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Guatemala's rural indigenous population suffers from one of the highest rates of chronic child malnutrition (stunting) in the world. Successfully addressing stunting requires defining the barriers to and opportunities for new behaviour‐change initiatives. We undertook a mixed‐methods assessment of feeding practices and food purchasing behaviours around infants and young children aged 6–36 months in two rural indigenous Guatemalan communities. We found that most caregivers were aware only of acute forms of child malnutrition and that they greatly underestimated the local prevalence of malnutrition. Despite moderate adherence to exclusive breastfeeding and timing of complementary food introduction, diets had poor diversity and inadequate meal frequency. Furthermore, perceptions of food insecurity were high even in the presence of land ownership and agricultural production. Although fortified foods were highly valued, they were considered expensive. At the same time, proportionally equivalent amounts of money were spent on junk foods or other processed foods by most participants. Biological mothers often lacked autonomy for food purchasing and nutritional decisions because of the power exerted by husbands and paternal grandmothers. Our findings suggest several creative and community‐based programming initiatives including education about the acute vs. chronic malnutrition distinction, engaging landowners in discussions about domestic food consumption, engaging with caregivers to redirect funds towards fortified foods rather than junk food purchases and directing behaviour‐change initiatives towards all household stakeholders. [ABSTRACT FROM AUTHOR]

Adolescent Maya girls are among the most vulnerable, marginalized sub-populations in Guatemala, a country that is largely young, indigenous and poor. Adolescent Maya girls have limited access to secondary schooling, opportunities to work or earn an income, and sexual and reproductive health information and services. This article explores the extent to which adolescent Maya girls are able to adopt what they have learned in a community-based skills-building and sex education programme in isolated rural, indigenous Guatemalan communities. This is presented through an interview between the authors, who met and worked together in the Population Council's programme Abriendo Oportunidades (Opening Opportunities) for girls aged 8–19 years. The interview discusses what can be done so that indigenous adolescents not only obtain the sexual health information they need, but develop the skills to make decisions, communicate with their peers and parents, and exercise their rights. Much culturally and linguistically sensitive work must be done, using a community-based participatory approach, so that young people who do want to use condoms for protection or contraceptive methods not only have access to the methods, but the support of their families and communities, and government-sponsored sex education programmes, to use them. Les adolescentes mayas sont parmi les sous-populations les plus vulnérables et marginalisées du Guatemala, un pays où la majorité de la population est jeune, autochtone et pauvre. Les adolescentes mayas ont un accès limité à l'enseignement secondaire, aux possibilités de travail ou de revenu, et à l'information et aux services de santé sexuelle et génésique. L'article analyse dans quelle mesure les adolescentes mayas peuvent appliquer ce qu'elles ont appris dans un programme communautaire de renforcement des capacités et d'éducation sexuelle dans des villages autochtones isolés du Guatemala rural. Ces conclusions sont présentées dans un entretien entre les auteurs, qui se sont rencontrés et ont travaillé dans le programme du Population Council Abriendo Oportunidades (Élargir les possibilités) pour les filles âgées de 8 à 19 ans. L'entretien aborde les mesures pouvant être prises pour que les adolescentes autochtones obtiennent l'information de santé sexuelle dont elles ont besoin, mais acquièrent aussi les compétences requises pour prendre des décisions, communiquer avec leurs pairs et leurs parents, et exercer leurs droits. Beaucoup de travail culturellement et linguistiquement sensible doit être accompli, par une méthode participative à assise communautaire, pour que les jeunes qui veulent utiliser le préservatif pour la protection ou la contraception aient accès aux méthodes, mais aussi au soutien de leur famille et communauté, et des programmes d'éducation sexuelle parrainés par les autorités, pour les utiliser. Las adolescentes mayas constituyen una de las subpoblaciones más vulnerables y marginadas de Guatemala, un país en su mayoría joven, indígena y pobre. Las adolescentes mayas tienen limitado acceso a enseñanza secundaria, oportunidades para trabajar o ganar ingresos e información y servicios de salud sexual y reproductiva. En este artículo se explora hasta qué punto las adolescentes mayas pueden adoptar lo que aprendieron en un programa comunitario de desarrollo de habilidades y educación sexual en aisladas comunidades indígenas rurales de Guatemala. Esto se presenta en una entrevista entre los autores, quienes se conocieron y trabajaron conjuntamente en el programa del Population Council "Abriendo Oportunidades" para niñas de 8 a 19 años de edad. Durante la entrevista se examina qué se puede hacer para que las adolescentes indígenas no solo obtengan la información sobre salud sexual que necesitan, sino también desarrollen habilidades para tomar decisiones, comunicarse con sus pares y padres y ejercer sus derechos. Se debe realizar mucho trabajo cultural y lingüisticamente sensible, utilizando un enfoque participativo comunitario, de manera que cada joven que desee usar condones para protegerse u otros métodos anticonceptivos no solo tenga acceso a los métodos, sino también el apoyo de su familia y comunidad, así como programas de educación sexual auspiciados por el gobierno, para poder usarlos. [ABSTRACT FROM AUTHOR]