This paper analyzes the social, ethnic and regional determinants of child malnutrition, as well as the effects of access to health services in the Andean region, by comparing conditions in Ecuador, Peru and Bolivia. These three countries are marked by a high prevalence of stunting and by wide socioeconomic, regional and ethnic disparities. The analysis used Demographic and Health Survey (DHS) data from Peru (1992, 1996 and 2000) and Bolivia (1997), and Living Standards Measurement Study (LSMS) data for Ecuador (1998). The paper adopts an international comparative perspective, analyzing Ecuador in particular detail.