Triple burden malnutrition in Africa: A Narrative Review of Trends and Challenges
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.
Akinade Enoch Ogunniyi, Oluwadamilola Elizabeth Adetoro, Genevieve Awuah-Cobbinah et al.