A Jhpiego/USAID worker stands next to an older woman, showing her how to cook a bean recipe. A toddler is strapped to the older woman's back.

Image caption: Community facilitator Glenda Sajic demonstrates how to cook a bean recipe to Ana Torres Canel

Credit: Jhpiego/Diego Guzman

A recipe for health in Guatemala

Nutrition project being implemented by Jhpiego, a Johns Hopkins affiliate, aims to reduce maternal and infant deaths in Guatemala

A big, blue bin of black beans—enough to last a season—sits outside Ana Torres Canel's earthen-floored house. A smaller stash, for daily use, occupies the rough-hewn shelf in her kitchen, alongside a few eggs and some tomatoes.

Black beans, simply prepared, are the main event of every meal in La Bendición in Cotzal, a rural village that's home to Indigenous Mayans like Ana and her husband, Francisco Lopez.

Ana, 38, is a woman of few words. When she speaks, it's softly in a local dialect of Ixil. The Ixil community was a target of the Guatemalan civil war (1960–96), which had long-term consequences that impacted Indigenous people—where they lived, the crops they grew, and ultimately the food insecurity and hunger they still experience.

Guatemala's high rates of maternal and infant deaths are linked to economic and social inequity, which is reflected by limited access to quality health services, particularly in rural, Indigenous communities, and presents one of the world's highest rates of stunting—a largely irreversible condition caused by poor nutrition and repeated gastrointestinal infections, and marked by impaired growth and development. Pregnancy and labor can be especially risky for short-statured mothers and their babies.

With five daughters and two sons of her own, Ana also is raising her granddaughter Cecilia, a toddler whose mother died 20 months ago during childbirth.

On this day, Cecilia situates herself on Ana's lap for the midday meal. She opens her mouth wide, like a quetzal chick. Today, her grandmother offers a protein-packed concoction instead of the usual fare.

An older woman spoonfeeds her granddaughter black beans

Image caption: Ana Torres Canel feeds her granddaughter, Cecilia

Image credit: Jhpiego/Diego Guzman

Awaiting the child's reaction with a measure of attention and a pinch of suspense are Glenda Sajic and Juana Lopez, community health volunteers working with the USAID-funded Health and Nutrition Project being implemented by Jhpiego, a Johns Hopkins affiliate. Earlier, they taught Ana to prepare frijoles charros, a beans-centric concoction that includes garlic, cilantro, and onions as well as peppers, tomatoes, chicken, and Incaparina—a corn and soy flour cereal with added vitamins, protein, and minerals used as a high-protein food supplement particularly for malnourished children.

This morning, Glenda and Juana hiked up a hilly path to Ana's house, complimented her on a thriving vegetable patch as well as a new chicken pen. All these recent improvements show the couple's willingness to adopt a continuum of health-related practices taught by Glenda and Juana for the family's well-being, starting with basic handwashing and food disinfection before meals.

Ana stoked a fire in the stove. As Ana can't read, Glenda and Juana demonstrated how to prepare a meal from an illustrated recipe book that features locally available, culturally appropriate, and nutritious ingredients. The recipe improves upon the nutritious value of the beans, they told Ana, citing the importance of protein and micronutrients for healthy development of children under the age of 5.

Children in Guatemala often are deficient in micronutrients such as zinc, and their mothers, in iron and folate. "Our aim," says Maggie Fischer, who directs the Health and Nutrition Project, "is promoting nutrition best practices to address maternal and child malnutrition. A key strategy involves community facilitators training moms on how to prepare evidence-based, low-cost nutritious meals that can be made using available foods and following local preparation customs."

One of the challenges, Fisher explains, is convincing couples like Ana and Francisco to keep some of the eggs and vegetables they produce and use them for their own family instead of selling everything to generate income for basic needs.

Ana cooks on a woodburning stove in a kitchen that, until recently, was a dark, smoky space. It's now a room with a view—and fresh air. A newly installed window allows fumes to escape instead of remaining trapped inside the house.

This improvement is the handiwork of Ana's husband, who, along with the couple's sons, earns a living by working on nearby farms. The window symbolizes this family's upward mobility and decision to invest in health rather than spend hard-earned money on other locally prized items like store-bought chips and soda. The kitchen's airy openness is a source of pride, a declaration of hope by a couple who are focused on the future of their children and granddaughter.

Not the least bit shy about being the center of attention, Cecilia ravenously rewards the community health volunteers' culinary efforts. The toddler eats every last morsel of the flavorful frijoles charros that her grandmother spoon-feeds her. Ana's gamble—learning how to fix a nutritious and culturally acceptable food using homegrown produce—has paid off.

"It tastes good," Ana's husband says.

Glenda and Juana let Ana know they'd like to visit again next month to demo another recipe as well as reinforce all the other healthful household practices that Ana has adopted under their tutelage. When this project formally concludes in June 2025, the expectation is that the national and local governments in Guatemala will continue to support community health workers engaging with families to improve nutrition.

"I feel very proud of the work that my colleagues and I do," Glenda says, referring specifically to home visits with couples like Ana and Francisco, whom she respects as examples for the entire community. "I have seen the improvements that have been made and the concern that she and her husband show to feed and keep their family healthy.

"Ana told me she had been worried at first because she had never tried other flavors, but that the whole family is happy to try something new and tasty."

Frijoles Charros

Serves 20

Ingredients

1 pound of black beans
1/2 chicken, cut in small pieces
4 tablespoons Incaparina
1/2 bunch cilantro, chopped
4 medium tomatoes, chopped
1 bell pepper cut in strips
1 medium onion, chopped
4 cloves of garlic, minced
4 ½ cups of safe water
1 tablespoon of oil
Pinch of salt

Preparation

1. Wash the bell pepper, tomato, onion, garlic, and cilantro. (Disinfect in 1 liter of water with 1 drop of chlorine for 5 minutes.)

2. Soak the black beans 4 hours beforehand to soften. Drain water.

3. Add the beans, chopped ½ onion, 2 cloves of minced garlic, and a pinch of salt to a pot with 4 cups of water. Boil for 40 minutes. Add the dissolved Incaparina in the remaining ½ cup of cold water.

4. In a separate saucepan, heat oil. Add the remaining ½ onion, chopped tomato, bell pepper, garlic cloves, and shredded chicken.

5. Add the sofrito described in Step 3 to the cooked beans.

6. Add the chopped cilantro as garnish.

Give your child 4 to 5 tablespoons per meal.