IDEAS home Printed from
MyIDEAS: Login to save this paper or follow this series

Low Malnutrition but High Mortality: Explaining the Paradox of the Lake Victoria Region

  • Priebe, Jan
  • Gräb, Johannes

Exploiting DHS data from 235 regions in 29 Sub-Saharan Africa countries, we find that the combination of low levels of malnutrition together with dramatically high rates of mortality, encountered in Kenya's Lake Victoria territory, is unique for Sub-Saharan Africa. This paper explores the causes of this paradox for the Kenyan context. Our identification strategy consists of two parts. First of all, we apply multilevel regression models to control simultaneously for family and community clustering of the observed malnutrition and mortality outcomes. Secondly, to address unobserved but correlated factors, we exploit information from GIS and malaria databases to construct variables that capture additional components of children's geographic, political and cultural environment. Our analysis reveals that beneficial agricultural conditions and feeding practices lead to the observed sound anthropometric outcomes around Lake Victoria. In contrast, high mortality rates rest upon an adverse disease environment (malaria prevalence, water pollution, HIV rates) and a policy neglect (underprovision of health care services). Nonetheless, a significant effect of the local ethnic group, the Luo, on mortality remains.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL:
Download Restriction: no

Paper provided by Verein für Socialpolitik, Research Committee Development Economics in its series Proceedings of the German Development Economics Conference, Frankfurt a.M. 2009 with number 26.

in new window

Date of creation: 2009
Date of revision:
Handle: RePEc:zbw:gdec09:26
Contact details of provider: Web page:

More information through EDIRC

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

as in new window
  1. Svedberg, Peter, 2000. "Poverty and Undernutrition: Theory, Measurement, and Policy," OUP Catalogue, Oxford University Press, number 9780198292685, July.
  2. Oster, Emily, 2012. "HIV and sexual behavior change: Why not Africa?," Journal of Health Economics, Elsevier, vol. 31(1), pages 35-49.
  3. Miguel, Edward & Gugerty, Mary Kay, 2005. "Ethnic diversity, social sanctions, and public goods in Kenya," Journal of Public Economics, Elsevier, vol. 89(11-12), pages 2325-2368, December.
  4. Rosenzweig, Mark R. & Wolpin, Kenneth I., 1984. "Heterogeneity, Intrafamily Distribution and Child Health," Bulletins 8429, University of Minnesota, Economic Development Center.
  5. David E. Sahn & David Stifel, 2003. "Exploring Alternative Measures of Welfare in the Absence of Expenditure Data," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 49(4), pages 463-489, December.
  6. Moradi, Alexander, 2009. "Towards an Objective Account of Nutrition and Health in Colonial Kenya: A Study of Stature in African Army Recruits and Civilians, 1880–1980," The Journal of Economic History, Cambridge University Press, vol. 69(03), pages 719-754, September.
  7. Kenneth Harttgen & Mark Misselhorn, 2006. "A Multilevel Approach to Explain Child Mortality and Undernutrition in South Asia and Sub-Saharan Africa," Ibero America Institute for Econ. Research (IAI) Discussion Papers 152, Ibero-America Institute for Economic Research.
  8. Behrman, Jere R. & Deolalikar, Anil B., 1988. "Health and nutrition," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 1, chapter 14, pages 631-711 Elsevier.
  9. Cohen, J.M., 1995. "Ethnicity, Foreign Aid, and Economic Growth in Sub-Saharan Africa: The Case of Kenya," Papers 520, Harvard - Institute for International Development.
  10. Bolstad W. M & Manda S. O, 2001. "Investigating Child Mortality in Malawi Using Family and Community Random Effects: A Bayesian Analysis," Journal of the American Statistical Association, American Statistical Association, vol. 96, pages 12-19, March.
  11. Carlos Bozzoli & Angus Deaton & Climent Quintana-Domeque, 2008. "Adult height and childhood disease," Working Papers 1119, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
  12. Fogel, Robert W., 1993. "Economic Growth, Population Theory, and Physiology: The Bearing of Long-Term Processes on the Making of Economic Policy," Nobel Prize in Economics documents 1993-1, Nobel Prize Committee.
  13. Emily Oster, 2007. "Routes of Infection: Exports and HIV Incidence in Sub-Saharan Africa," NBER Working Papers 13610, National Bureau of Economic Research, Inc.
  14. Filmer, Deon & Pritchett, Lant, 1998. "Estimating wealth effects without expenditure data - or tears : with an application to educational enrollments in states of India," Policy Research Working Paper Series 1994, The World Bank.
  15. Cebu Study Team, 1992. "A child health production function estimated from longitudinal data," Journal of Development Economics, Elsevier, vol. 38(2), pages 323-351, April.
  16. Richard H. Steckel, 1995. "Stature and the Standard of Living," Journal of Economic Literature, American Economic Association, vol. 33(4), pages 1903-1940, December.
Full references (including those not matched with items on IDEAS)

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:zbw:gdec09:26. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (ZBW - German National Library of Economics)

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.