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

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, analysing the determinants of mortality and under-nutrition jointly.

The paper’s findings point to the interplay of cultural, geographical and political factors in the Lake Victoria region which are responsible for causing the described paradox. Moreover, it demonstrates that a salient disease environment is one of the key drivers of the massive under-5 mortality rates in the lake region. This environment is characterised by extremely high malaria prevalence, polluted water sources and high rates of infectious diseases like HIV and AIDS.

On the other hand, it shows that an ethnic specific effect remains even after controlling for mother’s age at birth, birth spacing, birth order and HIV-status. Political discrimination seems also to be an important factor of the spatial variation in under-5 mortality rates through the channel of lower health expenditures per capita in disadvantaged provinces.

The authors note that a similar interplay of geographic conditions and cultural factors constitutes the extremely low incidence of stunting and wasting in the Lake Victoria region. Indeed, fish consumption in combination with an overall food secure situation spurs the growth process of children close to the lake and therefore leads to the much higher body height of children there. Yet, the food security situation by itself leads to better wasting rates in the area.

The paper demonstrates that the HIV status of the mother and children’s diarrhea status explain the largest part in the variation of stunting outcomes between families. However, the educational attainment of the mother turns out to be the single most important source in explaining mortality differentials between families.

Authors: J. Priebe (ed); J. Grab
Publisher: Norwegian University of Life Sciences, 2009

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