The Riddle of Malnutrition traces childhood malnutrition – and responses to it – in Uganda for over half a century. Historian Jennifer Tappan examined archival material, including the personal papers of doctors who worked on childhood malnutrition in Uganda in the early post-colonial period. She also interviewed Ugandan and expatriate scientists and physicians who worked on malnutrition. These materials drive the human story Tappan tells of response to childhood malnutrition that government reports and scientific articles omit.

Tappan also conducted oral histories with elderly men and women who lived in an area surrounding the Luteete Health Centre, the first rural extension of Africa's first nutrition rehabilitation programme, Mwanamugimu. [Mwanamugimu is the first word in a Luganda proverb, Mwanamugimu ava ku ngozi, which Tappan translated as ‘A healthy child comes from a healthy mother’ (p. xii).] These elderly respondents reflected on their memories of the Mwanamugimu programme as it was experienced by communities the programme intended to benefit.

Tappan's excellent and deeply researched book reads almost like a novel. The book is part of Ohio University Press's Perspectives on Global Health series, which is growing a reputation for publishing accessible books that study important public health interventions. While Tappan's book is a history of responses to malnutrition, its implications are important today; Tappan shares the grim statistic that in 2011, undernutrition accounted for over 3 million deaths in children under the age of 5 – accounting for 45% of worldwide infant and child mortality (p. 4).

Tappan provides important details about the broader Ugandan political context as she outlines the evolution of response to childhood malnutrition. For example, she writes about a scientific debate in the colonial period questioning whether childhood malnutrition in Africa was due to a protein or mineral deficiency. While this debate may seem technical on its surface, it also has a political dimension: it is one thing for children in British colonies to have a diet lacking in newly discovered vitamins or minerals but it was something completely different for those children to have a diet deficient in one of the major food groups. As Tappan writes, ‘Protein malnutrition pointed to the poverty of colonial populations’ (p. 15).

Ultimately, Tappan's book offers an exemplar case of health intervention. While she documents many of the serious blunders undertaken in the name of improving children's health, she also documents how the Mwanamugimu programme came to be successful. She lets readers connect on their own Mwanamugimu's successes to the shift in seeing malnutrition as a disease to seeing it as a preventable condition and to Mwanamugimu's involvement of the community in designing and implementing the programme.

This book could change the way we think about health interventions. The period in Uganda when (predominantly Western) scientists and doctors were looking for a magic bullet to deal with childhood malnutrition was not just frightening for children and their parents – it was deadly. When researchers and health providers changed their approach to combine the promise of biomedical advances with locally appropriate feeding practices, perceptions of Mwanamugimu changed.

Even through periods of political violence and waning donor support, Mwanamugimu persisted. Tappan writes, ‘The nutritional rehabilitation program became a truly local and sustainable public health initiative, dependent on local adoption and advocacy more than on national institutions and international donor funds’ (p. 112). Her history of the response to childhood malnutrition is an important reminder for those who design health interventions – especially from afar. It is a book I look forward to assigning undergraduate students interested in interventions to improve the human condition.