Micronutrient malnutrition is a large public health problem in many developing countries, but its dimensions and determinants are not yet clearly understood, especially with respect to sub- Saharan Africa. Based on 24-hour recall data from rural households in Rwanda, Uganda and Tanzania, this study analyzes dietary patterns to provide a comprehensive picture of the risk of micronutrient deficiencies, with particular emphasis on bioavailable vitamin A, iron and zinc intakes. The results confirm that micronutrient deficiencies are widespread and positively correlated with calorie deficiency. Regression analysis suggests that income growth will bring about important nutritional improvements. However, more targeted interventions are needed, especially for controlling vitamin A deficiency. Promising avenues include basic education, women empowerment, promotion of home gardens, awareness campaigns and vitamin A biofortification. Spatial differences within and across regions indicate that detailed knowledge of local conditions is imperative for designing and targeting effective food and nutrition policies.