Malnourished but Not Destitute: The Spatial Interplay Between Nutrition and Poverty in Madagascar

Abstract

Hidden hunger is a global issue that affects an astounding 2 billion people, demanding targeted interventions for better resource allocation. However, conventional methods for identifying high-prevalence areas often prove impractical in developing countries. This study introduces a cost-effective and practical approach to detecting hidden hunger, combining household budget data with health surveys and applying these methods to Madagascar. By using small-area estimation techniques, the study achieves precise commune-level estimates, addressing the limitations of survey data representativeness. The findings challenge poverty-based targeting, revealing that 17.9% of stunted children belong to non-poor households. Additionally, 21.3% of non-stunted children are found in impoverished households, supporting Sen's argument that malnutrition extends beyond destitution. The analysis further highlights key commune-level determinants of hidden hunger, including access to healthcare, improved roads, telecommunication networks and productive agricultural activities.