OBJECTIVES: The World Health Report 2002 attributes 15% of the burden of disease associated with major risk factors in developing countries to malnutrition and about 3% each to Vitamin A and zinc deficiency. Most of the burden is from diarrhea and pneumonia in children aged less than five years. This paper analyses the costs and effectiveness of selected personal and non-personal curative and preventive interventions, singly and in combination. METHODS: For each of 11 epidemiological subregions, the population health impact for each intervention or combination of interventions at different levels of coverage has been evaluated using a state transition model. Efficacy data come from systematic reviews or evaluations. Costs are estimated using the standardized WHO ingredients approach. An intervention is considered cost-effective if the cost-effectiveness ratio is <3 GDP per capita for the subregion. RESULTS: The highest health gains from a single intervention are from case management for pneumonia and oral rehydration therapy. The lowest costs are with fortification with Vitamin A and zinc. Cost-effectiveness ratios cluster in three groups with fortification with zinc and Vitamin A as the most cost-effective, and provision of supplementary food and nutrition counselling as the least cost-effective. In between are oral rehydration therapy, case management for pneumonia and Vitamin A and zinc supplementation. CONCLUSIONS: On the grounds of cost-effectiveness, Vitamin A and zinc fortification or supplementation should be considered for routine provision, together with oral rehydration therapy and case management for pneumonia.