Limited benefits and high costs are associated with low monetary returns for Guatemalan household investment in water, sanitation, and hygiene technologies.

• Within our partner community, household investments in sanitation and food preparation environments yield a positive net benefit. • Among the four regions we examined, only the state of San Marcos, Guatemala had a positive return on investment for households at year 60. • 'WaSH mobility' is a household's ability to improve its WaSH technology status. • Limited household options for improving WaSH technologies reduces WaSH mobility via reductions in return on investment. • SEM provides a novel method to allocate benefit estimates to multiple WaSH technologies in improving child height-for-age. The child stunting rate (low height-for-age) in Guatemala is the sixth worst in the world. Child stunting is correlated both with short and long-term economic costs. While technologies to improve water, sanitation and hygiene (WaSH) are effective at ameliorating child stunting, current household investment in WaSH technologies is constrained (i.e., self-supply). To understand this constraint, data on household spending priorities and barriers to investment in WaSH technologies must be assessed. We utilize primary data from our partner community in Totonicapán, Guatemala to populate a structural equation model and benefit-cost analysis assessing the association between household WaSH technologies and child height-for-age. To test regional variations, we scale-up our approach to examine four additional regions across western Guatemala. The results suggest there is limited monetary gain for households to invest in WaSH technologies. Among the communities and regions where higher returns on investment for households were identified, significant WaSH technologies were cumulatively low cost and simple to obtain and use. We encourage stakeholders supporting a self-supply model to evaluate that incremental improvements in WaSH technologies financed by the household do not impose large costs without sufficient benefits, facilitating healthy WaSH mobility (a household's ability to improve their WaSH technology status). [ABSTRACT FROM AUTHOR]