
12.3%
(7.5, 17.1)
5a4 D: Herbs
635
(35) 5.9% (2.9, 8.8) 172 (6) 4.5% (0.0, 13.6) 807 (41) 5.8% (2.9, 8.6)
5a5 E: Sugar
635
(116)
17.2%
(13.1, 21.4)
172
(44)
29.2%
(22.2, 36.1)
807
(160)
18.4%
(14.5, 22.2)
5a6 F: Oil 635 4.2% (2.1, 6.4) 172 0.7% (0.3, 1.1) 807 3.9% (2.0, 5.8)
MYAP 2011 Endline
Results
28 
Table III.B.2 Family Dietary Diversity and Family
Food Scarcity Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
(22) (3) (25)
5a7 G: Rice
635
(45)
7.3%
(4.6, 10.0)
172
(12)
7.3%
(6.1, 8.5)
807
(57)
7.3%
(4.9, 9.7)
5a8 H: Eggs
635
(40)
6.4%
(3.8, 8.9)
172
(8)
5.4%
(2.0, 8.7)
807
(48)
6.3%
(4.0, 8.6)
5a9 I: Meat
635
(90)
14.6%
(10.3, 18.9)
172
(33)
21.2%
(12.0, 30.4)
807
(123)
15.2%
(11.2, 19.2)
5a10 J: Others
635
(49)
7.3%
(4.3, 10.4)
172
(11)
6.4%
(1.9, 10.9)
807
(60)
7.2%
(4.4, 10.0)
5b
Reasons for food scarcity:
5b1 A: A lack of money
635
(240)
37.0%
(32.4, 41.5)
172
(63)
39.5%
(28.3, 50.7)
807
(303)
37.2%
(33.0, 41.5)
5b2 B: A lack of employment
635
(170)
27.4%
(23.1, 31.6)
172
(45)
27.3%
(19.3, 35.2)
807
(215)
27.4%
(23.5, 31.2)
5b3 C: A large family
635
(18)
2.7%
(1.0, 4.3)
172
(8)
5.5%
(1.3, 9.6)
807
(26)
2.9%
(1.4, 4.70)
5b4 D: Market/place to buy food is too far away 635 (6) 0.9% (0.1, 1.7) 172 (3) 3.0% (2.4, 3.5) 807 (9) 1.1% (0.4, 1.8)
5b5 E: No crop was harvested
635
(178)
28.9%
(25.2, 32.6)
172
(18)
13.7%
(6.0, 21.4)
807
(196)
27.5%
(24.0, 31.0)
5b6 F: The harvest was lost
635
(80)
12.4%
(8.0, 16.8)
172
(10)
8.8%
(6.6, 10.9)
807
(90)
12.0%
(8.1, 16.0)
5b7 G: Expensive food 635 3.5% (2.4, 4.6) 172 3.1% (0.0, 8.0) 807 3.4% (2.3, 4.5)
MYAP 2011 Endline
Results
29 
Table III.B.2 Family Dietary Diversity and Family
Food Scarcity Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
(22) (7) (29)
5b8 H: Others
635
(19)
2.8%
(0.8, 4.9)
172
(6)
3.8%
(3.4, 4.1)
807
(25)
2.9%
(1.1, 4.8)
6
Average of reduced severity index8
"What did you do for food during months of
scarcity?"
635
2.49
points
(2.14, 2.84)
172
2.32
points
(1.64, 3.0)
807
2.47
points
(2.15, 2.80)
6a What did you do for food during months of scarcity?
6a1 A: Sold an asset
635
(53)
9.4%
(5.6, 13.2)
172
(10)
7.6%
(5.9, 9.3)
807
(63)
9.2%
(5.8, 12.6)
6a2 B: Sold animals
635
(114)
17.9%
(12.9, 23.0)
172
(28)
17.9%
(5.0, 30.8)
807
(142)
17.9%
(13.2,22.7)
6a3 C: Sold land
635
(1)
0.2%
(0.0, 0.5)
172
(0)
0.0%
(‐)
807
(1)
0.1%
(0.0, 0.4)
6a4 D: Borrowed money
635
(78)
12.1%
(7.4, 16.9)
172
(22)
12.1%
(5.3, 19.0)
807
(100)
12.1%
(7.8, 16.5)
6a5 E: Some of the children had to work
635
(50)
7.3%
(4.0, 10.6)
172
(6)
5.2%
(2.0, 8.3)
807
(56)
7.1%
(4.1, 10.1)
6a6 F: A member of the family went to work somewhere else 635 42.2% 172 39.6% 807 41.9%
8 “Severity Index” also known as “CSI” (Coping Strategies Index). This index has been thoroughly studied in Africa, and was created by the World Food
Program (WFP) Assisted Refugees in Western Tanzania. The index is included in a document drafted by several organizations in 20088, and it is defined as the
sum of weighted adaptations (or strategies used by the family to face food crises). In Guatemala, JMatute‐CIENSA has estimated it for UNICEF and World
Vision. The index is based on a scale ranging from “0” a “20” points, in which “0” means that no strategy was used and “20”, which is the maximum severity,
means that all the strategies being measured were used.
MYAP 2011 Endline
Results
30 
Table III.B.2 Family Dietary Diversity and Family
Food Scarcity Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
(262) (37.0, 47.3) (54) (29.8, 49.3) (316) (37.1, 46.7)
6a7 G: Reduced the number of meals
635
(11)
1.4%
(0.5, 2.3)
172
(6)
1.3%
(0.4, 2.2)
807
(17)
1.4%
(0.6, 2.2)
6a8 H: Others
635
(21)
2.9%
(1.4, 4.5)
172
(8)
4.7%
( 2.7, 6.7)
807
(29)
3.1%
(1.7, 4.5)
III.B.2 Family Dietary Diversity and Family Food Scarcity
Main Findings:
Table III.B.2 shows that the population with
agricultural/livestock interventions has a dietary diversity
score that is higher than the one for the population without
such interventions. (8.11 points versus 7.04 points,
respectively, P<0.05). Similarly, the percentage of people
eating several food groups is higher in the population with
livelihoods activities (agricultural/livestock intervention). It
shows that 100% of families eat cereals and another similar
percentage (99.4%) eats sugar or honey. Other foods
commonly eaten include oils or fats (89.6%), legumes
MYAP 2011 Endline
Results
31 
(80.1%), and fruits (79.0%), followed by products such as milk and dairy products (29.5%). The foods that are less eaten are fish and seafood
(2.9%).
Results also show that adequate household food provisioning is
10.5 months; however, it is important to note that from the 809
households that were interviewed, 371 mentioned having had
adequate food provisioning during the 12 months (46%9) of the
year. Consequently, 436 reported having at least one month of
scarcity, and July was reported as the month in which there is
more scarcity (248 out of the 436 that were interviewed). The
food that is reportedly most scarce is corn (49.5%), followed by
beans (43.1%). The main reasons given by families for the
scarcity of these foods in the household were “a lack of money”
(32.7%), “no crop was harvested” (27.5%) and “a lack of
employment” (27.4%).
The severity index quantifies the family’s capability to face the food crisis resulting from the lack of food in the household. Index
values fluctuate from 0 to 20. “0”means that families did not have to adapt, while “20” means that they sought all possible coping
strategies (those that were measured). Results show an average value of 2.47 points, which indicates that the population that was
analyzed did not have much need to adapt during the past year. This result may be explained by the high percentage of households
9 Non‐weighted value
MYAP 2011 Endline
Results
32 
in which there was adequate provisioning during most months of the year. It is important to mention that not all possible
adaptation mechanisms were measured, and that consequently, the index is not sufficient to establish food insecurity in this
population. The most widely‐used adaptation mechanism was seeking employment somewhere else (41.9%), followed by selling
animals (17.9%).
MYAP 2011 Endline
Results
33 
III.B.3 Information, Education and Communication in Health and Nutrition
Table III.B.3 Information, Education and Communication
in Health and Nutrition
Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample
Size
(# Cases)
%
(CI 95%)
7
Percentage of women who state that they have received
health and nutrition advice during the past month
635
(534)
84.0%
(80.1, 87.9)
172
(141)
87.4%
(81.8, 92.9)
807
(675)
84.3%
(80.7, 87.9)
7a
Percentage of women who state that they have received
advice from MoH personnel and/or the Food Security
Program.
635
(530)
83.1%
(78.7, 87.5)
172
(133)
85.2%
(79.4, 91.1)
807
(663)
83.3%
(79.3, 87.3)
They received advice from:
7a1 A: MoH health personnel
635
(229)
37.8%
(28.9, 46.7)
172
(71)
54.2%
(32.6, 75.8)
807
(300)
39.3%
(31.0, 47.7)
7a2 B: Community personnel from the Food Security Program
635
(453)
70.0%
(65.8, 74.3)
172
(114)
73.4%
(72.4, 74.3)
807
(567)
70.3%
(66.5, 74.2)
7a3 C: Family, neighbors and others
635
(37)
6.8%
(3.3, 10.3)
172
(21)
12.7%
(10.8, 14.6)
807
(58)
7.3%
(4.2, 10.5)
7b Counseling topics:
7b1 A: Children’s health
635
(459)
70.5%
(64.3, 76.8)
172
(122)
82.4%
(73.9, 90.8)
807
(581)
71.7%
(65.9, 77.5)
7b2 B: Pregnant women’s health
635
(83)
12.6%
(7.3, 18.0)
172
(31)
19.6%
(12.9, 26.3)
807
(114)
13.3%
(8.4, 18.2)
7b3 C: Newborns’ health
635
(110)
17.1%
(12.5, 21.8)
172
(36)
18.1%
(8.8, 27.4)
807
(146)
17.2%
(12.9, 21.5)
7b4 D: Nutrition and feeding practices 635 90.2% 172 75.5% 807 73.7%
MYAP 2011 Endline
Results
34 
Table III.B.3 Information, Education and Communication
in Health and Nutrition
Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample
Size
(# Cases)
%
(CI 95%)
(463) (69.2, 77.8) (117) (73.1, 78.0) (580) (69.8, 77.6))
7b5 E: Hygiene in the home
635
(369)
58.9%
(55.6, 62.2)
172
(89)
59.2%
(48.2, 70.3)
807
(458)
58.9%
(55.8, 62.1)
7b6 D: Water treatment and care
635
(189)
30.5%
(26.1, 34.9)
172
(56)
31.5%
(29.6, 33.3)
807
(245)
30.6%
(26.6, 34.6)
7c Ways in which advice or messages were transmitted:
7c1 A: Counseling
635
(227)
35.1%
(27.3, 42.9)
172
(95)
61.4%
(36.4, 86.4)
807
(322)
37.6%
(29.9, 45.3)
7c2 B: Education sessions and/or demonstrations 635 (505) 78.9% (75.2, 82.5) 172 (125) 77.5% (72.1, 82.9) 807 (630) 78.7% (75.4, 82.1)
7c3 C: Home visits
635
(94)
14.4%
(9.3, 19.4)
172
(12)
5.1%
(6.8, 7.9)
807
(106)
13.7%
(9.1, 18.3)
7c4
D: Some type of social media (radio, posters, billboards,
TV, loudspeakers)
635
(69)
11.4%
(5.7, 17.1)
172
(33)
28.8%
(26.4, 31.1)
807
(102)
13.1%
(7.9, 18.2)
MYAP 2011 Endline
Results
35 
III.B.3 Information, Education, and Communication in Health and Nutrition
Main Findings:
84.3% of women reported having received health and nutrition
advice during the past month. Results show that receiving such
advice did not have any connection with disaggregation of the
population by agricultural/livestock interventions. This is
interpreted as being the result of IEC activities in health and
nutrition having been executed equally among both populations,
which was to be expected. There are a high percentage of
women (83.3%) who state that they have received advice from
qualified MoH or PROMASA personnel; most of them (70.3%)
received it from the latter source. The main topics addressed in
those instances were “Nutrition and Feeding Practices” and
“Children’s Health” (71.7%). The topics most seldom addressed
were “Pregnant Women’s Health” (13.3%) and “Newborns’
Health” (17.2%). The main method used to transmit this
knowledge was education sessions and/or demonstrations
(78.7%). It is interesting to note that the percentage of home
visits is considerably higher (P<0.05) among the population with
agricultural/livestock interventions (14.4%) than among the
population without this activity (5.2%).
MYAP 2011 Endline
Results
36 
III.B.4 Children Feeding Practices
Table III.B.3 Children Feeding Practices Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Breastfeeding in Children Under 6 Months Old
8
Percentage of children under six months old who were
exclusively breastfed in the last 24 months
100
(77)
79.7%
(72.7, 86.6)
30
(25)
84.1%
(60.3, 100)
130
(102)
80.1%
(73.4, 86.8)
8a
Percentage of women with children under six months old
who are breastfeeding them
100
(100)
100%
(‐)
30
(30)
100%
(‐)
130
(130)
100%
(‐)
Feeding Practices in Children from 6 to < 24 Months
9
Percentage of mothers of children from 6 to < 24 months
old who have breastfed their child
309
(299)
96.1%
(93.1, 99.2)
85
(84)
99.7%
(99.2, 100)
394
(383)
96.5%
(93.8, 99.3)
9a
Percentage of mothers of children from 6 to < 24 months
who are breastfeeding their children
309
(278)
89.5%
(85.7, 93.2)
85
(76)
95.9%
(94.6, 97.3)
394
(354)
90.1%
(86.8, 93.5)
10
% of mothers and caregivers of children from 6 to > 24
months who know and practice good weaning/
complementary feeding (started feeding their children
when he/she was 6 months old)
309
(280)
89.7%
(85.7, 93.6)
85
(74)
86.5%
(85.1, 87.8)
394
(354)
89.3%
(85.8, 92.8)
10a Average age in which children from 6 to < 24 months old started to be fed 294 6.54 months (6.31, 6.78) 80 6.33 months (6.00, 6.73) 374 6.52 months (6.31, 6.74)
11
Percentage of boys and girls from 6 to < 24 months old
(whether they are breastfed or not) fed according to
minimum standards for infant and children feeding
practices. It complies with the following: 11a1, 11a2,
11a3, 11a4
309
(20)
7.4 %
(4.8, 10.0)
85
(5)
9.4%
(3.2, 15.6)
394
(25)
7.6%
(5.2, 10.1)
11a1
Percentage of women who fed their children the
recommended number of times for their age:
 6 to 8 months, 3 or more times
 9 to 11 months, 4 or more times
 12 to < 24 months, 5 or more times
309
(107)
35.8%
(28.7, 42.8)
85
(17)
27.3%
(18.3, 36.4)
394
(124)
34.9%
(28.5, 41.2)
MYAP 2011 Endline
Results
37 
Table III.B.3 Children Feeding Practices Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
11a2
Percentage of women who prepared food as
recommended for their children’s age
 6 to 8 months, pureed or strained
 9 to 11 months, minced or diced
 12 to < 24 months, minced or diced or the same
as the rest of the family
309
(133)
40.8%
(32.4, 49.2)
85
(37)
39.3%
(36.2, 42.3)
394
(170)
40.6%
(33.1, 48.2)
11a3
Percentage of women who fed their children the number
of spoonfuls of food recommended for their age for
yesterday’s lunch:
 6 to 8 months, 3 spoonfuls or more
 9 to 11 months, 4 spoonfuls or more
 12 to < 24 months, 5 spoonfuls or more
309
(193)
64.5%
(59.0, 69.9)
85
(36)
46.2%
(39.7, 52.7)
394
(229)
62.5%
(57.6, 67.5)
11a4
Percentage of women who fed their families at least four
of the following foods groups yesterday:
a. Cereals, roots and tubers
b. Legumes and nuts
c. Dairy products (milk, yogurt, cheese)
d. Meats (meat, fish, chicken and liver or innards
e. eggs
f. fruits and vegetables rich in Vitamin A
g. other fruits and vegetables
309
(103)
36.1%
(30.6, 41.6)
85
(23)
28.0%
(16.2, 39.7)
394
(126)
35.2%
(30.1, 40.4)
Percentage of women who fed the following food groups
to their families:
Galim1 Cereals, roots and tubers
309
(282)
91.6%
(88.1, 95.0)
85
(76)
90.2%
(86.2, 94.2)
394
(358)
91.4%
(88.3, 94.5)
Galim2 Legumes and nuts
309
(194)
61.5%
(54.8, 68.3)
85
(56)
63.1%
(54.4, 71.7)
394
(250)
61.9%
(55.6, 67.8)
Galim3 Dairy products (milk, yogurt, cheese)
309
(14)
5.4%
(2.1, 8.7)
85
(0)
0.0%
(‐)
394
(14)
4.8%
(1.9, 7.7)
MYAP 2011 Endline
Results
38 
Table III.B.3 Children Feeding Practices Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Galim4 meats (meat, fish, chicken and liver or innards)
309
(66)
19.4%
(13.9, 24.8)
85
(16)
17.5%
(5.4, 28.2)
394
(82)
19.2%
(14.2, 24.1)
Galim5 eggs
309
(143)
50.0%
(44.9, 55.1)
85
(41)
43.1%
(34.2, 51.9)
394
(184)
49.2%
(44.5, 54.0)
Galim6 fruits and vegetables rich in Vitamin A
309
(53)
18.9%
(13.4, 24.4)
85
(12)
15.7%
(0.0, 32.5)
394
(65)
18.5%
(13.3, 23.8)
Galim7 other fruits and vegetables
309
(151)
52.9%
(46.4, 59.3)
85
(31)
39.9%
(30.2, 49.5)
394
(182)
51.5%
(45.5, 57.5)
Percentage of women who fed their families:
11a4a Only one group
309
(23)
7.3%
(1.4, 4.7)
85
(7)
11.6%
(9.3, 13.8)
394
(30)
7.8%
(5.4, 10.2)
11a4b Only two groups
309
(77)
22.3%
(18.3, 26.3)
85
(22)
21.6%
(18.2, 25.0)
394
(99)
22.2%
(18.6, 25.8)
11a4c Only three groups
309
(94)
30.3%
(24.0, 36.5)
85
(28)
32.5%
(25.0, 40.0)
394
(122)
30.5%
(24.9, 36.2)
III.B.4 Children Feeding Practices
Main Findings:
80.1% of children in the population in which PROMASA is being executed were exclusively breastfed when they were under 6 months old; these
values establish 73.4% and 86.8% (confidence interval) levels for this indicator. In comparison, results from the ENSMI 2008‐2009 survey show
60.4% for this practice. Thus, the values from this study are over the national average. In regard to breastfeeding in general, the ENSMI 2008‐
2009 survey reports 96.6% of breastfeeding with or without complementary feeding to children less than 6 months old in rural areas, which
concurs with the findings of this study (100%).
MYAP 2011 Endline
Results
39 
96.5% of boys and girls over 6 months old and under two
years old have been breastfed, and 90.1% of children were
being breastfed at the time of this study. Therefore, there are
almost 10% of girls and boys over 6 months old and under two
years old who are no longer being breastfed. The
recommended age for children to start receiving
complementary feeding is 6 months. We can see that the
percentage of women who engaged in this practice was 89.3%.
The average age in which boys and girls are first given solid
foods is 6.52 months.
With respect to complementary feeding, the indicator on mothers who engage in all good practices is very low (7.6%), which is explained by the
relatively low values obtained for the four indicators or practices that were measured and that make up this overall indicator: Feeding children
food the recommended number of times, 34.9%; preparing food in the recommended way, 40.6%; feeding children the recommended number
of spoonfuls, 62.5%, and feeding children a variety of foods (at least one food from at least four different food groups) the day before, 35.2%.
The food group that was most fed to children the day before was “cereals, roots, and tubers” (91.4%), followed by the “legumes and nuts” food
group (61.9%). The “dairy” food group was the one less fed to children (4.8%), followed by “fruits and vegetables rich in Vitamin A” (18.5%), as
well as “meats” (19.2%). It is important to take into account that within the percentages of the diversity of foods fed to children, there are some
low ones, but even so, these are relatively high owing to the biological impact that they can have on children’s nutritional status. In is also worth
noting that there was 7.8% of women who only fed one food group to their children, and 22.2% who only fed them two groups, both totaling
30% of women.
MYAP 2011 Endline
Results
40 
Additionally, it is important to note that the nutrition IEC strategy has been implemented during only one and a half years10. Thus, the findings,
which are rather good, speak well of this strategy.
10 Information provided by Save the Children
MYAP 2011 Endline
Results
41 
III.B.5 Danger Signs in Mothers’, Newborns’ and Children’s Health
Table III.B.5 Danger Signs in Mothers’, Newborns’, and
Children’s Health
Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
12
Percentage of women who recognize at least two danger
signs during pregnancy
635
(540)
84.3%
(77.3, 91.3)
172
(135)
86.6%
(76.0, 97.2)
807
(675)
84.5%
(78.1, 91.0)
13
Percentage of women who exhibited danger signs during
their pregnancy
Among those who stated recognizing at least one signal
560
(249)
45.4%
(39.4, 51.4)
145
(79)
53.6%
(34.9, 72.3)
705
(328)
46.2%
(40.6, 51.8)
14
Percentage of women who sought advice or treatment
when they recognized a danger sign during their pregnancy
249
(239)
96.5%
(94.0,99.0)
79
(70)
85.9%
(66.0, 100)
328
(309)
95.3%
(92.1, 98.5)
14a Where they sought advice
14a1
Hospital, health center/post, private clinic 239
(215)
89.1%
(80.8, 97.3)
70
(59)
83.6%
(73.6, 93.6)
309
(274)
88.5%
(81.1, 95.9)
14a2
MoH community centers, health promoters, traditional
birth attendants
239
(76)
32.2%
(20.2, 44.2)
70
(33)
52.9%
(11.3, 94.4)
309
(109)
34.3%
(23.0, 45.6)
14a3
Others 239
(5)
1.7%
(0.0, 3.5)
70
(1)
0.6%
(0.0, 1.6)
309
(6)
1.6%
(0.0, 3.2)
15
Percentage of women who recognize at least two neonatal
(less than 28 days) danger signs
635
(451)
70.6%
(64.4, 76.7)
172
(103)
63.2%
(58.5, 67.9)
807
(554)
69.9%
(64.3, 75.4)
16
Percentage of women who state that one of their children
exhibited a danger signal when they were newborns
Among those who stated recognizing at least one signal
517
(203)
39.9%
(33.9, 45.8)
125
(67)
62.1%
(56.6, 67.6)
642
(270)
41.9%
(36.5, 47.4)
17
Percentage of women who stated that they sought advice
and treatment when their newborn exhibited danger signs
203
(194)
96.4%
(93.5, 99.3)
67
(63)
98.1%
(97.6, 98.5)
270
(257)
96.6%
(94.2, 99.1)
17a Where they sought advice
17a1 Hospital, health center/post, private clinic 194 92.8% 63 95.5% 257 93.1%
MYAP 2011 Endline
Results
42 
Table III.B.5 Danger Signs in Mothers’, Newborns’, and
Children’s Health
Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
(182) (87.1, 98.4) (56) (89.9, 100) (238) (88.2, 98.1)
17a2
MoH community centers, health promoters, traditional
birth attendants
194
(33)
17.0%
(8.8, 25.1)
63
(12)
21.1%
(4.4, 37.8)
257
(45)
17.5%
(10.1, 24.9)
17a3
Others 194
(9)
4.4%
(0.7, 8.1)
63
(5)
10.2%
(1.9, 18.5)
257
(14)
5.2%
(1.8, 8.7)
18
Percentage of women who recognize at least two danger
signs that indicate that their children need treatment when
they are sick
635
(509)
79.5%
(74.6, 84.4)
172
(147)
91.3%
(79.0, 100)
807
(656)
80.6%
(76.0, 85.3)
19
Percentage of women who state that one of their children
has exhibited danger signs when he/she has been sick
Among those who stated recognizing at least one signal
571
(401)
69.4%
(63.7, 75.1)
155
(127)
86.5%
(79.5, 93.5)
726
(528)
71.2%
(66.0, 76.3)
20
Percentage of women who state having sought advice or
treatment when their children exhibited a danger sign
401
(399)
99.5%
(98.9, 100)
127
(126)
99.7%
(99.6, 99.8)
528
(525)
99.5%
(99.0, 100)
20a Where they sought advice
20a1 Hospital, health center/post, private clinic 399
(379)
94.7%
(89.8, 99.5)
126
(121)
94.3%
(90.0, 98.5)
525
(500)
94.6%
(90.3, 98.9)
20a2 MoH community centers, health promoters, traditional
birth attendants
399
(57)
16.2%
(7.5, 24.9)
126
(9)
7.0%
(1.8, 12.3)
525
(66)
15.1%
(7.3, 22.8)
20a3 Others 399
(18)
4.8%
(2.1, 7.6)
126
(13)
13.7%
(0.0, 27.7)
525
(31)
5.9%
(2.8, 9.0)
MYAP 2011 Endline
Results
43 
III.B.5 Danger Signs in Mothers’, Newborns’, and Children’s Health
Main Findings:
84.5% of women recognize at least two danger signs during pregnancy. It was determined that among those who recognize at least one such
danger sign, 46.2% stated that they had experienced one of these signs, and among these women, 95.3% mentioned that they had sought help
(advice or treatment). A high percentage (88.5%) of these women sought help from qualified personnel (hospital, health center/post, or private
clinic), and 34.3% sought help at the local level (MoH community centers, health promoters or traditional birth attendants).
The percentage of women who recognize
danger signals in newborns (at least two
signals) is 69.9%. Among those who stated
recognizing at least one danger sign, 41.9%
confirmed that one of their children
exhibited at least one danger sign when
he/she was a newborn, and almost all of
these women (96.6%) sought help from
qualified personnel (hospital, health
center/post, or private clinic), while 17.5%
sought help at the local level (MoH
community centers, health promoters or
traditional birth attendants).
MYAP 2011 Endline
Results
44 
80.6% of women recognize at least two danger signs when their children are sick. Among women who stated that they recognized at least one
danger sign, 71.2% stated that one of their children had exhibited some. In this case, almost all of them (99.5%) sought help, mainly from
qualified personnel (94.6%). Only 15.1% sought help locally.
III.B.6 Water Treatment
Table III.B.6 Water Treatment
Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
21
Percentage of families who treat their water (by
boiling, chlorinating, and filtering it or by using
the SODIS methodology)
635
(629)
99.0%
(98.1, 99.9)
172
(169)
99.6%
(98.7, 100)
807
(798)
99.0%
(98.2, 99.8)
Percentage of families who treat their water by:
21a
Boiling it 635
(608)
96.0%
(93.9, 98.1)
172
(167)
99.2%
(98.4, 99.9)
807
(775)
96.3%
(94.4, 98.2)
21b
Filtering it 635
(118)
16.6%
(10.2, 23.0)
172
(10)
3.8%
(1.3, 6.2)
807
(128)
15.4%
(9.6, 21.1)
21c
Chlorinating it 635
(20)
2.2%
(0.7, 3.6)
172
(2)
0.5%
(0.0, 1.4)
807
(22)
2.0%
(0.7, 3.3)
21d
SODIS 635
(86)
14.3%
(9.7, 18.9)
172
(17)
7.1%
(4.4, 9.8)
807
(103)
13.6%
(9.4, 17.8)
MYAP 2011 Endline
Results
45 
III.B.6 Water Treatment
Main Findings:
The microbiological quality of water is an important factor for good health. When water is contaminated with pathogens associated with
diarrhea, children’s nutritional status is negatively affected. The pathogen producing cholera is so virulent that it can cause death, especially
among populations who are vulnerable due to their poverty and poor nutritional status. In Guatemala, the Instituto de Nutrición para
Centroamérica y Panamá (Institute of Nutrition of Central America and Panama–INCAP) has studied the connection between diarrhea and the
nutritional status of children. These studies have shown how diarrhea episodes, when they are frequently repeated over long periods of time,
even if they are not serious, may affect children’s nutritional status. Since contaminated water is one of the vectors for these pathogens, it is
very important that water be treated before it is consumed by families. Almost all families (99.0%) treat water in one way or another: 96.3%
boils water; 15.4% filters it; 13.6% uses the SODIS methodology, and 2.0% uses chlorine.
MYAP 2011 Endline
Results
46 
III.B.7 Agricultural/Livestock Practices
A total of 807 households were selected and visited, and information was gathered in them. Not all families living in these households engage in
agricultural and livestock activities and thus, the sample sizes in this section are smaller than the ones in previous sections. There are 768
families engaged in agriculture and 135 engaged in livestock activities.
Table III.B.7 Agricultural/Livestock Practices Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Livestock Practices
Measured only in families who engage in agriculture
22
Percentage of producers adopting at least two good agricultural
practices
609
(405)
67.1%
(58.8, 75.4)
159
(54)
50.8%
(44.8, 56.9)
768
(459)
65.5%
(57.9, 73.1)
22a Agricultural practices adopted:
22a2
Percentage of producers with better corn and/or bean practices:
producers who use 4 or more seeds per hole when planting corn;
producers use improved seed to plant beans
609
(298)
47.8%
(40.4, 55.3)
159
(48)
37.4%
(32.0, 42.8)
768
(346)
46.8%
(40.0, 53.7)
22a4
Percentage of producers who adopt horticultural‐ diversification
practices
609
(292)
51.1%
(42.1, 60.2)
159
(33)
35.0%
(31.8, 38.1)
768
(325)
49.5%
(41.3, 57.8)
22a6
Percentage of producers who adopt soil‐conservation practices 609
(477)
79.5%
(74.2, 84.8)
159
(94)
75.2%
(58.8, 91.6)
768
(571)
79.1%
(74.1, 84.1)
22a7
Percentage of producers who adopt pest‐control practices 609
(171)
30.3%
(20.3, 40.3)
159
(4)
2.6%
(0.0, 5.3)
768
(175)
27.6%
(18.5, 36.7)
Livestock Practices
Measured only in families who engage in livestock activities
23
Percentage of producers adopting good livestock practices (with
goats)
Complying with the following two: 23a and 23b
127
(108)
83.4%
(74.0, 92.7)
8
(2)
8.4%
(4.8, 12.1)
135
(110)
81.3%
(72.2, 90.4)
MYAP 2011 Endline
Results
47 
Table III.B.7 Agricultural/Livestock Practices Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
23a2
Percentage of producers who fence in their animals (goats) 127
(117)
91.1%
(85.3, 96.8)
8
(6)
69.5%
(31.1, 100)
135
(123)
90.5%
(84.7, 96.2)
23b2
Percentage of producers who take care of their animals:
Giving vitamins to goats and deworming them
127
(117)
91.7%
(84.9, 98.5)
8
(3)
12.6%
(7.1, 18.0)
135
(120)
89.5%
(82.6, 96.4)
24
Percentage of families who consume at least one food
originating from their animal production (goats)
127
(124)
96.9%
(93.4, 100)
8
(8)
100%
(‐)
135
(132)
97.0%
(93.6, 100)
25
Percentage of producers who sell at least one of the foods
originating from their animal production (goats)
127
(101)
76.9%
(62.6, 91.2)
8
(8)
100%
(‐)
135
(109)
77.5%
(63.6, 91.5)
Production Information, Education and Communication (considering individuals who engage in agricultural and/or livestock activities)
26
Percentage of individuals who have received
agricultural/livestock production advice
635
(417)
67.9%
(63.1, 72.6)
172
(65)
48.2%
(41.9, 54.4)
807
(482)
66.0%
(61.5, 70.5)
27 Frequency with which they are given advice:
27a
Once per month 417
(267)
62.9%
(52.2, 73.6)
65
(24)
33.6%
(0.0, 80.8)
482
(291)
60.8%
(50.3, 71.4)
27b
At least once every two months 417
(53)
13.6%
(8.7, 18.4)
65
(7)
12.7%
(0.0, 31.3)
482
(60)
13.5%
(8.8, 18.2)
27c
Every three months 417
(35)
8.7%
(5.2, 12.3)
65
(8)
16.1%
(6.1, 26.1)
482
(43)
9.3%
(5.8, 12.7)
27d
More than three months apart 417
(35)
8.0%
(4.6, 11.5)
65
(8)
14.6%
(13.0, 16.3)
482
(43)
8.5%
(5.3, 11.7)
28 The advice received during the past year has centered on:
28a
Improving their agricultural production 417
(383)
92.8%
(90.7, 94.9)
65
(53)
88.9%
(87.9, 89.9)
482
(436)
92.5%
(90.5, 94.6)
28b
Improving their business 417
(46)
9.6%
(4.3, 14.9)
65
(0)
0.0%
(‐)
482
(46)
8.9%
(4.0, 13.8)
MYAP 2011 Endline
Results
48 
Table III.B.7 Agricultural/Livestock Practices Results
Indicator Population WITH
Agricultural/Livestock
Interventions
Population WITHOUT
Agricultural/Livestock
Interventions Total Population
Code Name
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
Sample Size
(# Cases)
%
(CI 95%)
28c
Guidance to earn more money 417
(22)
4.9%
(2.3, 7.5)
65
(0)
0.0%
(‐)
482
(22)
4.5%
(2.1, 7.0)
28d
Improving their livestock production 417
(377)
90.9%
(86.7, 95.0)
65
(55)
89.5%
(86.0, 93.1)
482
(432)
90.8%
(86.9, 94.6)
29 Who have provided advice in recent years:
29a
Organizations that support production and commercialization 417
(339)
83.7%
(72.3, 95.1)
65
(30)
43.7%
(0.0, 97.8)
482
(369)
80.9%
(69.4, 92.4)
29b
Family or neighbors 417
(15)
3.1%
(0.9, 5.3)
65
(11)
10.5%
(7.9, 13.0)
482
(26)
3.6%
(1.5, 5.7)
29c
Communication media (radio, TV, printed, loudspeakers) 417
(3)
1.1%
(0.0, 2.4)
65
(2)
1.1%
(0.1, 2.0)
482
(5)
1.1%
(0.0, 2.3)
29d
Local technicians or promoters 417
(86)
18.1%
(5.1, 31.2)
65
(26)
48.3%
(0.0, 97.0)
482
(112)
20.3%
(7.5, 33.0)
III.B.7 Agricultural/Livestock Practices
Main Findings:
As all the communities where Save the Children works generally engage in agriculture, it is to be expected that even in those communities where
Save the Children did not implement its agricultural and production strategic objective, good agricultural practices have been implemented. This
is evidenced in Table III.B.7, since it shows that there is implementation of these good practices, as well as education on agricultural/livestock
topics, both in communities in which the agricultural objective was developed and in those in which it was not.
MYAP 2011 Endline
Results
49 
The achievements of PROMASA’s Livelihoods component (agricultural/livestock interventions) in the communities where it was implemented
are also shown in this table, since the percentage of producers adopting at least two good agricultural practices is significantly higher (P<0.05) in
those communities with this component (67.1%) when compared to the population in communities without this component (50.8%): An
agricultural producer who lives in a community that has been exposed to agricultural/livestock interventions is 1.53 times (odds ratio) more
MYAP 2011 Endline
Results
50 
likely to adopt at least two good agricultural practices than a producer who lives in a community that has had no such exposure. Similarly, the
percentage of producers who have implemented good corn and/or bean practices is significantly higher (P<0.05) among the population with
agricultural/livestock interventions (47.8%) than among the population without this component (37.8%). Likewise, practices such as
horticultural diversification (with Program, 51.1%; without Program, 35.0%) and pest control (with Program, 30.3%; without Program, 2.6%)
were significantly (P<0.05) higher in the population with agricultural/livestock interventions.
Livestock practices are limited to those who are raising an animal. In this regard, Save the Children has promoted and encouraged goat raising,
which, as shown in the table, is being practiced by 135 families. Almost all of them (127) are located in communities where Save the Children
has implemented livestock activities. As can be seen, 83.4% of those who have goats and live in areas with Program influence have adopted two
good practices: Fencing in their animals (goats) and taking care of the goats (giving them vitamins and deworming them). Both practices,
individually, have been adopted by 91% of producers. Implementing these two practices is important, both because they guarantee the
productivity of these animals and also because they promote a cleaner and more healthy environment in the household.
Because of the economic and hygienic importance of good livestock practices, it is considered that they could be connected to the nutritional
level shown in the anthropometric section, in addition to good agricultural practices which can also contribute to families’ food security.
Implementation of good practices is, in turn, a reflection of an education process. Results show that the percentage of individuals who received
advice on agricultural/livestock production is significantly higher (P<0.5) among the population in which agricultural/livestock interventions have
been implemented (67.9%) compared to the population in which they have not (48.2%). It is also important to underscore that the frequency
with which they receive this advice is greater in those communities where the Program is implementing these activities that in those where it is
not. Additionally, results show that most producers (83.7%) state that this advice has been provided by organizations that support production
and commercialization, such as PROMASA.
MYAP 2011 Endline
Results
51 
III.B.8 Improved Income (Formal Marketing)
The information contained in this table was obtained by means of a sub‐sample of the original sample. This sub‐sample was composed of all the
participants in marketing or improved‐income activities located within the communities selected for this survey. In this case, this involved three
communities.
Table III.B.8 Improved income (Formal Marketing)
Results
Indicator
Code Name
Sample Size
(# Cases)
%
(CI 95%)
30
Percentage of producers implementing two formal‐marketing practices (ind30a1 y/o Ind30a2) 43
(42)
99.2%
(98.5, 99.9)
Formal marketing practices used:
30a1
Percentage of producers who make their production and/or marketing estimates 43
(43)
100%
(‐)
30a2
Percentage of producers keeping production and/or commercialization records 43
(42)
99.2%
(98.5, 99.9)
31
Percentage of producers who receive institutional technical assistance for formal marketing 43
(41)
95.9%
(93.0, 98.8)
31a Type of producers’ businesses:
31a1
agricultural 43
(43)
100%
(‐)
31a2
livestock 43
(10)
25.0%
(13.1, 36.8)
31b
family business 43
(2)
7.0%
(0.0, 13.8)
32
Percentage of producers implementing production/marketing plans 43
(43)
100%
(‐)
Places where they sell their products:
MYAP 2011 Endline
Results
52 
Table III.B.8 Improved income (Formal Marketing)
Results
Indicator
Code Name
Sample Size
(# Cases)
%
(CI 95%)
32a1
community market 43
(17)
18.8%
(15.5, 22.1)
32a2
municipal market 43
(34)
74.8%
(16.7, 100)
32a3
regional market, wholesaler in the capital city, agent, export market 43
(29)
81.2%
(78.1, 84.3)
33
Percentage of producers who state that they have had problems that have affected their businesses 43
(41)
94.0%
(89.9, 98.1)
33a Type of problem:
33a1
Lack of marketing or lack of expert advice 43
(33)
78.8%
(19.6, 100)
33a2
Lack of money or capital or raw materials 43
(33)
81.7%
(61.7, 100)
33a3
Lack of control of operation records or lack of organization by producers 43
(2)
4.4%
(1.5, 7.3)
III.B.8 Improved Income
Main Findings:
Contrary to the indicators in previous sections, which were measured considering the general population, Improved Income was measured in a
small sample of program participants engaged in this activity. Thus, a total of 43 individuals were interviewed. Results show that 100% of these
individuals have an agricultural business and that a small percentage of them have some additional business (25% have livestock businesses and
7% have a family business).
MYAP 2011 Endline
Results
53 
As to practices connected to Improved Income, 99.2% of individuals have implemented two formal‐marketing practices: “making production
and marketing estimates” and/or “keeping production and marketing records”, and 100% have implemented production and marketing plans.
The great majority of these individuals (81.2%) sell their products in markets outside their communities, seeking larger markets (regional
markets, wholesalers in the capital city, export markets). However, there are also 74.8% of them who do not miss the opportunity of selling
their products in their municipal markets; very few of them (18.8%) sell their products locally in their communities.
Almost all of these individuals (94%) stated that they have had problems affecting their businesses. The main problems they have encountered
are the lack of markets and lack of expert advice (78.8%) and the lack of capital/raw materials (81.7%).
MYAP 2011 Endline
Results
54 
III.B.9 Community Risks
The information for this table was gathered by interviewing community leaders (especially those from COCODES), so the sample in this case
corresponds to communities and not to individuals.
Table III.B.9 Community Risks (Sentinel Sites)
Information from sentinel sites
Indicator
Results
Sample Size = 2
Number of cases
Number of communities where COCODES have received training on risk management 2
Number of communities where COCODES have received training on COCODES’ functions 1
Number of communities where COCODES have received training on the risk of food and nutritional insecurity 1
Number of communities where COCODES have received training on the risk of disasters 1
Number of communities where COCODES have received training on project profiles 1
Number of communities where COCODES have received training on food and nutritional security 1
Number of communities where COCODES have received training on project management 1
Number of communities that have a community risk‐management plan (the existence of this document was verified) 1
Issues in which the community is actively working
Accidents and disease
Rainfall
Plant and animal pests and diseases
Prices of the basic food basket
Materials were provided during training 1
Which are the topics that the community most liked or considered the most important?
Authorities’ and COCODES’ functions
Rescuing malnourished children
Project management
Reforestation
They have negotiated resources at the municipal level to respond to your needs. 2
They have executed a project that benefits the whole community. 2
They have participated in an activity or training connected to a surveillance system or a lack of food warning system
or a Sentinel Site.
2
Potable water
Paving streets
Roofing homes
MYAP 2011 Endline
Results
55 
Table III.B.9 Community Risks (Sentinel Sites)
Information from sentinel sites
Indicator
Results
Sample Size = 2
Number of cases
Sports playing fields
People in the community participate in a surveillance system or a lack of food warning system or a Sentinel Site. 1
They know what a community surveillance board is. 1
The presence of a community surveillance board was verified (through observation). 1
They have an updated notebook (verified through observation). 1
They know how to use colored faces. 1
They know what the early‐warning system or Sentinel Site is used for. 1
They have the Information Table for the community Sentinel Site. (Verified through observation.) 1
There is a notebook in which Sentinel Site records are written. 1
They know what a rain gauge is. 1
They have installed a rain gauge. 1
They keep a log on sheets of paper or a notebook on the amount of rainfall for each day. 1
III.B.9 Community Risks
Main Findings:
No comments are possible with a sample that is so small. However, considering that only two Sentinel Sites were observed (those located within
the 31 communities that were visited), and that one of them had so many weaknesses, it is recommended that the Program strengthen its
system to follow up and supervise these sites.
Línea Final MYAP 2011
Conclusions
56 
IV Conclusions
Based on the foregoing findings, the following conclusions have been drawn:  
1. Save the Children’s Maya Food Security Program surpassed the indicator values that it
committed to at the baseline.   Because of its importance, it is essential to underscore the
decrease in chronic and overall malnutrition in children under five years old.  It is also important
to mention the positive changes achieved in areas such as adopting good health and nutritional
practices and good agricultural/livestock practices.  The increase in household dietary diversity,
as families incorporated a greater variety of foods into their diets is another factor that must be
highlighted.
2. Except for one indicator (average number of months of adequate household food provisioning),
all the other exceeded the established goal for each one of them, which indicates program
performance.
3. The impact that PROMASA’s nutrition and health, and agricultural/livestock activities have had
on families’ food security is evident, especially the agricultural/livestock activity, which is
reflected in boys’ and girls’ nutritional status.   In places where there was an
agricultural/livestock intervention, the nutritional development of children is better, compared
to those places where there was no such intervention.
Línea Final MYAP 2011
Annexes
57 
V Annexes
1. Effects of the Design of 2011 MYAP Indicators
2. A summary of surveys by communities, in the Nutrition and Health and the
Agricultural/Livestock components.
3. A summary of the surveys by communities, in the Marketing and Commercialization
component.
Attached documents:
4. First Progress Report:  Training field personnel, attached document:
Primer informe de avance Capacitación.docx (First Progress Report on Training.docx)
5. Second Progress Report:  Field Work, attached document:  
Segundo informe de trabajo de campo.docx (Second Progress Report on Field
Work.docx)
Databases (attached documents)
6. File with original EPI INFO bases (REC files)
7. File with EPI INFO bases containing indicators (REC files), as well as programs used to
develop them (PGM files)
Línea Final MYAP 2011
Annexes
58 
ANNEX 1:  Effects of the Design of 2011 MYAP Indicators
Area Indicators
Effect of
Design
Anthropometry
in children
under 5 years
old
1
a
Percentage of children under 5 years old with chronic malnutrition
(Z < ‐2SD height/age),  NCHS 4.084
1
b
Percentage of children under 5 years old with chronic
malnutrition (Z < ‐2SD height/age), WHO 4.767
2
a
Percentage of children under 5 years old with overall malnutrition
(Z < ‐2SD weight/age), NCHS 2.049
2
b
Percentage of children under 5 years old with overall malnutrition
(Z < ‐2SD weight/age), WHO 2.689
Anthropometry
in children
under 36
months
2
a
Percentage of children under 36 months old with overall
malnutrition (Z < ‐2SD weight/age), NCHS 2.049
2
b
Percentage of children under 36 months old with overall
malnutrition (Z < ‐2SD weight/age), WHO 2.689
Family dietary
diversity and
family food
scarcity
4 Average dietary diversity score 2.036
5
Average number of months of adequate household food
provisioning 1.643
Children
feeding
practices
8
Percentage of infants under 36 months of age who were
exclusively breastfed during the past 24 hours 0.953
Danger signs in
mothers’,
newborns’, and
children’s
health
1
2
Percentage of mothers of children under 36 months of age who
recognize at least two danger signs during pregnancy that indicate
the need to seek health services
6.654
1
5
Percentage of mothers of children under 36 months of age who
recognize at least two danger signs in newborns  (<28 days) that
indicate the need to seek health services
3.059
1
8
Percentage of mothers and caregivers of children under 6 months
of age who recognize at least two danger signs of childhood
illnesses that indicate the need to seek health services
2.945
Agricultural/Liv
estock Practices
2
2
Percentage of producers adopting at least two good agricultural
practices 5.083
2
3
Percentage of producers adopting good livestock practices 1.927
Improved
income
3
0
Percentage of producers adopting at least two good formal‐ 
marketing practices 0.069
Línea Final MYAP 2011
Annexes
59 
ANNEX 2
A Summary of Surveys by Communities, in the Nutrition and Health and the
Agricultural/Livestock Components
Department Community Surveyor
Group
No. of Selected
Households
No. of Effective
Interviews
Quiche Santa Clara 3 35 23
Quiche Xemac 2 35 18
Quiche Ilom 1 35 25
Quiche Sotzil 2 35 27
Quiche Xolcuay 3 35 24
Quiche Santa Abelina 2 35 27
Quiche Chonchola 1 35 32
Quiche El Pinal 3 35 26
Quiche Vichibilá 1 35 33
Quiche Pamaxán 1 35 31
Quiche Actxumbal 3 35 25
Quiche Pulay 2 35 25
Quiche Palop 3 35 27
Quiche Villalá 2 35 25
Quiche Rio Azul 1 35 29
Quiche Xexucap 3 35 28
Quiche Salquil Grande 1 35 27
Quiche Vicalamá 2 35 23
Quiche El Pinal 1 35 24
Quiche Tierra Blanca Pericón 3 35 25
Quiche El Palmar 2 35 24
Quiche El Caracol 3 35 25
Quiche Jacubí 1 35 26
Quiche San Antonio 2 35 25
Quiche Chiul 3 35 25
Quiche Batzulá 2 35 25
Quiche La Hacienda 1 35 27
Quiche Chacaguex 2 35 25
Quiche Trapichitos 3 35 26
Quiche Patulup 1 35 26
Quiche 1er Centro de Rio Blanco 1,2,3 35 29
Línea Final MYAP 2011
Annexes
60 
Línea Final MYAP 2011
Annexes
61 
ANNEX 3
A Summary of the Surveys by Sentinel Sites, in the Marketing and Commercialization
Component
Department Community Surveyor Group No. of Marketing Forms
Quiche El Palmar 2 8
Quiche El Caracol 3 20
Quiche Chiul 3 15
A Summary of Surveys by Community Sentinel Sites
Department Community Surveyor Group Situation Room
Quiche Santa Abelina 2 1
Quiche Actxumbal 3 1