In response to the 2014 Global Nutrition Report call for a nutrition data revolution, global, regional, and national efforts have focused on addressing data gaps and barriers to strengthen the nutrition datavalue chain. The 2018 Global Nutrition Report specifically highlighted the lack of data on the global micronutrient burden andthe need for more surveillance data to achieve global targets.

No single data source can serve all data purposes and meet all data needs insingle data source can serve all data purposes and meet all data needs ina country. Timely, high-quality, population-based nutrition data are keysources of information required by policymakers and program implementers to make evidence-informed decisions. These data are used for nutrition planning and advocacy, to improve nutrition programs and support effective and safe implementation, for accountability of government and agency commitments and investments, to monitor trends in malnutrition, and to track progress to achieve global targets, such as the 2025 World Health Assembly Global Nutrition Targets and the 2030 Sustainable Development Goals. There have also been calls to share practice-based and tacit knowledge regarding efforts to strengthen available data.

In Guatemala,>40% of children aged<5 y have stunted growth, and>15% have iron deficiency (9); among nonpregnant women of reproductive age, almost 60% have either overweight or obesity, and >17% have iron deficiency. In Guatemala, long-term and sustained investment in nutrition-sensitive and nutrition-specific interventions, as expressed in the national food and nutrition annual plan and budget for 2014 to 2018, has been viewed as unstable and insufficient to meet the nutritional needs of all vulnerable groups. In Guatemala, evidence to guide policymaking and nutrition program implementation has centered on the Demographic and Health Surveys (DHS) conducted every 5 to 8 y, which provide critical information to the country. The Ministry of Health and other ministries and institutions produce other sources of health and nutrition data through routine systems, but the participation in and coverage of the public health system is ∼70%. Neither the DHS nor the government information systems provide data on all large-scale nutrition-specific interventions being implemented in the country or micronutrient status of vulnerable populations. Based on the experiences in Nicaragua with the government establishing the Integrated Surveillance System for Nutrition Interventions with the support of partners, in 2010 the United States Agency for International Development (USAID), the CDC, and the Institute of Nutrition of Central America and Panama (INCAP) began supporting and providing technical assistance to Guatemalan government agencies and other in-country partners to develop a nutritional surveillance system that would satisfy needs for policymaking and effective program implementation,taking into consideration relevant questions that Guatemalan political and technical actors need answered to guide national decisions regarding food and nutrition security. The purpose of this article is to describe the processes, methods, and lessons learned from developing and implementing a population-based national nutrition and health epidemiological surveillance system in Guatemala 2011–2021.

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