Context
The 1992 peace settlement that ended the civil war in
El Salvador included land redistribution and other provisions designed
to improve the socioeconomic status of ex-combatants and vulnerable
civilians.
Objective
To describe associations between postwar social and
economic assistance programs, especially land reform, and current child
health status as reflected by nutrition in a population of resettled
rural refugees.
Design
A population-based cross-sectional survey of child
nutritional status and principal elements of the reconstruction
process.
Setting
A single rural municipality in northern El Salvador.
Participants
A representative sample of 761 children younger than
5 years, living in 27 villages.
Main Outcome Measure
Prevalence of stunting (low height for age)
in children younger than 5 years.
Results
Prevalence of stunting was 32.4%. Stunting was
significantly more prevalent among children whose families cultivated
less land (odds ratio [OR] for stunting per additional hectare of
redistributed land cultivated, 0.64; 95% confidence interval [CI],
0.44-0.93). Less than half of newly transferred land was being
cultivated by its owners. Most of the children (84.7%) lived in
families cultivating 2 hectares or less of redistributed land. Stunting
was also more prevalent among children whose households lacked piped
water (adjusted OR, 2.72; 95% CI, 1.87-3.96) vs those who had had
piped water since before the cease-fire.
Conclusions
Malnutrition, particularly stunting, persisted at high
levels and was strongly associated with delay in full cultivation of
redistributed land and in provision of water.