Addressing malnutrition through effect-ive

communication:The case of Totonicapán, Guatemala

A Research Paper presented by:

Gabriela María Díaz Salazar(Guatemala)

in partial fulfillment of the requirements for obtaining the degree of

MASTERS OF ARTS IN DEVELOPMENT STUDIES

Specialization:Local Development Strategies

(LDS)

Members of the examining committee:

PhD. João GuimaraesPhD. Nicholas Awortwi

The Hague, The NetherlandsNovember, 2011

Disclaimer:This document represents part of the author’s study pro-gramme while at the Institute of Social Studies. The views stated therein are those of the author and not necessarily those of the Institute.

Inquiries:Postal address:Institute of Social StudiesP.O. Box 297762502 LT The HagueThe Netherlands

Location:Kortenaerkade 122518 AX The HagueThe Netherlands

Telephone: +31 70 426 0460Fax: +31 70 426 0799

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Contents

Chapter 1: Introduction and Research Design 11.2 Background 1

1.2.1 Malnutrition in Guatemala 41.3 Making use of communication 61.4 Identification of the Problem 71.5 Research Objectives 81.6 Research Question 81.7 The Methodology 81.8 Limitations 9

Chapter 2: Understanding communication from different perspectives and experiences 102.2 Models of Communication 102.3 Social Marketing 122.4 Experiences of Social Marketing and Health 142.5 Information, Education and Communication for

Change of Conduct –IEC/CC 152.6 Communication for Development 172.7 Experiences of Communication for Development 212.8 Methodologies and Techniques used in Communica-

tion for Development 222.8.1 Outcome Mapping 222.8.2 The Most Significant Change 24

2.9 Analytical Framework 26

Chapter 3: Study Case: Totonicapán, Guatemala 283.2 Totonicapán, Guatemala 283.3 Malnutrition in Totonicapán 293.4 Consequences of Malnutrition 303.5 Views about Malnutrition 313.6 Responses from Different Actors 33

3.6.1 Ministry of Public Health and Social Assis-tance 33

3.6.2 Government 353.6.3 Local NGO in coordination with International

Cooperation and other actors 36

Chapter 4: Malnutrition and Communication 394.1 From Social Marketing, going through IEC/CC

reaching Communication for Development: the road

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to improve inter-sector integration and participa-tion 39

4.2 Integration of local actors in a territory 394.3 Local Voices 41

4.3.1 Focus Group 414.3.2 Most Significant Change in Totonicapán 43

Chapter 5: Conclusions 46Income differences 48Malnutrition 49Communication 50Totonicapán, Guatemala 50

Production and Economy in Totonicapán 51Malnutrition in Guatemala 52

The Most Significant Change in Totonicapán, Guatemala 53MSC in the Quality of Life (Parents) 53Story 1: “That my children have a better life” 53Story 2: “The value of herbs” 54

MSC in the Quality of Life (Local Actors) 54Story 1: A speed recovery 55MSC in knowledge and application 55Story 2: I made my voice be heard in my language 55MSC in the participation and coordination of an or-

ganization in COMUSAN or Municipal Team of Communication 56

MSC in comprehension and appraisal of C4D 56Story 3: C4D in the City Hall’s Plan 56

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List of TablesTable 1.1: Ethnic Groups in Guatemala................................1Table 2.1: Intentional Design....................................................................................22Table 2.2: Program Framework................................................................................23Table 2.3: Overview of the approaches...................................................................26Table 2.4: Indicators that lead to the integration of actors..................................27Table 3.1: Municipality Priority, according to Quality of Life.............................29

List of FiguresFigure 2.1: Communication as a Process of

Dialogue...................................20 Figure 2.2: Signals of Progress..................................................................................23Figure 3.1: Totonicapán's Municipalities.................................................................28Figure 3.2: Linking Local Actors..............................................................................37

List of BoxesBox 2.1: Social Marketing Planning…………………………………………13Box 2.2: Participatory Approach…………………………………………….18Box 2.3: Signals of Progress………………………………………………....24

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List of Acronyms

SESAN Secretariat of Food and Nutritional SecuritySecretaría de Seguridad Alimentaria y Nutricio-nal

COCODES Development Community CouncilConsejo Comunitario de Desarrollo

COMUDE Development Department CouncilConsejo Municipal de Desarrollo

COMUSAN Municipal Commission of Food and Nutritional SecurityComisión Municipal de Seguridad Alimentaria y Nutricional

CODESAN Department Commission of Food and Nutri-tional SecurityComisión Departamental de Seguridad Alimen-taria y Nutricional

MPO Municipal Planning OfficeOficina Municipal de Planificación

OMM Women’s Municipal OfficeOficina Municipal de la Mujer

CTA Technical-Managerial CoordinatorCoordinador Técnico Administrativo

MINEDUC Ministry of EducationMinisterio de Educación

MIFAPRO My Family Progresses ProgramPrograma Mi Familia Progresa

PRORURAL Programa Nacional de Desarrollo RuralNational Program of Rural Development

K’iche’ Mayas K’iche’, one of the 21 Mayan groups in Guatemala

MSPAS Ministry of Public Health and Social AssistanceMinisterio de Salud Pública y Asistencia Social

CECODE Centro de Comunicación para el DesarrolloUNICEF United Nations Children’s FundUNDP United Nations Development Program

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Abstract

This research has been done in order to contribute to the Social Sciences from Communication for Development. Communication for Development is a participatory ap-proach of communication as process of dialogue. It is also a response to the Western way of doing communication, since its beginnings date back from the decades of the 70s and from Latin American countries. There has been an ongoing debate amongst the practitioners of communication as mass media and the practitioners of Communication for Develop-ment. The first ones have believed that what the products that they produce are the result of communication. The lat-ter, have claim the true meaning of doing communication and also take it as a citizens’ right. Therefore, the efforts are always prepared in the best interest of the people that the development project intends to help.

Throughout the research three approaches to commu-nication have been analyzed, from the literature and from experiences, in order to assess which is the adequate to ad-dress a particular social issue: malnutrition in Totonicapán, Guatemala. Worldwide experiences have been included from the three approaches; an overview of the approaches has been made based on the literature. The case of Totonic-apán, Guatemala has been chosen since it has been an ex-ample of a participatory project from the perspective of Communication for Development. The views and experi-ences from people of the area have also been included to give relevance and importance to the local knowledge of the area of interest.

Relevance to Development StudiesCommunication as part of the Social Sciences is gaining im-portance in development projects around the world. Since the right to communication is also a citizen’s right it should be promoted and respected. This research tries to contrib-ute to the vindication of the right to communication in com-munities of Totonicapán, Guatemala. It is also a contribu-tion to the importance of communication in development projects in order for them to be successful and not just a re-petition of previous experiences. The relevance of local knowledge is also an important issue in the paper, which

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can be taken as an example for future researches and pro-fessionals to be working in different contexts (from what they know).

KeywordsCommunication, information dissemination, Communication for Development, K’iche’, Totonicapán, Guatemala

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Chapter 1: Introduction and Research Design

This research examines the effects of communication ad-dressing malnutrition, but to understand the context, then it is necessary to understand the country and its current problem of malnutrition of children. The research has also been done to provide an explanation of effective communic-ation with development programs.

1.2 Background

Guatemala is located in Central America and it is politically divided in 22 departments and the departments make 333 municipalities. It has a population of 14,713,7631 . Guatem-ala has different characteristics that make it a unique coun-try, rich in cultural diversity since it is one of the Latin-American countries that still has a numerous indigenous populations from different groups.

Table 1.1: Ethnic Groups in Guatemala2

Ladino 6,750,170 60.36 %Maya 4,411,964 39.45 %Xinca 16,214 0.15 %Garífu-

na5,040 0.04 %

Total 11,183,388

100 %

The cultural diversity is important since the different groups make the country. The Ladinos are the ones that do not belong to an indigenous group, and it is said that are the ones who have a Spanish link. This group is also known as the Mestizos, because in times of the colonization the Spanish people mixed with indigenous groups and created

1 Instituto Nacional de Estadística http://www.ine.gob.gt/np/poblacion/index.htm Au-gust, 2011

2 Instituto Nacional de Estadística http://www.ine.gob.gt/np/poblacion/index.htm Au-gust, 2011, data from the last National Census of 2002.

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the “mix of cultures” the Mestizos. As the years went by, the term changed into Ladino, but it basically refers to people who don’t have a specific indigenous culture. The Mayas on the other hand, were the settlers of the country with the other two; Xinca and Garífuna. The Mayas are the second biggest group in population of the country, but have struggled since the colonization. After that period they lost their rights and ever since it has been a constant battle to access a better quality of life. Within the Mayas there are 21 groups that are spread in different departments and mu-nicipalities of the country. The Xincas; a smaller group in numbers but it is also part of the cultural diversity; the de-partments where they live are the East. The Garífunas are also located in one department of the country, in the Carib-bean area.

Whether big or small in numbers all these groups are recognized in by the State. Although the country is still struggling to become a more inclusive nation and to be able to improve the access of the basic services, such as Health, Education, Sanitation, Security, etc.

Guatemala is also a country with high inequality amongst its groups, which can be one of the reasons why there are some groups that have access to all the basic ser-vices and others have problems accessing them. Because the lack of access to the basic services and other factors, the indigenous groups have suffered the consequences and are the ones who have more problems related to health and nutrition, but also the ones with highest rates of illiteracy, low income, etc. These problems, together with other factors, have caused the country to remain as a developing country because when the population gets a different treat-ment the country’s growth will also be different. The oppor-tunities and the access to the growth opportunities have been different too. There are some examples that illustrate the differences between indigenous and non-indigenous population in terms of access to basic services (Appendices Table 1).

Regarding the poverty, there are also differences between the two groups3. In Guatemala 56% of the popula-tion lives in poverty, from this percentage, 58% of the poor people are indigenous. 16% of the population lives in ex-

3 Diagnose of Racism in Guatemala, 2006

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treme poverty, from this percentage, 72% are indigenous people.

These indicators show a gap that has been increasing between the indigenous population and the non-indigenous population and also between the rural and urban areas. The issues of inequality and the lack of access to basic services have been in the eye of the international community. Many efforts have been done in order to improve the quality of life of these groups, by the Government itself and also with the help of the international cooperation through different strategies.

The State, since 2002 and following the agreements of the Peace Accords signed in 1996, the end of Internal Armed Conflict, approved the creation of the Commission Against Racism and, the Indigenous Women Advocacy. Steps have been taken into respecting indigenous people’s rights, but there is more to be done.

Guatemala has had a history of discrimination and ra-cism, and the victims of these actions have been the indi-genous groups. After the sign of the Peace Accords, atten-tion has been given to reduce and eliminate discrimination and racism. An example of this attention has been the UNDP’s National Human Development Reports –NHDR- of the past years, more specifically 2005 and 2008. NHDR of 2005 describes and analyzes one of the basic dimensions that define the nation; its multiethnic character. Guatemala has an asymmetry in the inclusion of indigenous and non-in-digenous people in the socio-economic structure. “More than 80% of the indigenous population is located in the low and extreme low strata. This means that 8 out of 10 Mayas, are in the bottom of the social structure” (UNDP, 2005:98). Because of this the indigenous population is excluded from participating in highest social strata.

Income difference is also significant and, it has an im-portant role since it is the mediator between the economic activity and the access to satisfy the needs that will lead to have a dignified life. Graph 1 illustrates the level of inequal-ity of the Guatemalan population (Appendices Graph 1).

Living in poverty or extreme poverty has been a situ-ation that has affected more indigenous people in the coun-

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try. In 2004, 21.9% of the population lived with less than $1.00 per day and, in relation to the indigenous rural popu-lation, for the same year, 38% were under this category. When the country’s income is concentrated in one group of the society it makes it difficult for others to have the same opportunities.

International laws and agreements have been signed to reduce inequalities. The Convention 169 from the Interna-tional Labour Office –ILO- is the most important framework referring to development, economy and cultural-ethnic equity. “Establishes that the indigenous people should have the right to decide their own priorities regarding the pro-cess of development, if affecting their lives, believes, insti-tutions, spiritual wellbeing and the lands that they occupy and use. Therefore it warranties the right to control, as pos-sible, their economic, social and cultural development” (UNDP, 2008:76).

Even though there are national and international docu-ments, agreements and more, there is always the chance for improvement. In the words of an economist Maya K’iche’ “Very little has been analysed in the cultural-ethnic dimension of the Guatemalan economy. This should be ana-lysed due to the importance of the historical circumstances of the country and considering that the indigenous popula-tion is the one that presents the highest levels of poverty and extreme poverty, low social indicators and less levels of public investment. This dimension could be analysed in three aspects: a) the relation between cultural exclusion and economic exclusion, b) the nature of the culture and, c) aspects like the indigenous economy in the last years. To understand it better will help the definition of measures so that the Guatemalan economy could be more inclusive and sustainable” (UNDP, 2008:77). This shows that the notion of a non-inclusive economy is present and there is a need to work on it so that the country can achieve the desired de-velopment.

Different strategies can be developed in order to ad-dress an issue, but the results may vary. This research is focused in one issue that affects the majority of the indigen-ous children in Guatemala, malnutrition. More specifically, the research presents the findings of what the Ministry of Public Health and Social Assistance has done over the past years and also was has been done for the last two years by

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a local NGO. Also for a better understanding of the analysis, an explanation of the ways for doing communication and sending information is presented. The reason; it is import-ant to recognize and identify the strategies of information from the strategies of communication.

1.2.1 Malnutrition in Guatemala

According to the information provided by “Situational Ana-lysis of Malnutrition in Guatemala: Causes and Approach” elaborated by UNDP Guatemala 2009-10, malnutrition asso-ciated to poor nutrition and other issues such as low human development in Guatemala is understood as a vicious cycle. “It is recognized that malnutrition, as a visible expression of food and nutritional insecurity, it is also a barricade to growth and national development. The authors’ opinion is that the complex nature and the multiplicity of determin-ants and factors that affect food and nutritional security, coupled with the limited participation of civil society in these efforts, makes the current models of governance poorly successful. This requires the strengthening of com-prehensive view in the adoption of strategies, constant com-mitment of society as a whole” (UNDP, 2009-10:7).

Understanding malnutrition has had shift, it is clear that this is no longer just a health problem but one that in the long run affects national development. And, it is not a new problem. The Analysis (UNDP) establishes that malnutrition has been society since the decades of the 30s and 40s. It was until the late 50s4 when the characteristics (clinic, bio-chemical and pathological) were defined, with children who suffered from malnutrition and also the recommended treat-ment and the prevention measures of nutrition and sanita-tion were established. Since the 60s the attention on malnu-trition kept increasing and a proof of that is that investiga-tions have been done to identify more details on the prob-lem and also effects of malnutrition.

The Analysis (UNDP) mentions studies from different years5 and “these all agree on the attention that has to be

4 Information linked to the release of an African Report on Kwashiorkor around the same time, 1955

5 1994: Rivera and Martorell, 2001: Fuentes, Hernández y Pasucal, 2005: Behrman, Martorell and Stein and 2006:

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given from the moment of the child’s conception until the first three years of life. This being important because it has been shown that it makes a difference in the potential of growth and human development, including development of intelligence, personality and social behavior, as well as physical and intellectual productivity in the adult age” (UNDP, 2009-10:9).

Recent information is integrated in the “Third National Height Census” from Ministry of Education in coordination with SESAN. This was done in 2008 and the goal was to elaborate a current diagnose to know the children’s nutri-tional state, through the height indicator. This indicator, as stated in the Census, measures the delayed growth size, it also establishes the degree of severity of chronic malnutri-tion and allows making a direct relation of social and eco-nomic development of the family and community where the measured children live in. The Census was done with chil-dren from First Grade from the Official Sector a total of 459,808 children from the ages of 6 years 0 months to 9 years and 11 months.

According to the Census, 54.4% of the children have been classified as normal in relation to their height and the other 45.6% are delayed in height or with chronic malnutri-tion. From the ones with delayed height, 32.9% are moder-ate and 12.7% are severe. More in detail, information has been summarized in: Age, Urban and Rural Areas and Lan-guage (percentages can be found in Appendices Box 1).

UNICEF’s report entitled “El Enemigo Silencioso (The Silent Enemy)” provided a view on the problem faced by the country. According to the Representative of UNICEF for Guatemala Manuel Manrique, stated that “chronic malnutri-tion needs to be explained because it can’t easily be recog-nized like acute malnutrition (children with swollen stom-achs and the hair looks light in color). A child who suffers from chronic malnutrition has an inferior height, the health is fragile and the intellectual development is severely di-minished” (UNICEF, 2007:3).

The World Bank., information from “Situational Analysis of Malnutrition in Guatemala: Causes and Approach” elabo-rated by UNDP Guatemala 2009-10

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About the efforts done in Guatemala, Manrique men-tioned that “for years Guatemala made an effort to face this reality, and as stated in the Policy of Food and Nutritional Security, these attempts lacked of the political decision needed and a methodological development with a multi-sec-tor approach, because of these the result was not positive” (UNICEF, 2007:3).

The problem of malnutrition has been a constant and, different Governments have developed actions, strategies and even policies have been approved in order to address it. Whether or not these have been successful does not mean that the problem has been neglected. This is one of the reasons for the research, to analyze what has been done and is being done, from a communicational view, since it is also important in the development processes. Chapter 3 provides more information about other efforts done in Guatemala.

1.3 Making use of communication

On a daily basis, we make use of words, sounds, messages, technology, media and other tools in order to make ourselves understood but also to keep in touch with our sur-roundings. Many times all of the tools mentioned are put in one same basket called “communication” but what most of the time is not mentioned is that not all of them are commu-nication. As simple as it may sound, people do not always know the difference or meaning of communication and in-formation. Both terms have been wrongly interpreted as meaning the same. This clarification is a “must” because part of the problem of dealing with issues is that the actions or strategies have not been the most accurate ones. If the differentiation is clear and if people understand what it is that they are doing, then the planning, the actions them-selves, and the results may change from what has been ac-complished in the past.

Throughout this research communication is understood a process of inclusive dialogue, like it is in Communication for Development, were the people involved become active Subjects of the process. Subjects meaning as presented in Pedagogy of the Oppressed “subjects; this term denotes those who know and act, in contrast to Objects, which are

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known and acted upon” (Freire, 1996:18). Communication for Development has its fundaments in different methodolo-gies for social change, for this research, the reference is to Pedagogy of the Oppressed. This methodology, created to empower people through education, people that have been neglected by the social structure that oppresses them. In Shaull’s words “those who, in learning to read and write, come to a new awareness of selfhood and begin to look crit-ically at the social situation in which they find themselves, often take the initiative in acting to transform the society that has denied them this opportunity of participation” (Freire, 1996:11).

The principal is the same, through participation people become aware of their reality and with the proper commu-nication tools and guiding them in the process of improving their capacities, and they will become agents of their own change. As oppose to other strategies which make use of media in order to somehow manipulate these people by giv-ing the impression of helping them, but in reality what they seek for is to keep the social structure: the same; people op-pressing others for their own benefit and others being the oppressed, who miss the growing opportunities. Dialogue and communication are very important for Freire as well in Communication for Development, “dialogue which is radic-ally necessary to revolution corresponds to another radical need: that of women and men as beings who cannot be truly human apart from communication, for they are essentially communicative creatures. To impede communication is to reduce men to the status of things –and this is a job for op-pressors, not revolutionaries” (Freire, 1996:109). In Com-munication for Development, people’s right to communica-tion is being vindicated so that they are no longer the “re-cipients” of the people in power who want to keep control of the rest. Realizing that communication is a right, will give them the tools to plan their own actions and strategies that will help them in the process of social transformation.

1.4 Identification of the Problem

Malnutrition of children is the problem that has been ad-dressed in different ways, following different methodologies and techniques (with different results and responses from people). The communication approaches that have been used in the area of interest have not helped in making signi-

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ficant changes in people. The reason being is that these ap-proaches are not communication, but information dissemin-ation and therefore lack the interpersonal communication, hence people don’t show interest.

A positive aspect of information dissemination is that it can help in creating awareness of an issue. Changes will not happen, in this case in reducing malnutrition if people aren’t interested in hearing what the experts tell them. Ef-fective communication will provide spaces for local know-ledge to be linked with the information shared by a facilit-ator of a developmental program. If transmission of mes-sages, alone was enough, then why is it that people have complained of not having proper information on the issue? Something has been missing, and as simple as it may sound, is the interaction between local actors and experts (in the interventions). To clarify the results of both, trans-mission of messages and effective communication, Totonic-apán, Guatemala is a useful example, since it has received both approaches to address malnutrition.

Communication alone cannot change the problem of malnutrition, but it can improve the knowledge, attitudes and practices through people’s participation in different spaces that will lead to improve the children’s health and nutrition.

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1.5 Research Objectives General Objective:

Analyze and compare different approaches to commu-nication and information used in development-ori-ented projects, both from the point of view of their as-sumptions and from that of their effectiveness.

Specific Objectives: Identify and describe the elements that are key com-

ponents of a Communication for Development Pro-cess.

Study one region in Guatemala that has been subject to two different approaches of communication to ad-dress malnutrition of children under five years of age.

1.6 Research QuestionResearch Question

How have Social Marketing and effective Communica-tion for Development differed in addressing malnutri-tion of children under five years of age in Totonic-apán, Guatemala?

Sub-questions1. What are the main criteria that should be satisfied by

communication for effective change?2. What are the main characteristics of and differences

between Social Marketing and Communication for De-velopment for civic driven change?

3. How the current project in Totonicapán has helped to improve or not the integration of different local actors to organize the efforts of fighting malnutrition prac-tices of the families?

1.7 The MethodologyThe research analysis has been done with the information obtained by Primary and Secondary Data Collection from the local NGO working in Totonicapán. The information from the Ministry of Health and Social Assistance has been provided by the representative of the Program of Promotion

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and Health Education from the Ministry. The Municipal Monitors from SESAN have also contributed with the in-formation. Testimonies, Most Significant Change Stories and focus groups of women, have been a contribution from the local NGO.

Communication, as a process of dialogue and participa-tion, helps empower people in the communities so that they can be agents of their own change. Experiences around the world, but mostly from developing countries, have given ex-amples of how effective communication can help in social problems. Communication for Development, although began since the early 70s has not had enough attention and this research a contribution to the field.

To have a better understanding of whether and how the project helped in the situation related to Food and Nutri-tional Security in Totonicapán, the ones best to evaluate the actions are the local actors. For that reason the use of the Most Significant Change, “a dialogical, story-based tech-nique to facilitate program improvement by focusing the direction of work towards explicitly valued directions and away from less valued directions” (Dart and Davis, 2003:137) is important, as well as the interviews of the act-ors.

1.8 Limitations

To recognize that not everything is possible or easy is not a signal of weakness but of ethics and professionalism. There-fore, it is important to clarify that one of the limitations that affected the initial purpose of the research, was the fact that I didn’t personally get the data analyzed. This was done with the help of the local NGO and because of that I had to wait for the information to be gathered and then sent. This partly affected my schedule. There were some events that also made it difficult to get the information due to the natural disasters that took place in the country and affected the rural areas (Totonicapán). Regarding the pro-ject mentioned, it is important to state that I had been in-volved in it, but needless to say that the information has been treated professionally to avoid bias in the results and the analysis.

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Chapter 2: Understanding communication from different perspectives and experiences

This chapter tries to provide an overview of the different models of communication that have been the foundation for recent ones. Understanding communication may seem sim-ple since we all make use of it in daily basis. There is a need to go beyond of what has been understood, since different authors have presented their own view of doing communi-cation. This research has its focus on two particular ap-proaches to communication and their foundation. This anal-ysis can help the clarification on what has been done in terms of communication in a particular area of interest. Also in order to understand how the two of them can com-plement each other, or not, it is necessarily to review where they came from.

Communication is a term that even nowadays is causing confusion amongst the practitioners and those ones that are trying to learn more of it. For some people, communication is a synonym of mass media: television, radio, newspapers, Internet, etc. For others, communication is a process of dia-logue that can make use of mass media for a specific pur-pose, but mass media is taken as part of a more complex process. Another difference is how the strategies and pro-cesses are planned from one view of communication or an-other (more on this to be explained in each approach).

2.2 Models of Communication

The social sciences have interpreted communication in dif-ferent ways. As the years have gone by, different communi-cational models have been presented which respond to ap-proaches or paradigms associated to social, political and economic aspects from various authors. Each model presents a new element, which helps understand better what communication is from the perspective of its drivers. It is important to note that unlike what happens in the so-called Rigorous Sciences, the challenge here is not to dis-place one theory with another, but to make them coexist at the same time. However, in many of these theories or mod-

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SENDER

MESSAGE

RECEIVER

SOURCE

MESSAGE

RECEIVER

ENCODER DECODER

FEEDBACK

Encoder

Interpreter

Decoder

Decoder

Interpreter

Encoder

MESSAGE

els, communication is not yet conceived as a process of dia-logue and exchange (with all that the word implies).

The most common and well known models of communi-cation are presented in the following section6. In each model, a new element can be identified and later an analy-sis will be given.

a) Schramm

The traditional models, or the way communication be-gan to be presented, had a linear and simplistic perception where a Sender sent a Message to a Receiver without eval-uating if there was an answer or if the message was under-stood.

b) Shannon y Weaver

This model has an Encoder, Decoder and Feedback. The Encoder helps to create the Message and the Decoder helps in the understanding. Although, new elements are incorpo-rated, the linear process is still present but the Feedback has been incorporated. This can be used to evaluate how the Receiver behaves, for example: if a person buys certain product, then the message was received, but this isn’t be communication.

c) Osgood and Schramm

6 Díaz, G. (2009). BA Thesis, Universidad Rafael Landí-var, Guatemala.

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This model presents both sides as equals, Sender and Receiver, Encoder and Decoder. It recognizes that Feed-back can’t be just from the Receiver, but that the Sender and the Message can be the source of it. Even though it presents a different view, it is missing the Channel, which is used to send the message.

This model is more dynamic one than the previous, but as some authors explained “is clearly better suited to the description of face-to-face interaction than to the more re-mote processes of the mass media, but remnants of the same psychological interaction can still be seen in more dis-tant communication” (Beck, et al., 2004:39). This could be a model closest to communication as a process of dialogue; because it shows that a situation can change rather than be still.

The approaches discussed in the following paragraphs are the ones being used in development projects around the world, in the context of this research, have also been used in Totonicapán, Guatemala.

One of their differences is in the way these conceive communication, Social Marketing is more an example of the linear process and, Communication for Development makes use of communication as a process of dialogue and partici-pation. The importance of this analysis is to identify the dif-ferences, strengths and weaknesses, and at the same time evaluate the results in a specific context, as a combination of strategies from both approaches.

2.3 Social Marketing

Social Marketing; a term commonly used by organizations and institutions that focus their work in social issues. Philip Kotler brought the term into discussion and for that he is always a reference of the approach. The definition of Social Marketing has been; “the use of marketing principles and techniques to influence a target audience to voluntarily ac-

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cept, reject, modify, or abandon a behavior for the benefit of individuals, groups or society as a whole” (Kotler, et al., 2002:5).

The marketing principles are present in what is done, by following the Marketing Planning Process. Social Marketing even uses the Marketing Mix, which is the 4Ps –product, price, place, promotion. There are three aspects that social marketers keep in mind; selling a behavior, influence to change a behavior, use of the marketing principles and identify target audiences.

Another characteristic of this approach is that goals and objectives are set by the social marketer in order to meet what the organization and/or institution has established. “Marketers divide the market into similar groups (market segments), measure the relative potential of each segment to meet organizational and marketing objectives, and then choose one or more segments (target markets) for concen-trating their efforts and results” (Kotler, et al., 2002:7).

The information above is the process of how the actions and decisions that social marketers take are done. In com-parison to commercial marketing; social marketers sell a change in a behavior, in terms of the gain, they seek to gain the greatest returns and regarding the competition, they study and analyze what other organizations are doing in the same area. In Social Marketing feedback, is in the measure of results and it is used for improvement. The feedback is for marketers and how they can improve next time.

This approach is related to Behavior Change, and is how marketers plan their actions. In order to achieve a change in the behavior, marketers influence people in different ways. A strategy that they use to address the issue and peo-ple is by using other people. Some experiences have made use of singers, movie stars, athletes or others, to reach a group of the population. This can’t make a person do some-thing but it can help in raising awareness.

According to Kotler, et al., 2002, social marketers have other ways to influence people’s behavior by using technol-ogy, economics, legal – political – policy making and educa-tion. The way these are used is as follows: 1. Technology: can contribute and/or support the behavior change. 2. Eco-

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nomics: used in the way to pressure people or as an incen-tive. 3. Legal-political-policy making: when other fails, then marketers turn to the law to make the change. 4. Educa-tion: is used to communicate information, build skills, is more the Promotion (4Ps).

Social marketers also have their strategic planning or Marketing Planning Process, although it has different steps to be followed (eight steps). The steps seem as a marketing strategy, which demonstrates that social marketers try to differentiate themselves from commercial marketers, but from what is presented, they aren’t too different.

Box 2.1: Social Marketing Planning

The eight steps followed in the Marketing Planning Process

1. Analyze the social marketing environment; campaign purpose.2. Select Target Audience; segmenting the market and ends with

choosing one or more targets (segment by behavior).3. Set objectives and goals; social marketers decide what they

want their target audiences to do and what they may need to know and believe to make the behavior change more likely.

4. Understanding the target audiences and the competition (often-skipped step)

5. Determine strategies; following the 4Ps6. Develop Evaluation and Monitoring Strategy7. Establish Budget and Find Funding Sources8. Complete an implementation plan

Source: Kotler, et al., 2002:34.

In the context of Guatemala, for years the way of doing communication in order to address social issues related to poverty alleviation actions, has been done from the Social Marketing approach. The approach tries to bring social change by influencing the behavior of the audience (people in communities). “Marketers know that what appeals to one individual may not appeal to another. They divide the mar-ket into similar groups (market segments), measure the rel-ative potential of each segment to meet organizational and marketing objectives, and then choose one or more seg-ments (target markets) for concentrating their efforts and resources” (Kotler, et al., 2002:7). Social Marketing relates to the audience by implementing and using the commercial

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techniques with people. It also makes use of media in order to influence the behavior or other techniques (group work) to tell people what they need and how to do things. With this approach, the interventions have been done to convince people of changing. Maybe in some countries experiences have helped in relation to awareness, like stated before, but it doesn’t mean that it works in the same way in every con-text.

In terms of resources, great amount of the money from the project is invested in mass media and campaigns, which can be useful to some extent but what these strategies could also use is the participation from people who they are trying to reach and money could be allocated in doing so (creating spaces for dialogue). In the immediate future, in terms of the sustainability, after the intervention is done the messages sent by mass media could be forgotten and the efforts would have to be repeated with a new project.

2.4 Experiences of Social Marketing and Health

Experiences of Social Marketing and Health are commonly linked to HIV/AIDS since it is a problem that has been af-fecting many countries around the world.

In 2007 a Social Marketing experience was done in Zambia; “The Reach and Impact of Social Marketing and Reproductive Health Communication”. According to the re-port, to deal with health issues, several social marketing and health communication programs have been imple-mented, but for this particular one the impact was focused on condom use, HIV/AIDS and reproductive health.

How the experience worked? The campaign made use of radio and TV programs about family planning and HIV/AIDS to increase and/or create awareness of condom use because as presented in the report “95% of Zambians have heard of AIDS and know is fatal, a substantial fraction continue to engage in risky sexual behavior” (Van Rossem and Meek-ers, 2007:2). The target groups for this experience were: women, adolescents, truck drivers, and commercial sex workers.

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The use of mass media has always been high and for the campaign, four radio programs and four television pro-grams were used. The findings showed that the exposure to programs made a difference in males and their use of con-dom. In terms of radio and TV effectiveness, the results on radio exposure were positive and the TV results showed no significant effect. In relation to condom use, the emphasis was on one brand and the advertisement of it proved to be positive.

Information provided by a Zambian citizen also men-tions a recent campaign to address HIV/AIDS. The Regional Campaign “One Love Kwasila”, as taken from the web site7

“The campaign aims to get us thinking and talking about our sexual behavior in this time of HIV and AIDS”. In the context of Zambia “The national campaign aims to prevent HIV transmission through Multiple and Concurrent (sexual) Partnerships (MCP) in Zambia by providing basic informa-tion about the risks posed by MCP and generating thought and dialogue about social issues that make people decide to have more than one sexual partner. The primary target au-dience of the campaign is married men age 25-50 years. The secondary target audience is women age 15-45 years (the wives and girlfriends of the primary target audience)”. The mass media resource used in this experience is a 10 se-ries-drama called Club Risky Business8 which “follows three male protagonists as they navigate their sexual networks and learn about the risks therein”.

2.5 Information, Education and Communication for Change of Conduct –IEC/CC

Information, Education and Communication for Change of Conduct is another technique that it is linked to Social Mar-keting. As stated in Minja et al., “its main approach drew on basic principles of social marketing, namely that certain messages should be promoted together with a product car-rying and appealing brand name and logo, and that the

7One Love Regional Campaign (launched in 2008) http://www.onelovesouthernafrica.org/index.php/about/ September, 2011

8 http://www.onelovesouthernafrica.org/index.php/coun-tries/zambia/ September, 2011

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marketing should be consumer-oriented and target specific segments of the society”(2001:615).

This is used around the word in order to achieve a change in people’s behavior and there are experiences that have shown positive results after the implementation of an IEC/CC intervention. Aggleton et al., 2005, comment on the effectiveness “IEC programs need to be evaluated on two levels, both in terms of their outcome (does an intervention influence behavior?) and, process (how an intervention works and assists in developing and refining programs). Studies also need to be undertaken which compare the ef-fectiveness of intervention with and without certain IEC components” (2005:21).

In Aggleton et al. “HIV/AIDS and injecting drug use: In-formation, education and communication” it is stated that “IEC has an important role to play in HIV prevention, though it should be combined with other approaches if it is to prove effective. There are many different IEC strategies, including the provision of information about HIV/AIDS-re-lated risks through posters, pamphlets, newsletters, videos, face-to-face work, and radio and television broadcasts”(2005:22). Even though this experience is re-lated to HIV/AIDS the IEC component is similar in other cases that have dealt with health issues. This experience ex-plains that “IEC can be used to establish a policy climate supportive of working with injecting drug users –IDUs- and sensitive to the most effective approaches. It can do this through advocacy with politicians and political decision-makers, religious leaders and community groups” (Aggleton et al 2005:27). These are examples of how IEC can lead to a positive change that can also be sustainable.

An experience in Vietnam illustrates the use of IEC, in combination with other techniques) to transform IEC. Lav-erack and Dap “IEC in Vietnam is widely understood to in-clude strategies and approaches used in health communica-tion and health education” (2003:364). An explanation is provided on how IEC is understood in the Western and the Vietnamese context (Appendix Table 2).

In the context of Vietnam, IEC activities, in the past, have followed a top-down approach through the govern-mental apparatus that was the one “telling people what to think rather than what to think about” (Laverack and Dap,

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2003:364). According to the same information, IEC activi-ties have been planned in terms of resources, which also in-cluded the available funding; this determined what was used and most of the time this resulted into the selection of one channel. This approach has changed using other experi-ences regarding health communication and education. The new approach “understands that IEC can be more effective when a combination of activities and channels are used as a part of the same intervention” (Laverack and Dap, 2003:366).

The approach was developed as a combination of the previous experience and “the need to build on existing ca-pacity for IEC including: mass media, face-to-face communi-cation, print material, and opportunistic activities, at the provincial, district, commune and village levels. Also, the need to improve the quality and delivery of IEC through better design; implementation and evaluation of interven-tions using a systematic and structured approach” (Laver-ack and Dap, 2003:366). In terms of the improvements, sus-tainability is mentioned but in relation to the cost of pro-ducing certain materials that can be used in the interven-tion and that should be locally produced to reduce the cost. It shows the ability to recognize what has been done, to evaluate it and to be able to improve in order to achieve the goals that have been set. Now the approach is perceived as an interaction and complement of the activities, including the participation of village volunteers. The interaction be-tween actors and sectors is also recognized.

The authors identified the importance of building capac-ity and improving coordination of key communicators, as a way to improve and transform IEC in Vietnam. In doing so, they suggested that communicators should make use of par-ticipatory methods and materials, and this could be pro-vided by development agencies to strengthen the capacity of their counterparts. Laverack and Dap also identified the importance of the materials and the distribution and re-garding communication, “must be properly evaluated as an integral part of the design using correct procedures and providing a critical analysis of the process and outcome of the intervention” (2003:368). Sharing experiences amongst the actors of a territory can lead to improve the IEC activi-ties. Therefore, spaces should be created to share the expe-riences in order to complement what is being done, to learn from others and to organize efforts towards the same goals.

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2.6 Communication for Development

Communication for Development, the other way of doing communication, as it’s known by its practitioners. This has been understood as an alternative way from the traditional one. In this approach people are not considered as target groups or audiences, but as strategic partners and as indi-viduals who have something to say. Also, doesn’t tell people what to do but works with them since the beginning and, they are the ones who propose the changes and actions that are considered important to improve their quality of life. Participation in a real sense, where all have the chance to talk and listen, promoting a process of dialogue is what makes this approach different too. In relation to how the money is invested, this approach focuses on actions that are planned by the people for the rest of the community. Com-munication for Development goes beyond the mere action of sending messages. People in the communities are the ones elaborating the messages and, this approach helps them upgrade in communication skills, not just for one project or one particular issue, but helps them realize that can be used in daily life; work, home, school and other spheres of their society.

This approach has not been used or recognized by dif-ferent actors in societies, even though in 2006 the World Congress on Communication for Development was orga-nized by the Food and Agricultural Organization –FAO- in order to establish what was going to be understood when talking about this process but also recommendations were reached as reference to undertake this approach. In Latin America and, other developing countries, this approach has become important since the 70s and, nowadays institutions which were used to Social Marketing (or others ap-proaches) are shifting into Communication for Develop-ment.

For people working in Communication for Development projects, “communication can create a favorable ecology for development programs by re-linking and facilitating inter-actions between economically, politically and culturally dis-connected groups and ideas-between indigenous knowledge and science, elite national policymakers and rural communi-ties, donor agencies and local NGOs, men and women, and didactic pedagogy and participation” (Inagaki, 2007:2).

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The established methods, the way communication has been wrongly presented has its fundaments in the modern-ization paradigm and are the example of top-down, one-way dissemination. These methods “tried to resolve Third World problems by facilitating the transformation –through infor-mation transmission in mass media- of pre-modern and “backward” attitudes and practices of “traditional” societies into modern, rational and Western ways of life” (Inagaki, 2007:5). Modernization paradigm can be found in Social Marketing, Entertainment-Education; mass media for per-suasive messages.

In response to this paradigm, participatory communica-tion approaches have emerged since the early 70s in Latin America. “The problem of underdevelopment in Third World countries was created not by the endogenous factors in these countries but by the international political economic order subjugating the South to the advanced capitalist states in the North” (Inagaki, 2007:7). By criticizing this po-litical order -dependency theory- and also the one-way flow of information, the Latin American countries have come up with communication approaches that emphasize in partici-pation.

Box 2.2: Participatory Approach

Participatory Model of Communication

1. The participation of the intended beneficiaries in different or all of the project-cycle stages.

2. Horizontal dialogue rather than vertical information transmis-sion.

3. Cultivation of trust and mutual understanding rather than per-suasion.

4. Local-level actions rather than national-level programs.5. Local knowledge.6. The role of development specialists as the facilitator and equal

participants rather than decision makers.7. Communication process rather than specific outcomes.8. The use of communication to articulate deep-seated social rela-

tions.

Source: Inagaki, 2007:7

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The action of participation, which is a key element of these processes, has also been subject for discussion, be-cause it should be defined who gets to participate and how real is that participation. As presented in Inagaki 2007, par-ticipation is a term that in different projects and experi-ences it can have different meanings and writes about four: 1) participation in decision making, 2) participation in im-plementation, 3) participation in evaluation, and 4) partici-pation in receiving benefit. Experiences have shown that sometimes participation is just a word in the project but is not exercised by people and if so, then the project shouldn’t be associated with Communication for Development.

The interest is growing amongst the practitioners of de-velopment strategies; successful experiences (from differ-ent countries) have been documented to show this side of Communication and Development, for that matter. This ap-proach is also vindicating the real meaning of communica-tion so that it will no longer be confused with dissemination of information or as Gumucio-Dagron in Fowler and Malunga stated “none understands the role of communica-tion as facilitating dialogue, enhancing participation in the decision-making process and ensuring sustainability of so-cial and economic change” (2010: 303). His observation is related to NGOs, multilateral organizations or bilateral agencies that imagine or understand communication as other actions that also need to be done, like propaganda, institutional image and not as a tool to achieve social change.

According to Quarry and Ramírez “Communication for Development is the use of communication processes, tech-niques and media to help people toward a full awareness of their situation and their options for change, to resolve con-flicts, to work towards consensus, to help people plan ac-tions for change and sustainable development, to help peo-ple acquire the knowledge and skills they need to improve their condition and that of society, and to improve the effec-tiveness of institutions” (2009:9).

Sometimes the meaning of communication gets con-fused, even amongst practitioners of it. The activities re-lated to communication are also assigned to almost anyone in the organization and shouldn’t be this way, because it re-quires the attention of a person who knows the difference between communication and dissemination of information.

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As Quarry and Ramirez pointed out in relation to all that surrounds the meaning of communication and the actions that are related to it is that “what matters most is to have clarity around the purpose of the communication initiative –the overall intent. What is it that the communication initia-tive is trying to do and what do we hope it will achieve?” (2009:18). As long as the organization and people who prac-tice communication have these points clear, then they can define what is the purpose or the function that communica-tion is trying to help.

In Guatemala, efforts have been made in order to help with the clarification of the concept and practice of Commu-nication for Development, one way of understanding it is ex-plained by Gularte9 “has its focus in the emphasis on the de-cision-making of the subjects, they are the ones who make the conscious decision of wanting to change a situation that affects them. It is based on full respect for the person as an agent of its own change, orderly facilitates the tools to suc-ceed in achieving a change. For this, there are some tech-niques that have to be followed, clearly, but techniques that have been improved from other participatory projects or that have been developed within a project”. From this per-spective, communication is understood as an exchange process between the subjects that have the capacities needed for it and in terms to improve their quality of life.

In relation to the projects from Communication for De-velopment, what is sought is to strengthen the right to com-munication so that the subjects can be able to put it into practice in order to change their reality. This is something that is entirely up to them (people in the municipalities and/or communities), in any case the intention is to find out how to strengthen a process so that it can be effective and help improve people’s life. Figure 2.1 illustrates how to un-derstand the process of communication in Communication for Development.

Figure 2.1: Communication as a Process of Dialogue

9 Eduardo Gularte, President of Centro de Comunicación para el Desarrollo –CECODE-, Guatemala. (Interview via email, September 21, 2011)

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FRAMEWORK

Shared Code

Medium / Resource

Transmitter Percipient

Source: Adaptation from CECODE Guatemala

2.7 Experiences of Communication for Development

Some experiences of Participatory Communication for So-cial Change have followed the principles of Communication for Development. Related to empowering people with knowledge and strengthening local capacities, there are several experiences around the world. Some have vindi-cated the use of mass media, since it has been used as means of providing the knowledge. For some of these expe-riences, local media has been used and strengthened in most of the cases.

The production of information is a shared activity amongst the ones from the experience and people of the territory where it has been held. Experiences have been presented in different ways and countries, Making Waves –Stories of Participatory Communication for Social Change10- is an example of where to find them. These selected experi-ences are the ones that had a participatory approach. The action of participation was also included in these experi-ences, in the author’s words “these examples show that the

10 Gumucio-Dagron, A., 2001: a collection of fifty case stories from three specific regions Latin America, Africa and Asia.

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beauty of participatory communication is that is can adopt different forms according to need, and that no blueprint model can impose itself over the richness of views and cul-tural interactions" (Gumucio-Dagron, 2001:6). This is an ex-ample of the strategies that can be successful moving away from the social marketing view. What is also represented throughout these experiences is that the community showed that they had appropriated the initiative, which means is now sustainable and organized by some of its members. Another aspect taken into account here is that in the experiences people have been part of the different stages and/or the complete process. Because the ones who initiated the project weren’t looking to gain visibility, which is the case of some international organizations and that is one of the reasons why they always rely on mass media, ad-vertising, etc.

These experiences of participatory communication have been developed in many countries, but mostly in the Third World, and even more specific, most of these first experi-ences began in Latin America. Because communication has been neglected in development projects, as mentioned in Gumucio-Dagron, 2001, these experiences show that com-munication can’t be ignored and should be interpreted as dialogue to be able to understand the cultural and ethnic view, that other project neglect for being too general to be accepted by all.

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2.8 Methodologies and Techniques used in Communication for Development

In order to achieve the goals established in a Communica-tion for Development Project there are a series of method-ologies that can be used and/or improved, based on previ-ous experiences. A participatory methodology and a moni-toring and evaluation technique are presented here; Out-come Mapping and The Most Significant Change.

2.8.1 Outcome Mapping

This is a methodology that explains in a different way how the results can be achieved in a process of change, not from the linear logic of “X” leading to “Y” as a cause effect, but as from “X” to go to “Y” there are multiple ways, multiple actors and factors and it is more dynamic the process. Out-come Mapping is different from other ways of planning since it represents the difference between giving the an-swers (external action) as oppose to give the tools to create elaborate the answers (internal action) from a participatory approach. It is also different because, as explained by Briggs (2010) it promotes transition, is flexible (adapts to its variations), is participatory (promoting commitment with change and the responsibility per result), allows to visualize the process of change from its multiple dimensions and out-comes.

Table 2.1: Intentional Design

Why? Vision

Whom? Direct partners

What? Desired outcomes and progress signals

Wow? Mission, map of strategies, practices of the organization

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In the case of the Outcome Mapping, the Direct Part-ners are the ones that the project will be working directly with. These actors are direct partners because, even though the project works with them to promote a change, they are not under the project’s control, they always have the power to exercise an influence on the development.

The desired outcomes are the most significant changes in behaviour that the direct partners are able to achieve with the project’s support. These outcomes are the effects that the program will achieve with its intervention, with the emphasis in the way that the actors behave as a result of its influence. These are stated in a way that will reflect the how an actor will behave y relate to others if the program uses its potential as an agent of change.

Table 2.2: Program Framework

VisionMissionDirect Partner 1: Outcome 1: Direct Partner 2: Outcome 2: Direct Partner 3: Outcome 3: Direct Partner 4: Outcome 4:

For each direct partner and outcome is established in consensus with the people who are participating in the planning. The signals of progress are set in a gradual man-ner. That is to reach and Outcome it can’t be done overnight and it acknowledge that it will take time to reach a difference from the reality until the Outcome. This should be coherent to the Direct Partners’ capacities. Outcome Mapping suggests three levels for the signals of progress: 1. It is expected to… 2. It would be positive to… 3. It would be ideal to…

Figure 2.2: Signals of Progress10

98 IT

WOULD BE IDEAL TO…

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76 IT WOULD BE

POSITIVE TO…5

43 IT IS EXPECTED TO…

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The Signals of Progress are a participatory step as well. The local actors are the ones who know best their situation, reality and context, therefore are the ones who can set their goals in a realistic manner. They are explained what is the difference between each signal, and then they are able to establish what would be expected, positive and ideal.

Box 2.3: Signals of Progress

It is expected to…These are signals that make reference to reactive changes, that have priority because can activate the actions for change in the process.

It would be positive to…Signals that make reference to more elaborated changes, result from the learning and transformations from exchange and new experiences.

It would be ideal to…Signals that make reference to changes from initiative of the partners inspired in the changes already achieved.

Source: Beatrice Briggs, International Institute for Facilitation and Change

Map of Strategies, are resources that the program has to support the changes undertaken by the direct partners, which are also expressed in the Signals of Progress. The strategies should have a satisfactory process of concentra-tion with the ones that will be using them. The kind of strat-egy is different depending on the use. The strategies di-rected to people: are to support the changes undertaken by people. The strategies directed to the context: are to create favorable conditions in the context so the changes can hap-pen and can also remain.

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2.8.2 The Most Significant Change

The Most Significant Change –MSC-, according to Dart and Davies “is a story-based technique to facilitate program im-provement by focusing the direction of work towards explic-itly valued direction and away from less valued directions. It can make an important contribution to evaluation prac-tice, its unusual methodology and outcomes make it ideal for use in combination with other techniques and ap-proaches”(2003:137). In this technique the terms to be used when talking about the ones involved is important. Therefore, to talk about the beneficiaries, in MSC the proper term is participant, instead of intervention, is pro-gram and instead of donors are funders.

MSC is a technique of Monitoring and Evaluation. “Mon-itoring in the sense that it occurs throughout the program cycle and provides information to help people manage the program. Evaluation in the sense that it provides data on impact and outcomes that can be used to help assess the performance of the program as a whole” (Dart and Davies, 2005:8). In monitoring, “MSC is suited to monitoring that focuses on learning rather than just accountability. For staff, it can help them improve their capabilities in captur-ing and analyzing the impact of their work” (op.cit.:13).

Dart and Davies, 2005, have also identified purposes on why to make use of MSC, from identifying unexpected changes, to identification of values, as well as being a par-ticipatory form of monitoring that requires no professional skill. Also, it encourages analysis and data collection, builds staff analytical capacity, gives a rich picture of reality and monitors and evaluates bottom-up initiatives.

As indicated by Dart and Davies, “MSC represents a radical departure from the conventional monitoring against quantitative indicators that is commonly seen in the sector and involves the regular collection and participatory inter-pretation of stories about change rather than predeter-mined quantitative indicators” (2003:138). Because it is a technique, there are some steps that can be followed in or-der to use it; 1) Raise the interest, 2) Define the domains, 3) Define the period (from when to when), 4) Collect the MSC stories, 5) Selection of the MSC stories, 6) Feedback of the process of selection (give back the stories), 7) Verifying the

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stories, 8) Quantification and, 9) Monitoring the system, secondary analysis. Step 8 and 9 are optional. Quantifica-tion has been used in order to keep track of the number of activities or people who have attended an activity. Also to be able to tell what kind of effects have been made and how many people have recognize to have made a change.

When defining the domains (step 2), it has been sug-gested to leave an “open window” domain and it is recom-mended to use between three and five domains. In the Step 4, the information included can be divided into three cate-gories; “1) Information: about who collected the story and when the events occurred, 2) Description: of the story itself (what happened) and, 3) Significance: (to the storyteller) of events described in the story” (Dart and Davies, 2005:25). The first category later can help as a follow up of the sto-ries.

Because the technique uses a question to generate the telling of the story, which usually is “During the last month, in your opinion, what was the most significant change that took place for participants in the program”, sometimes it can be confusing for the person responding. If this is the case, then it is recommended to “re-phrase it carefully and, once a good way is found in the local language, one must stick to it” (op.cit.:46).

For MSC to be successful or to be used properly, an or-ganization may have to evaluate if it has what is needed. Dart and Davies, 2005 consider strategies that can help, a) building the capacity of the champions, b) building the ca-pacity of the staff and, c) consideration of costs and time.

2.9 Analytical Framework

The theory and experiences presented are valuable from their own perspective and as everything else that has been done; it has a reason for being a certain way. Table 2.3 gives an overview of the approaches. These are the ones that have been implemented in the area of Totonicapán in different years and through different interventions. The ele-ments identified from the literature are the ones analyzed in the case through the experiences of the MSPAS, the Gov-ernment and the local NGO.

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Table 2.3: Overview to the approachesApproach Actions Desired Goal

Social Marketing

Information dissemination. Planned Activities (from a

central level) Elaborated messages Production and distribution

of materials Target groups / audiences Communication = informa-

tion

Influence a target audience to change their be-havior.

IEC/CC

Identifies audiences. Elaborated messages. Transmission of messages. Production and distribution

of materials.

Change people’s behavior.

Communication for Development

Provide spaces to access information.

Participatory planning of activities.

Participatory elaboration of messages.

Spaces for dialogue. Key and/or direct and

strategic partners. Right to communication =

dialogue.

Strengthening the capacities of local actors and provide useful information so people can make the decision to change a behav-ior.

Social Marketing and some activities are analyzed by the actions and plans from MSPAS. IEC/CC has also been identified in the actions from the Government, especially in the ones by SESAN and is also analyzed. In the case of Communication for Development, is identified in the project of the local NGO. The main difference within the three ap-proaches lies in the understanding of communication and participation.

The literature showed that in Social Marketing and IEC/CC, participation is not as relevant as it is in Communi-cation for Development. Following these approaches, the actions have been implemented in Totonicapán achieving different results. The one of Communication for Develop-ment is in the interest in order to analyze in depth the par-ticipation and integration of the local actors in a project. Table 2.4 is a summary of the indicators identified from the

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literature in each of the approaches and that can be found in the study case as well.

Table 2.4: Indicators that lead to the integration of actorsIndicator Social Market-

ingIEC/CC C4D

Integration of a Com-mission of Communica-tion

Plans of Communication *Production and distribu-tion of materials *

Monitoring and Evalua-tion *

Audiences

Partners

To achieve Local Development in a territory, it can’t be done from the efforts of just one institution, organization or a single actor. The participation of all the local actors, who are sharing a territory and therefore a reality, has to be taken into consideration for the strategic planning of future activities. To recognize the experience from each local ac-tor is a must when planning and to value these experiences and respect the background will contribute to reach a con-sensus to address the issues that affect the territory.

From the Communication for Development approach (*), the plans of communication are planned together with the local actors that have integrated the Commission of Com-munication and that are assuming an active role.

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Chapter 3: Study Case: Totonicapán, Guatemala

This chapter gives a description of the department of Toton-icapán, which is the area of interest. Brief context informa-tion is provided followed by the information related to mal-nutrition in Totonicapán.

3.2 Totonicapán, Guatemala

Figure 3.1: Totonicapán’s Municipalities

The population in Totonicapán, in its majority is Maya K’iche’, and therefore the language that is used the most is K’iche’. Most of them live in the rural areas, but there is also a considerable number living in the urban areas; rural population 64% and urban population 36%.

Within the economic activity of the locality, the industry is diverse manufacturing; fabrics, furniture and pottery.

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The population density, the low productivity of the land and the inadequate use of it, makes the family maintenance a problem. This has caused the population to seek for other or additional occupations, even temporarily migration to the plantations in the Coast Area of the country, in order to make the family budget. In the department there are great forest extensions in which fir and pines trees have been abundant. In the Appendices (Table 3 and 4) more informa-tion of Totonicapán can be found regarding its characteris-tics and the economic activity.

3.3 Malnutrition in Totonicapán

According to the Nutritionist from the Ministry of Health for the area of Totonicapán, chronic malnutrition is when children have an inadequate height for their age and she explained that in Totonicapán, 69.7% of the children have chronic malnutrition. It is has been mentioned that one of the reasons for this problem is because people in the com-munities don’t have good access to food and also because the families are numerous. Language has limited the access to information and to reach more people. There are some cases of severe malnutrition in Santa María Chiquimula and Santa Lucía La Reforma (the information in detail of per-centages of malnutrition can be found in Appendices Tables 5, 6, and 7). Table 3.1 illustrates where these municipalities stand compared to the rest of the country. The order goes from 1 to 333 (the number of municipalities in the country) and 1 stands for lowest.

Table 3.1: Municipal Priority, according to Quality of LifeNo. of Order

Quality Criteria Municipality Population

(2002)Projection

(2008)11 Very low Santa Lucía La Re-

forma13,479 18,862

27 Very low San Francisco El Alto 45,241 57,92640 Very low San Andrés Xecul 22,362 30,27246 Very low Momostenango 87,340 113,12054 Low Santa María

Chiquimula35,148 43,562

155 Average San Cristóbal Totonicapán

30,608 35,326

168 Average San Bartolo Aguas 8,684 14,432

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Calientes186 Average Totonicapán 96,392 120,250

TOTAL 339,254 433,750

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3.4 Consequences of Malnutrition

Information provided by the Nutritionist from the Ministry of Health for the area of Totonicapán, indicates that the consequences can be intellectual deficit, when the children grow up they will be less productive, in the childhood they tend to fail the school year, and all of these because their development has been affected. About the causes of malnu-trition in Totonicapán, the situation of poverty and extreme poverty in which families live in, is part of the reason. Mass media has also been identified as a cause because of the constant advertisement of diverse products. Families also tend to sell what they produce but don’t leave enough for family consumption and the cultural practices also have a role in this situation.

It has been recommended and suggested that the moth-ers should take their children (under 3 years of age) to the health services to get the checkup they need. This has also been promoted so that the children will receive the mi-cronutrients and vitamins they need (is given for free).

From the information provided by UNICEF, 2007 “The Silent Enemy”, Manuel Manrique explained some of the consequences of malnutrition “a chronic malnourished child will have learning difficulties as well as problems to use the intelligence and physical performance. This condition will be present for the rest of his/her life”. Later in the same re-port from UNICEF, it is stated that if the brain of a child is not saved before the third year of age, the implications in the physical and emotional development will be negative” (UNICEF, 2007:9). The consequences of an insufficient nu-trition are serious, especially in children under five years of age.

UNICEF’s report entitled “La Niñez Guatemalteca en Cifras – Guatemalan Childhood in numbers”, explains that the problem of a low food intake during a child’s first years of age not only affects the child for life but also makes him/her more vulnerable to diseases, poor educational per-formance, which in the future can be translated into low productivity of the human resource, for that in low income. This will lead to repeat, from one generation to the other

38

the same situation of poverty that, most likely, has been the reason for malnutrition” (UNICEF, 2007: 47).

Guatemala at a regional level has had the highest rates of malnutrition. Information from 2002, used in “Guatemalan Childhood in numbers” 2007, presented the rates of malnutrition in the Latin American Region, Guatemala had 49%, followed by Honduras with 29%, Bo-livia with 27%, Ecuador with 26%, Perú with 25% and the lowest rate in the region was 6% of Costa Rica.

From the information provided by the Third National Height Census of 2008, it positions Totonicapán amongst the departments in Guatemala with high prevalence, 69.4% and the National Average is 45.6%. (More information is provided in detail in the Appendices).

Coincidence or not, the departments with high preva-lence are the ones that have majority of indigenous popula-tion and are all located at the West Region of the country. In the case of the departments with low prevalence, the ma-jority of their population is non-indigenous and the depart-ments have are located in the East Region. Although in 2002 the first Nutritional Emergency was in two municipali-ties of an East Department, which still have high preva-lence; Jocotán: Total 72. 8% and Camotán: Total 63.5% and the department Chiquimula: Total 50.5% of prevalence, about 5 points above the National Average. It is needed to be clarified that this is also a department where most of the population belong to an indigenous group. In comparison to Totonicapán the difference is 18.9, so this can be a relative successful example of how a department can improve in terms of nutrition.

3.5 Views about Malnutrition11

Information provided by the Municipal Monitor from SESAN, identifies the lack of information as one of the rea-sons for the problem. There aren’t enough inputs in order to be able to have good nourishment within the households,

11 The testimonies mentioned in this section were pro-vided by CECODE Guatemala/ Auditoría de Información y Comunicación de Totonicapán

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there’s no availability of resources. According to the institu-tion, out of the eight municipalities, two are the most vul-nerable ones: Santa María Chiquimula and San Bartolo Aguas Calientes.

According to the Coordinator of the Program of Projects Support from the Ministry of Education, regarding the nu-tritional insecurity there are some factors that influence the continuity of this situation. It is recognized the lack of infor-mation on the matter and as stated by Mr. Tzul –Coordina-tor- “there are families that have some kind of nourishment, but they miss a proper orientation on how to consume the food, therefore real information is needed to be delivered to people so that they can bring it into practice”.

He also mentions that the school attendance is affected due to a proper food intake. The performance is affected and can be seen in the low attendance and eventually chil-dren drop out of school.

The Catholic Church in one of the municipalities has a program that supports families with undernourished chil-dren. Mr. Pú López, from the Church, identified that “there isn’t enough access to food, because the stores in the com-munities do not sell fruits and vegetables and for people to be able to buy them, they have to travel to the urban area of the municipality (sometimes is very far from where they live) and this is done twice a week when the market is held at the central park of the municipality. The intake of fruits and vegetables is low and what mothers provide to their children is corn based food, black beans and coffee, but this is not proper nourishment”.

Because this is a current problem, in most of the munici-palities of Totonicapán, there is an organization that helps the different actors to deal with the problem. Most of them are bring support to the Health Center because are the ones who provide medical attention. Mr. Vásquez, from one of these organizations called Asociación Toto12 Integrado –Association Toto Integrated- “considers that the problem with the parents in the rural areas is that they think their children seem fine, because the children not complain. In general, a child who is undernourished has attention prob-lems at school and may feel a constant desire to sleep, this

12 Toto: short name given to Totonicapán.

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is misinterpreted by the parents as laziness, and they can’t identify the undernourishment problem. If the children do not get the proper nourishment will not have a proper men-tal development”.

Local Governments have also taken a stand regarding malnutrition, as Mr. Vásquez, from the Municipal Planning Office San Bartolo Aguas Calientes, explains “acute and chronic malnutrition is consequence of the processes that have not been taken from an institutional approach, like the information in each community. Spaces are needed for training, promotion and release of information in the com-munities, especially for mothers, so that they can improve their role and that they can appropriate the information re-ceived and practice it too”.

The communicators from the municipalities, perceived the problem of malnutrition as a lack of information. They also think, that people who identify a problem of nutrition and health, mention the lack of control from the Health Center, as well as the lack of proper nourishment and the economic factor.

It has been identified that the mothers believe that after two months of changing the nutrition, mostly by giving for-tified drinks, the children will become “chubby” and will be healthy again. Since they don’t realize that a change like will take more time, they stop giving the vitamins and drinks provided by the Ministry of Public Health and Social Assistance. The mothers give up easily and they lose faith in the Health System.

There are different practices that have been identified by personnel from the institutions. One that is very common but also extremely wrong is to give other liquids to children before reaching 6 months of age. With that, mothers and caregivers, interrupt the period of exclusive breastfeeding. This is also done by another common practice, advice given from family members but it only reflects the lack of access to information.

3.6 Responses from Different Actors

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3.6.1 Ministry of Public Health and Social Assistance

The Ministry is divided in different Programs, Areas and De-partments; each has a specific function and addresses im-portant issues related to people’s health. In terms of Com-munication and Education, there is a Department of Promo-tion and Education in Health. The objective of this Depart-ment is to promote and develop health protection through Health Promotion with community participation and an ef-fective social mobilization. The Department also tries to give the knowledge to the communities through Informa-tion, Education and Communication –IEC- Strategies, as well as the skills needed to make actions that are determi-nant for their health. At the same time the Department is divided in 14 Programs, one of this is focused in Food and Nutritional Security.

Regarding the Program of Food and Nutritional Secu-rity, the Department follows a list of steps, which are also taught to the Staff in charge of the Program. This specific Program also has produced educational material such as the Nourishment Guides and the Breastfeeding Standards that are distributed in the Health Districts of the country.

Since 2007 the Department of Promotion and Education in Health has been following the IEC/CC approach. This ap-proach is linked to the principles of Social Marketing that follows the same steps in different issues. In relation to Food and Nutritional Security and Supplementary Feeding the MSPAS has been training its staff in IEC/CC throughout the Health Districts in the country.

As explained by Mendoza13 “IEC has been used as an easy tool for the Health Areas to elaborate their work plans within the different Programs of the Ministry. Also to give attention to the Local Health Plans, which include informa-tion and education to people through communication about different behaviors and practices that help to sustain and improve the health but also prevent diseases”. According to this information, the way IEC/CC has been used is to reach the health staff that is the one who has direct contact with

13 Emma Mendoza; Program of Promotion and Health Education from MSPAS Guatemala. (Interview via email, September 20, 2011)

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the people that the intervention is seeking to help. If the Program from the Ministry tries to establish alliances with other initiatives, the actions would reach more people and the risk of repeating an activity (educational, informational or other) will be less and people’s attention will not be lost.

IEC/CC efforts have been focused in two aspects: Food and Nutritional Security, for Promotion of Breastfeeding and Supplementary Feeding and the second; Promotion and Education in Health. These IEC/CC strategies have been given to all the Health Districts so that the health staff is aware of the activities that have been planned in order to be organized later in the communities and also to have a common understanding on the messages that will be given, first to the health staff and later to people in the municipali-ties and/or communities.

As part of the recent responses and in combination with IEC/CC strategies, the Ministry of Public Health and Social Assistance has been giving different complements for the nutrition in the most affected areas. These nutritional com-plements are: Vitacereal and Chispitas14 (Appendices Box 2). These complements are sent to the Health Services and then the educators from the health staff have to show peo-ple, mothers and caregivers of children, how to prepare them. The reason why this is explained is because these complements have not been used in the right way by the people who actually need them, mostly because of the lack of information which affects the actions that people do.

The strategies of IEC from the Programs of the MSPAS have also included training workshops for mothers and caregivers on how to prepare the nutritional complements. This activity was a necessity because the mothers com-plained that the children didn’t like the complements. One of the reasons was because they kept changing the way they prepare them to try and “fool” the children into taking it. The language was also a problem, mothers didn’t fully understand what was being said and then prepared the complements as they could remember. Because the staff in some Health Services does not speak the Mayan language

14 Vitacereal: is a kind of pap that should be given and prepared correctly in order to work well.

Chispitas: are the micronutrients and vitamins in pow-der that are needed for these special cases.

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then people don’t understand and are feel ashamed to keep asking questions. They do not feel comfortable enough to ask the same question over and over. However, they have been requesting for health staff who can speak to them in their mother tongue. It has been a slow process, but in some Health Centers there is at least one person who will be able to speak to them in their language.

3.6.2 Government

The Government has addressed the issue with different strategies. After the Food and Nutritional Crisis of 2002, policies and programs have been created and approved by the Government; even an entity which is fully dedicated to this issue, Food and Nutritional Security. The help from the Government has been problematic because when a new President takes over, then the progresses that have been made can’t continue because the actions have to undergo through some changes. The current Government (2011) is the third one that has continued to deal with the problem of Malnutrition but is also the third change in the strategies.

Because the problem of malnutrition became more seri-ous, then actions were needed by different sectors. During the Government period of 2004 -2008, several actions were taken in order to address the problem. The Policy of Food and Nutritional Security, the creation of the Secretariat for Food and Nutritional Security and, the National Program for Reduction of Chronic Malnutrition were created. As from the Secretariat of Social Work of the President’s Wife, a program called Creciendo Bien –Growing Well- was also approved, this was an effort which directly worked with the affected communities, with indigenous women from the ru-ral areas and the poorest municipalities of Guatemala. The reach of the Program and the approach was showing posi-tive results until 2007, later in 2008 the Program had a change in the name Creciendo Mejor –Growing Better- and also changes were done in the way it worked. Even though it still remained with the objective to train women with an approach of Food and Nutritional Security, the results until now have not been as positive. This illustrates that when a change in Government is done, the positive actions can con-tinue or can disappear, in this case the Program was af-fected, hence the people who were getting a benefit too.

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The current Government (2011) also initiated a purely paternalistic social program in order to help the poorest families in the country. The Social Cohesion Program which gives Q200.00 (€20.00 aprox.) to each family (who meets the criteria) to be used in the household rather than having to send of their children to work. It has a reach of 307 mu-nicipalities out of 333 and helps 890,38415 families. There is also the Bolsa Solidaria16 –Solidarity Bag- which has the ba-sics to complement a balanced nutrition, especially for the women who are pregnant or breastfeeding. The commit-ment of the family is that the parents have to attend the meetings were staff from the Social Cohesion Program gives them talks about community development.

The Secretariat for Food and Nutritional Security –SESAN-, has been increasing its work and has been strengthening its offices in the different areas of the coun-try. As explained by a Nutrition Monitor from SESAN of To-tonicapán, this Secretariat is the one in charge to propitiate spaces of inter-institutional coordination to work Food and Nutritional Security, in its most strategic function. It does not have direct intervention with families, but sometimes it is done in coordination with organizations that are obliged to do it. SESAN from the community and municipal levels has to present the work plans. This were done in a partici-patory way and in this process people from the communi-ties, as well as from institutions (and in some cases from City Hall), are the ones that had been involved. The opera-tionalization of the plans was responsibility of the institu-tions, with people’s support. SESAN then had a monitoring role of the plans. Recently (2010) this changed and the plans were being done from the Central level and then sent to the departmental office, which means that the plans had to be adjusted at the municipal level. The participatory method is no longer viable, and the focus has been more on campaigning, the State has changed and now is also using Information, Education and Communication –IEC-, seeking to change behaviors.

15 Information from www.mifamiliaprogresa.gob.gt Octo-ber, 2011

16 Information from www.bolsasolidaria.org October, 2011

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3.6.3 Local NGO in coordination with International Cooperation and other actors

For years UNICEF Guatemala has been making use of na-tional campaigns to address issues that affect children’s life. The use of mass media has always been a regular strat-egy and they have also made use of Social Marketing, specifically when asking famous people to make a radio spot, which then is sent to the national and local radio sta-tions. The same is done with the TV spots and sometime is the same message but the format is the one that changes.

As from 2009, UNICEF Guatemala took a different turn and has been funding a local NGO to address the problem of malnutrition in two areas of the country (for this re-search one has been explained). The approach of this local NGO comes from Communication for Development and has been constant in its work and projects. At the beginning UNICEF Guatemala, through the Department of Communi-cation (the one funding the project) was hesitating of the outcomes of project form this approach. Two years later, the project is still working in both areas of the country.

The Project 36 Cero Malnutrition seeks to strengthen people’s communicational skills, more specifically in the ones that are considered key partners -in the Project- in the eight municipalities of the Department of Tototnicapán. All of this is done so that they can assume the task of improv-ing the information and communication in issues related to health and nutrition. This can help in the preparation of the mothers and caregivers (direct partners) to face the eco-nomic crisis, so that they can be less vulnerable in the topic of children’s health and nutrition.

The fundaments of this Project are based in Communica-tion for Development, strengthening key actors’ skills, in order to be able to improve the quality of life of their fami-lies as well as the rest of the families in their communities. The objectives and/or goals are focused in the strengthen-ing of skills, communication structures, access to informa-tion, and also exchange and generate communicational spa-ces for parents, caregivers and pregnant women, with insti-tutions that can contribute to improve their attitudes and practices between them.

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The NGO has limited the topics to be address, because are the ones that can be improved and/or are linked through communication actions. Before the developing of the activities and the elaboration of the communicational plans (per municipality) a Communicational Audit was made in order to have a clear scenario of how much do people know in terms of children’s health and nutrition.

There is also an emphasis on working and linking the ac-tivities with other local actors that can be; institutions, gov-ernment offices, City Halls, church, education, people from the communities who want to take part in the whole process. SESAN from Totonicapán has been a key institu-tion in order for this Project to have access and reach peo-ple in the communities. Since the beginning of the Project a contact was established with the eight City Halls as well as the Health Centers. SESAN through its Nutritional Moni-tors (one per two municipalities) has been part of the Project and has helped to give information of the current situation. An explanation is given on how the NGO links the participation from other local actors through the Municipal Team of Communication (Figure 3.2).

Figure 3.2: Linking Local Actors

These experiences from different actors showed that ac-tions are being done in order to decrease the high rates of malnutrition and that the institutions are trying to contrib-ute from their area of expertise. Although all of these can

MTeam of Communication /Commission of Communica-tion

&ĂŵŝůŝĞƐ &ĂŵŝůŝĞƐ

&ĂŵŝůŝĞƐ &ĂŵŝůŝĞƐ City Hall

Civil Organizations and Associations

Education Health

SESAN

D ƵŶŝĐŝƉĂů dĞĂŵŽĨ

ŽŵŵƵŶŝĐĂƚŝŽŶ Churches

COCODES

Source: Adaptation from CECODE Guatemala

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seem positive, the lack of inter-institutional coordination affects the outcomes of “X” or “Y” project, regardless the approach. These examples also show that communication cannot change a situation by itself, communication and its strategies planned from different approaches are a way to-wards an improvement, but a key component that should be present is that the integration of efforts can lead to achieve better results. This will be discussed in the next chapter.

Looking at the experiences in one particular area and from the approaches used, it is important to acknowledge that participation and the integration of local actor is a key component of the development projects. If communication is promoted and respected by each actor involved in the process, then strategies/actions will have a higher chance to be successful.

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Chapter 4: Malnutrition and Communication

4.1 From Social Marketing, going through IEC/CC reaching Communication for Development: the road to improve inter-sector integration and participation

The experiences presented in Chapter 3 have illustrated that there is a need for coordination amongst the actors in-volved. Each experience should establish which or who could represent the best alliance (for the project) and then work together. At some point the activities from an ap-proach are done at the same time from others and, there-fore activities may overlap. To avoid repetition of efforts, communication is needed between the institutions, organi-zations and all the ones being part of the same effort.

The approaches (reviewed) seek to change a behavior of people in a locality. One of the differences is the way these changes are achieved. As understood from the literature, one is more participatory than the others and, contributes to the integration and visibility of the local actors who are working towards the same goal.

4.2 Integration of local actors in a territory

From the experiences presented and from the approaches to communication reviewed, the reality in the case of Toton-icapán, Guatemala has showed that not all the approaches lead to successful integration of the actors. It is recognized in Communication for Development that all the actors, taken as agents of change and as partners, should be in-volved in the planning of the activities of their territory. In Social Marketing and IEC/CC, the participation is not men-tioned and the people are taken as passive agents since they are audiences or target groups.

The indicators from each approach, presented in Table 2.3, can help identified the ones that can or cannot contrib-

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ute to achieve the inter-sector integration that is needed for a project to be successful.

The inter-sector integration is assured from Communi-cation for Development because the actors, taken as part-ners, assume an active role and also assume responsibilities for one or more of the actions that are in the Plan of Com-munication, which also assures the contribution of the rest of the actors since they all had a say. The production and distribution of materials are; produced with cultural perti-nence and distributed through an established group (Com-mission of Communication), try to reach as many people as possible and not to be left in certain offices. Monitoring and Evaluation is also done in a participatory way and it values the changes and learning that people feel they have accom-plished.

In the experience of Totonicapán, in the eight municipal-ities the Municipal Commission of Nutritional Security, ap-proved by the Mayor integrated a Commission of Communi-cation which is the one in charge to plan, organize and be the responsible of the communication aspect of the Nutri-tional Security in the locality. These Commissions communi-cate with the Commissions of the other municipalities to have an integrated view of what is being done and to con-tribute with each other.

In the case of Social Marketing and IEC/CC participa-tion is not an option because the messages sent as well as the materials, are produced at the Central Level. This means that the MSPAS and SESAN in the national offices based in the Capital City of the country are producing the messages, and materials as well as the Plans of Communi-cation. Later, these Plans are sent to the regional offices and the ones who received them face the challenge to make them fit in the territory, or not to follow them as intended. Totonicapán, nowadays, is receiving the support from the Communication for Development approach. Offices have to undertake their Plans as sent but now have the chance to be part of the Municipal Commission of Nutritional Secu-rity, which is useful for these actors who represent the Min-istry and SESAN.

SESAN has changed from making the plans participa-tory and, now the plans that come from Central Level are being implemented. The information provided by the Repre-

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sentative of SESAN for Totonicapán17, explained that the plans were done from the municipalities and communities, since there are the Commissions of Food and Nutritional Security, but there were not specific guidelines from SESAN. The Departmental office of SESAN only had the Strategic Plan of Food and Nutritional Security (at a na-tional level) as a reference. This Plan had its own object-ives, guidelines and general actions. Following this National Plan, the ones made from the municipalities and communit-ies didn’t follow the framework established and because of that SESAN at a Central Level made the decision of making the plans for all.

Another reason for this change was that the plans from the localities were not in line with the Central Level be-cause were made from the conception and views from people in the communities. The Strategic Plan of Food and Nutritional Security didn’t include these views, and as stated by the Representative of SESAN for Totonicapán, this Plan should have had a participatory group to include the different views but it wasn’t like this and so the result was a Plan created only by people from the Capital City. Be-cause of this the local plans weren’t in line the ones sugges-ted by Central Level. Therefore, the Department Council of Food and Nutritional Security (CODESAN) from Totonic-apán suggested an initiative to create spaces at the muni-cipal and department level to have people’s participation (that was neglected before). The initiative was presented to the Observatory of Food and Nutritional Security which was working in Totonicapán in 2011.

Another important reason, as explained by Mr. Chom, is that SESAN was being pushed to satisfy the fiscal goals ap-pointed by the Ministry of Finance in order to receive the disbursement. Amongst these goals were the elaboration of the plans at all levels, and because some of the SESAN of-fices in different municipalities didn’t manage to have them on time, a change was done. This was also a reflection of the lack of organization form SESAN in these municipalit-ies, which in the long run affected the whole process. The decision made by SESAN Central Level was to create the plans and then have them distributed in to the department offices and then each office will have to adapt them in order

17 Mr. Chom, SESAN’s representative for the Depart-ment of Totonicapán (Interview via email, October 13, 2011)

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to achieve the fiscal goals and some of the Food and Nutri-tional Security goals of each place.

4.3 Local Voices

4.3.1 Focus GroupMunicipality: MomostenangoGroup: Mothers from the community that have been at-tending the activities from CECODE/UNICEF

Changes in the eating and food preparation habits.

The women who were answered said that they have changed their eating habits. They said that before (Project 36) they didn’t vary the food, especially what they used in the food. What was mostly used were: black beans, herbs and eggs. Now they say they combine other kinds of food because they know that the food they give to their families should be balanced and should have vegetables, herbs, rice or any other carbohydrates and at least once a week chicken, meat or Protemás18.

They also said that the activities have been useful to learn how to prepare the food, so that their children will not get bored having the same thing, because they have men-tioned that before the children refuse to eat what they pre-pared. Even though nowadays the food that they give them is made with the same basic ingredients, the preparation is different and that has been good for the children. So now, the children eat the food, they have said they like it too and the mothers know that it helps the nourishment of them.

The mothers also entered a “Cooking Contest”. This Contest was of preparation of nutritious dishes, and it was among 8 groups form the communities of Momostenango. Each woman had to explain what she had prepared and why it was a nutritious dish. In the explanation, they also talked about the importance of having the four groups of food: vi-tamins and minerals, carbohydrates, proteins and fats. They prepared a dish that had these four food groups and pre-

18 Protemás, is a substitute for meat made out of soy pro-tein and it is accessible to people’s budget.

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sented them at the park, before the public that gathered there.

This shows that they have appropriated the information that they have received and that they have learned some-thing useful for them. Something to highlight is the group from Pabaquit from the Community Santa Ana, that a few months ago learned to incorporate fish into the diet with vegetables and rice (seafood in general terms is not part of the diet of indigenous families from Momostenango). But now, they participated preparing a variant of this dish with fish fillet and explained that it is important to include it in the diet, at least twice a month. They explained to people that fish is good because it helps children to learn, since it contains phosphorus. This can also show that there has been a change in their diet from the food preparation work-shops and from playing the Nutritional Lottery. They have been the ones who have taken the initiative to investigate on their own the properties of the food that they are using now to prepare the food, and this was also part of the infor-mation that they gave in the contest; to the public and the jury.

What they also recognize is that now there has been an increasing rejection for “junk food”. They now know and tell other people that it does not have any benefit and that is bad for children’s growth. They have also started to prepare natural juices, rather than keep on buying sodas. An exam-ple of this change was also presented in the Contest be-cause one of the mothers prepared beetroot and orange juice, and explained the nutritional properties of the drink. They recommended other mothers to give natural juices be-cause are better than sodas.

This chapter has presented an analysis of the different approaches that have been used in one same area in order to address a specific social issue that has been affecting the poorest people in the rural areas. Although there are the examples of how the personal attention benefits better the families and people who need the attention, the other ways of sending messages and information have been useful to create an awareness amongst the people in the communi-ties, but mostly the people that are creating these mes-sages.

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4.3.2 Most Significant Change in Totonicapán19

Since participation has been a relevant issue throughout this research it is important to have a section dedicated to the local actors’ voices. The women and men that have been involved in the process are the ones who can tell better their stories and also tell what they have found “signifi-cant”. Some stories have been selected to be included in this section, and more can be found in the Appendices Most Significant Change in Totonicapán.

Parents

Story 1: “Thanks to a friendship, I have improved my-self”Sonia Maribel Tuch de LucasMunicipality: San Cristóbal Totonicapán

Mother of three children; her experience in attending the trainings happened through María Sapón, who moti-vated her to attend. Sonia’s husband is jealous and he doesn’t allow her to go out often, but the need to receive VITACEREAL for her son, made her go to the Health Cen-ter. Sonia then began to go with María, and motivated by the Health Center’s Project, of making raffia baskets, she decided to get involved to the point that she became the leader in her community. She also got involved in the group called “Friends of the Nutrition”, a training that is offered downtown. She mentions that the MSC is to have become leader of her community’s group and to be part of the COLOSAN. “Now I can give my opinion, and it is heard be-cause I have been trained in the topic. I also know how to properly feed my family and I am teaching my daughters too. We have been able to negotiate a proper latrine and they (daughters) always try to separate the garbage in or-der to have the house cleaner.” This family has also been planting their home garden and they are harvesting radishes for their consumption. For this process they re-ceived the support of the City Hall, Health Center, Peace Corps, the Project and SESAN.

Story 2: “Accepting challenges”19 Information provided by CECODE Guatemala/ El Cam-

bio Más Significativo de Totonicapán

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Isarel Yat Zárate, Municipality: Santa María Chiquimula

Israel is a very active person; however the topics of the trainings have never been his priority. When the first edu-cational session of the COMUSAN started, he approached it out of curiosity and also because he had been asked to at-tend. Now he recognizes that “has raised awareness” and the MSC that he considers is that now he wants to actively work for the wellbeing, not only of his family, but also for his community. A proof of that is that he has accepted to be part of the Board of Parents in issues of health and nutri-tion, organized by the Health Center and the Project.

Local Actors

Story 1: Joining efforts for the same purposeMaría Gutiérrez, City Hall’s OMM Municipality: San Bartolo Aguas Calientes

The MSC has been the support given by the Commission of Food and Nutritional Security, Communication and Health in the activities towards a better nutrition of the population. Previously, in 2009 the COMUSAN existed and with the beginning of the Project the work was done with its members to analyze the communicational situation re-garding children’s health and nutrition in the municipality. As a result a Municipal Team of Communication was cre-ated, which also elaborated a Communicational Plan. In 2010, as a decision of the COMUDE, the integration of the Municipal Team of Communication into COMUSAN was ap-proved, being set as the Commission of Food and Nutri-tional Security, Communication and Health. At the same time, the current plans were integrated into one. From that moment onwards, the Commission began to execute the planned communicational activities in a coordinated way.

In this situation the ones involved were: Health Center, the Project, PRORURAL, MIFAPRO and SESAN. This change was possible by joint efforts from the different insti-tutions for the same purpose. The relevance of this change is that if the institutions work in coordination with each other, the planned activities will be successful because the

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efforts are towards the same purpose and each institution brings its experience from its specialization. The recom-mendation was to continue with the processes and strengthen some activities in the communities.

Story 2: Communicational EmpowermentGiovanni León, CTA/MINEDUC Municipality: Santa María Chiquimula

Giovanni León has been part of the Municipal Team of Communication from Santa María Chiquimula since 2009 and through the sensitization about the problem of chronic malnutrition and food insecurity; he has gotten involved to the extent that he considers to have empowered the topic. For this educator, the MSC has been the empowerment, since he indicates that each time that there are new projects or programs, the organizations aren’t always will-ing to support their drive. He recognizes that the use of Communication for Development in improving families’ situ-ation with chronic malnutrition is very important, consider-ing that it is a space where people can analyze the problem that they face, also comment and take actions on it. Addi-tionally, C4D encourages subjects to decide in changing at-titudes and a behavior for themselves. This change is also significant because of its organization, the people who are part of the Municipal Team of Communication have also un-derstood the importance of communication and this will im-prove as long as the technical assistance and the presence in the municipality is strengthened.

From the testimonies presented in this section, the local actors are the ones who talked from experience. These ac-tors have been part of other projects and interventions, but were in the role of “recipients” of the information brought by experts of Social Marketing and IEC/CC. In their words, the appreciation can be read regarding the opportunity for participation. They have come to realize that small changes can make big differences, but most important is that they were the ones who made the decision to change. The infor-mation, the spaces for participation and dialogue were pro-vided but in the end they are the ones who make the ulti-mate decision and through it the life of their families im-proves.

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Chapter 5: Conclusions

To understand the real process of communication can lead practitioners of it and the ones from mass media to focus their efforts in the right direction. It can’t be said that there is a right and a wrong way, is just that different processes have to be named differently and not to be assumed that all can fit in the same “basket”. In the case of Social Market-ing, the approach is to deal with target audiences in order to change a behavior, but what these strategies really ac-complish is to raise awareness of an issue. This is not wrong, but it can’t be called communication since it does not involve people’s views, experiences and knowledge. Communication for Development on the other hand, does not aim for publicity, but its focus is to empower people through different processes that include upgrading their ex-isting capacities.

Malnutrition is one of the different problems that have been affecting the poorest people in Guatemala. Even though it has been a problem existing for over the past 30 years, for some reason the strategies have not fully reached the ones in real need for help. This could be to the fact that the efforts have been done from an individual perspective, rather than an integrated work from all the sectors that can help in decreasing the high rates that the country has. Re-sources could have been used in a more efficient way if the organizations, Government and other important local actors could reach consensus in the actions. The relevant input is the one that can be delivered from the different actors ac-cording to their experience and knowledge.

Before Communication for Development, the communi-cation models had their foundations from the modernization paradigm. In contrast and since the 70s the South has been proposing participatory communicational approaches. These approaches have given importance to: true participa-tion, a horizontal dialogue, local actions, local knowledge, the role of facilitators and communication as a process. These are the response to the Northern way of doing com-munication. This can also be an explanation why Communi-cation for Development is more important in the South than in the North, it started as need for social responses to social issues.

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Participation as mentioned before can be defined de-pending on the project, and in Communication for Develop-ment it tries to get the integration of local actors and it is considered as “the development goal in and of itself for its potential to activate local mobilization, consensus building, self-reflexivity, indigenous knowledge, awareness of struc-tural problems, and other practices and changes leading to self-development” (Inagaki, 2007:13). Participation is the way to vindicate people’s right to communication which has been neglected or denied in some cases. Also through par-ticipation, the local knowledge recovers importance and rel-evance in the actions that will directly affect people in a ter-ritory. To be able to reach consensus within the actors is also through participation that, in this study case was through the strengthening and/or creation of the Commis-sions of Communication. With this the actors involved in the project had a place to discuss, plan and decide together the right actions to address the issues that can help to decrease the high rates of malnutrition. Not directly but through the activities, and like it was said before, creating the aware-ness so that people can recognize what is being done and what can be best for them as well as their families and com-munities.

When people are taken seriously into account in a project, they tend to show interest and commitment to the activities. If they see that their ideas and the local knowl-edge are represented, they are willing to take responsibility in some of the activities. People have also shown apprecia-tion for the information received, but mostly because of the fact that they were able to take part in the planning of the activities that affects them and their communities.

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Appendices

The following Table shows examples that illustrate the dif-ferences between indigenous and non-indigenous popula-tion in terms of access to basic services.

Table 1: Differences in access to services and other health indicators20

Service / indicator Indigenous Population

Non- Indigenous Population

Piped water 61% 70%Sanitation (toilet / latrine) 82% 88%

Percentage of literacy 52.3% 79.6%Average schooling (in

years) 2.5 5

Infant mortality (per each 1,000) 69 52

Immunization (complete scheme) 61.4 63.3

Chronic malnutrition(height /age 36-59

months)69.5 35.7

Maternal mortality (per each 100,000 born alive) 211 70

Income differencesThis inequality manifests itself in access to income as

well as consumption patterns. Income discrimination is given when a person with the same productive capacities as another, but with differences in a personal characteristic non-related to income generation, gets a different treat-ment. On average, indigenous people receive a lower in-come. The low incomes produce high levels of poverty which affect in the nutrition and levels of schooling. This provokes monetary expenses for the ones suffering of poverty, their families, the State and the country in the fol-lowing ways: the private expenses that families have to face due to incidence of diseases that have an additional cost: treatment, and also the amount of money that these people stop receiving because they can’t go to work (UNDP, 2005).

20 Diagnose of Racism in Guatemala, 2006

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Graph 1: Thresholds of poverty, extreme povertyand average private consumption (2004)

Extreme Poverty Poverty Private Consumption

2,560

5,780

1,5400

Annual Quetzales per capita

Source: Adaptation from UNDP, 2005:100

Malnutrition

The Census was done with children from First Grade from the Official Sector a total of 459,808 children from the ages of 6 years 0 months to 9 years and 11 months.

Box 1: Malnutrition in different aspects

Age: the children with 8 and 9 years showed a prevalence of 51.6% and 60%, while the ones with 6 and 7 years showed 34.8% and 39.6% of prevalence. This illustrates that the older the chil-dren get, the worse the nutritional damage.

Urban and Rural Areas: the ones from urban areas showed a prevalence of 28.3% and the ones from rural areas 49.7% of prevalence, which presents that these areas are more affected and the difference is of 21%.

Language: the children who have Spanish as their mother tongue have a prevalence of 34.6% and the children who have a non-Spanish mother tongue, most likely a Mayan language the preva-lence of 62.5%, almost twice as much.

Source: adaptation from Third National Height Census, 2008

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CommunicationHow IEC is understood in the Western and the Vietnamese context.

Table 2: IEC in different contexts

Western

A general term for communication activities to promote a variety of is-sues including health, for example, water supply and sanitation and child rights.

An approach based on the need to make all concerned, become more effective communicators.

Vietnamese

Has a combined meaning that en-compasses both communication and ideological orientation.

The term includes complex concepts: propagation and education, social-ization, community organization.

A more controlled process of coordi-nated action toward a national ap-proach within guiding ideological principles.

Source: Laverack and Dap, 2003

Totonicapán, Guatemala

Table 3: Population of TotonicapánPopulation Data21 2011 Ethnic

Groups22 2002

TOTAL 476,369 Maya 333,438MEN 226,873 Garífuna 4WOMEN 249,496 Xinca 9

Ladino 5,640

21 INE: http://www.ine.gob.gt/np/poblacion/index.htm, September 2011

22 INE: http://www.ine.gob.gt/np/poblacion/index.htm, September 2011

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Table 4: Technical Information of TotonicapánTerritorial Extension 1,061km2

Meters Above Sea Level 2,495Languages K´iche´Climate cold

Totonicapán one of the 22 departments of Guatemala23, is located in the area of the Sierra Madre and it’s integrated by eight municipalities: Momostenango, San Andrés Xecul, San Bartolo Aguas Calientes, San Cristóbal Totonicapán, San Francisco El Alto, Santa Lucía La Reforma, Santa María Chiquimula and Totonicapán. It borders with four de-partments: at North with Huehuetenango, East with Quiché, South with Sololá and West with Quetzaltenango.

To access Totonicapán, the main road is the Interameri-cana CA-1 (the paved road that also connects to other de-partments); there are other roads that will lead to it too. Within the eight municipalities there are roads, not in good conditions and mostly not paved, that connect each other. In the rainy season this is usually a problem because the ac-cess is limited to most vehicles; therefore people face a problem to get to the urban area of the municipality.

Production and Economy in Totonicapán

Within the agricultural, commercial and industrial activity of the population; the products that highlight are: wheat, maize (which is mostly for the family consumption), beans, potatoes, oat, barley and others. Great part of the lands is eroded and some are non-productive, especially in Momos-tenango. Regarding poultry, there is no organized or techni-cal growth and each family owns a number of animals that are sold or for family consumption. Milk and its derivatives are for business and few people leave part of it for con-sumption.

23 Information from Diccionario Geográfico de Guatema-la.

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Malnutrition in Guatemala

Table 5: Prevalence (%) Delayed in HeightDepartment Total Moderate SevereSan Marcos 55.5 38.4 17.1

Huehuetenango 62.8 41.4 21.4Quiché 63.9 42.5 21.4Sololá 65.2 43.8 21.4

Totonicapán 69.4 44.8 24.6Note: the National Average is 45.6%.

Table 6: Departments with Low PrevalenceDepartment Total Moderate SevereCapital City 18.5 16.0 2.5

Escuintla 25.3 20.8 4.5El Progreso 25.5 20.3 5.2

Jutiapa 28.1 21.7 6.4Guatemala 28.7 23.3 5.4

In the specific case of Totonicapán, even though it has the highest rate there is a difference between its eight mu-nicipalities.

Table 7: Prevalence (%) of TotonicapánMunicipality Total Moderate Severe

San Cristobal Totoni-capán 62.5 44.2 18.2

Totonicapán 65.2 44.1 21.2San Bartolo Aguas Calientes 66.6 43.9 22.7

San Francisco El Alto 66.9 44.1 22.8Santa Lucía La Re-forma 67.8 45.8 22.0

San Andrés Xecul 68.9 43.3 25.6Momostenango 74.1 45.9 28.2Santa María Chiquim-ula 75.5 45.3 30.3

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The Ministry of Public Health and Social Assistance has been giving different complements for the nutrition in the most affected areas.

Box 2: Nutritional Complements

Vitacereal: is a nutritional complement that is given to mothers through the educators of each Health Service. It should be pre-pared as compote, but the mothers have said that the children don’t like it like that and they decide to change the way it has to be prepared. When it is prepared differently, like a shake or a regular drink, then it loses its effect.

Chispitas: another kind of nutritional complement that has to be spread over the food, the food has to be solid or semisolid. It has also been identified that mothers don’t follow the instructions and have been giving them as a drink. If it is a liquid it will not have the same effects and may also send a wrong message to children, making them think it is a medicine and hence, reject it.

Source: Mónica Ramos, Nutritionist from MSPAS

The Most Significant Change in Totonicapán, Guatemala

MSC in the Quality of Life (Parents)

Story 1: “That my children have a better life”The story of Marta María Ixcoy AjiatazMunicipality: San Bartolo Aguas Calientes

Marta María values the improvement of her knowledge: “The talks and the demonstrations of how to prepare food are very good, that you (Project) provided. Before I didn’t know or didn’t have the knowledge because I didn’t attend the talks, but now I do, I have knowledge. With the money from MIFAPRO I buy books, notebooks and I contribute with the school. My experience is that I only attended until the second grade, and for that I tell my children to study so that they won’t be like me. Before the talks, we did things just for the sake of doing them, without knowing about the benefits: cleaning the house, family planning, etc. In this change have influenced: The Health Center, MIFAPRO, and what’s important our willingness to learn.” She values this

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change and her participation because: “I don’t want my children to be ignorant, and for that reason they should go to school; so that in the future they can be a teacher, be a professional. If not, they will be like me, not having the ca-pacity to read or write and like that one can’t move for-ward. Also what’s important is that with the economic help or without it, I have to send my children to school and to keep attending the talks that are very important. If I knew how to read and write, I wouldn’t be receiving these talks because I would know about the topics. So now, that I have realized this, I don’t want my children to be like me.”

Reasons for the selection

This case is about changes were a connection has been made between what is known and the practice, one of the challenges established at the beginning of the Project. This person’s participation in the educational activities, linked to the participation in other programs that benefit her, have helped her established the connection between knowledge and the activities she has to make in order to improve the quality of life of her family.

Story 2: “The value of herbs”The story of María Griselda VicenteMunicipality: Momostenango

Griselda is a member of the group of mothers that is in-volved in educational activities organized by the Project in coordination with the Health Center. She has attended video forums, demonstrations of how to prepare food and recreational activities about prioritized topics; health and children’s nutrition. Griselda’s children are 2 years old and the other is 9 months old, she recognizes to have learned about the value of food, like the herbs. Now she buys the herbs and prepares them at home in the way she has learned from the demonstrations and she is confident that these herbs, together with other food is good for her chil-dren to grow better. She learned to prepare proper food for the children, which she has done at home and they liked it.

Reasons for the selection

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This case illustrates the effectiveness of the educational activity focused in food preparation, since the resources used are available in the community but at the same time are nutritious. In the preparation this kind of food (herbs) is combined with other type of food rich in nutrients, also available in the community. María Griselda, like other women, says that what she has learned to cook, she has prepared it a home and her children liked it. Actually, there are some women who recognize that now, that they prepare the herbs in a different way; their children are more likely to try them and have liked them too.

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MSC in the Quality of Life (Local Actors)

Story 1: A speed recoveryThe story of Josefina Poroj Morales Municipality: San Andrés Xecul

Josefina’s daughter is chronically undernourished, and the problem has increased since she also became acute mal-nourished. With the help of the Health Center and the dia-logue that has been established with her, her daughter has recovered. For her (Josefina), the MSC is that she has un-derstood the importance of taking care of the family, espe-cially of her children since she has noticed that otherwise it can lead to serious consequences. Now she has decided to take action to improve her family’s situation, in this change the Health Center has been involved and recently the Project. For Josefina is a Significant Change because now she is conscious of the problem and knows that her family’s nutritional situation will improve. She suggests that the or-ganizations should join and cooperate in a better way, car-rying out integral assistance to families. Since she has al-ways dreamed of having a family garden but due to the eco-nomic limitations it has not been possible. For that she sug-gests for the organizations to work together to make ac-tions of deep impact.

Reasons for the selection

It is about changes in a direct partner, a mother, who had a girl with chronic malnutrition, but due to her partici-pation in the activities from the Health Center and the Mu-nicipal Team of Communication of San Andrés Xecul, pro-moted by the Project, she understood the magnitude of the problem and chose to improve her family’s quality of life.

MSC in knowledge and application

Story 2: I made my voice be heard in my languageThe story of Santa Pelicó Chanchavac

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Municipality: San Bartolo Aguas Calientes

The MSC consist of “being taking into account in the activi-ties organized in my community to improve my family’s health and to avoid the consumption of bad food and also avoid sicknesses in my family members. Nowadays we are changing as parents, so that our children can be better than us, and so that they won’t suffer like we have in the past. We weren’t allowed to attend school, and when the schools censuses were done, we were forced to hide in a chest where our parents kept the corn. Until now and with the support of our husbands, who have also had to understand that as women we also generate an income to support our home, aside from the fact that we are the ones who also stay at home to care for our children. Today, by the infor-mation received from the different organizations, we know how to communicate with each other, and even though is hard to give our opinion, we do it in our way and in our lan-guage because we are not ashamed of who we are or where we come from; we are Mayan women.” The ones involved in this change were: UNICEF / CECODE, PRORURAL, City Hall, other institutions as well as the Health Center. This change happened because “we are aware now and we have received orientation in our community.” This change is valuable because “we see that the children don’t get sick as much and we (mothers) take the advantage of the advice to improve the health of our children since their birth and throughout their growing years. I recommend for the orga-nizations to keep visiting the communities and to keep giv-ing us their support.”

Reasons for the selection

Since the work’s emphasis of fighting nutrition is set to strengthen the communicational capacity between the ac-tors, this case shows the advance in recovering the right to communication, especially in the case of women and with the value added, that is a communication with cultural rele-vance and in their mother tongue.

MSC in the participation and coordination of an organization in COMUSAN or Municipal Team of Communication

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MSC in comprehension and appraisal of C4D

Story 3: C4D in the City Hall’s Plan

The story of Benjamín PuacPresident of COMUSAN and City Hall’s CouncilorMunicipality: San Cristóbal Totonicapán

For Benjamín, the MSC has been to include in the City Hall’s Operational Plan; for 2011 and onwards, the area of C4D and with it strengthen the institutions. He expresses that the dialogue and participation from the communities and institutions it is also needed.

Reasons for the selection

It is a significant change for the Local Government to assume the commitment of including C4D in the Opera-tional Plan. This represents innovation in the municipal management, given the fact that C4D isn’t just a tool to ap-proach malnutrition problems, but also has a broader sense of intervention, that if the City Hall makes use of, can be effective for Local Development.

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