Peer-reviewed article
Triple burden malnutrition in Africa: A Narrative Review of Trends and Challenges
Akinade Enoch Ogunniyi, Oluwadamilola Elizabeth Adetoro, Genevieve Awuah-Cobbinah, Latifa Sandra Badmus, Folashade R. Sikiru et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This narrative review looks at the triple burden of malnutrition in Africa, where undernutrition, overnutrition and micronutrient deficiencies exist side by side. It draws on demographic and health surveys, regional studies and peer-reviewed research from Sub-Saharan and North Africa. Child stunting and wasting remain widespread in East and West Africa, while overweight and obesity are rising in cities. Micronutrient deficiencies affect more than half of women and children in many countries. The authors point to inequality, urbanisation, gender disparity and weak food-system governance as common drivers, and call for joined-up action across sectors.
Key points
- Childhood stunting and wasting remain widespread in East and West Africa.
- Adult overweight and obesity are rising sharply in urban centres such as Accra, Nairobi, Johannesburg and Cairo.
- Anemia, vitamin A and zinc deficiencies continue to affect more than half of women and children across many African countries.
- In Ghana, triple burden prevalence declined modestly from 7.6% to 5% between 2003 and 2022; in South Africa, stunting and obesity coexist in over one-third of households.
- In Ethiopia, spatial clustering of stunting, obesity and micronutrient deficits indicates strong geo-ecological influences.
Limitations
This is a narrative review, so it summarises existing studies and does not test an intervention or show what works. The abstract does not describe how studies were selected or give detailed child-specific figures, and much of the discussion covers adults and women as well as children.
Abstract
Background: Malnutrition in Africa presents an increasingly complex public health dilemma characterised by the coexistence of undernutrition, overnutrition, and micronutrient deficiencies, a phenomenon now recognised as the triple burden of malnutrition (TBM). Method: This narrative review synthesises evidence from demographic and health surveys, regional studies, and peer-reviewed research conducted across Sub-Saharan and North Africa to examine prevalence trends, determinants, and policy responses. Results: The findings reveal that while childhood stunting and wasting remain widespread in East and West Africa, adult overweight and obesity are rising sharply in urban centres such as Accra, Nairobi, Johannesburg, and Cairo. Micronutrient deficiencies, particularly anemia, vitamin A, and zinc deficiencies, continue to affect more than half of women and children across many African countries. Country-specific studies demonstrate distinct but overlapping patterns: in Ghana, TBM prevalence declined modestly from 7.6 % to 5 % between 2003 and 2022 in Ethiopia, spatial clustering of stunting, obesity, and micronutrient deficits indicates strong geo-ecological influences and in South Africa, stunting and obesity coexist in over one-third of households. Conclusions: The review identifies socioeconomic inequality, urbanisation, gender disparity, and weak food-system governance as common structural drivers. Without integrated, multisectoral interventions linking agriculture, health, education, and social protection, the continent risks deepening the nutrition inequality divide. Tackling the triple burden is essential to achieving Sustainable Development Goal 2 (Zero Hunger) and Goal 3 (Good Health and Well-Being) and to realising the African Union’s Agenda 2063 vision for a healthy and productive population.