The experts on malnutrition

Based on studies and observations this book argues that a point of departure to reduce malnutrition is to determine who the experts are; and indicates that the mothers with well-nourished children living in poor conditions are the experts. We should then examine what they are doing differently. They are called positive deviant cases. 

[In Vietnam] [t]he two standout practices related to the content of the diet and the way food was administered. In every positive deviant family, the mother or father was collecting a number of tiny shrimp, crabs, or snails -- making for a portion 'the size of one joint of one finger' -- from the rice paddies and adding these to the child's diet. 'Although readily available and free for the taking, the conventional wisdom held these foods dangerous, for young children.'11 Families also varied the frequency and method of feeding. Other families fed young children only twice a day, before parents headed to the rice fields early in the morning and in the late afternoon after returning from a working day. Because these children had small stomachs, they could only eat a small amount of the available food at each sitting. The positive deviant families, however, instructed the home babysitter (an older sibling, a grandparent, or a neighbour) to feed the child regularly, four or even five times a day. Using exactly the same amount of rice, their children were getting twice the amount of calories as their neighbours who had access to exactly the same recourse. Other key factor included atypically high levels of hand hygiene in positive deviant families. p. 274

Malnutrition and sanitation facilities

. . . [O]ne underlying determinant had a major impact in the prevalence of malnutrition: improved sanitation facilities. 

That is the conclusion of a paper by Emely García, she wrote it when she was an undergrad student in my health econ class. 

Undergraduate research is a challenge and a great opportunity.  

The long-term benefits of improved access to water and sanitation

The graph is from this paper by Marc A. Jeuland, David E. Fuente, Semra Ozdemir, Maura C. Allaire, & Dale Whittington. In the graph "WSH" means water, sanitation, and hygiene. 

The authors talk about the long term benefits of improved access to water and sanitation, which are probably the most effective factors against some infections diseases and malnutrition in children in developing countries. 

The Lasting Impact of Parental Early Life Malnutrition

From a paper by Seonghoon Kim, Quheng Deng, & Belton M. Fleisher

We investigate whether the effects of parents’ in utero malnutrition extend to the second generation (their children). Specifically, we explore whether the second generation’s level of schooling is negatively impacted by their parents’ malnutrition in utero, using the China Famine as a natural experiment. We find that, the impact of mother’s in utero malnutrition due to the Famine reduced second generation male and female entrance into junior secondary school by about 5–7 percentage points. We measure famine severity with provincial excess death rates instrumented by measures of adverse climate conditions, which corrects for possible biases induced by measurement errors and omitted variables. Our findings indicate the existence of an important second-generation multiplier of policies that support the nutrition of pregnant women and infants in any country where nutritional deficiencies remain today.

A draft is here. 

Wife's bargaining power and nutrition (Bangladesh)

Using calories in a unitary framework, previous literature has claimed lack of gender inequality in intrahousehold food distribution. This paper finds that while there is lack of gender disparity in the calorie adequacy ratio, the disparity is prominent among children, adolescents, and adults for a number of critical nutrients. Pregnant and lactating women also receive much less of most of these nutrients compared with their requirements. A wife's bargaining power (proxied by assets at marriage), as opposed to her husband's, significantly and positively affects the nutrient allocations of children and adolescents and of adult females. The bargaining effects remain significant after controlling for unobserved household characteristics and the potential nutrition-health-labor market linkage. The findings, which have important policy implications for the growing problem of micronutrient malnutrition in the developing world, also imply that perhaps the nutrition-health-labor market linkage as a key explanation for intrahousehold food distribution has been overemphasized in the previous literature.

That is from a new paper by Aminur Rahman (February 2013). 

Aminur concludes:

The measure of bargaining power used in this paper (assets at marriage) is largely determined by parental wealth, and in this society the norm is that parents arrange marriages for their offspring. Thus, future work perhaps could focus on how the policy change leading to increased female controls of resources could potentially affect household formation and dissolution and not just intrahousehold allocation in a traditional poor rural society.

The title of the paper is "Does A Wife’s Bargaining Power Provide More Micronutrients to Females: Evidence from Rural Bangladesh."

Peanut Butter Medicine for Malnutrition

This peanut butter has a lot of extra ingredients: milk powder, oil, sugar and all the vitamins and minerals a growing child needs. 

After three or four weeks of eating this daily package of energy and nutrients, the children will be fine, she says.

The article is here. This might be a solution for malnutrition problems in some other countries like Guatemala.  Thanks to Carlos Mendoza for the link. 

More:

This recipe has transformed the treatment of malnutrition. A French doctor, Andre Briend, came up with it just over a decade ago. In much of the world, it's called Plumpy'Nut. Among specialists, it's called ready-to-use therapeutic food, or just RUTF.