Integrated Delivery of Malnutrition and Malaria Prevention Programs for Children Under-Five in Sub-Saharan Africa: A Systematic Review of Effectiveness
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Background- Malaria and malnutrition co‑occur and mutually reinforce each other in children under five years in sub‑Saharan Africa, yet preventive interventions are delivered through separate vertical programmes. Seasonal malaria chemoprevention (SMC) campaigns reach millions of children door‑to‑door each year and may offer a viable platform for co‑delivering nutrition interventions. Methods: A systematic review was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420261381714). Studies co‑delivering at least one malaria prevention and one nutrition prevention intervention to children aged 0–59 months in sub-Saharan Africa via a shared platform were eligible. Evidence was stratified into Stratum 1 (controlled effectiveness studies) and Stratum 2 (implementation, feasibility, acceptability and cost studies). Risk of bias was assessed using design‑appropriate tools; certainty of Stratum 1 evidence was appraised using GRADE. Results: Eight reports representing six unique studies from four West African countries (Nigeria, Burkina Faso, Guinea, and Mali) met eligibility criteria, all using SMC with sulfadoxine–pyrimethamine plus amodiaquine as the malaria component. Adding medium‑quantity lipid‑based nutrient supplements (Plumpy'Doz) to SMC plus vitamin A reduced uncomplicated malaria by 23% and severe malaria by 52% (moderate certainty), but produced no consistent improvements in anthropometry or anaemia. A cluster‑randomised trial of micronutrient powders plus SMC in southern Mali reported null nutritional and hematological effects. Four implementation studies demonstrated that integration was feasible, acceptable, safe and increased vitamin A coverage substantially, at an incremental cost of approximately US$0.24 per child. Conclusions: Integrated SMC–nutrition delivery is operationally viable and may enhance malaria prevention through lipid‑based supplementation, but current evidence does not support clear nutritional gains. Scale‑up should be equity‑focused, adaptive, and accompanied by rigorous evaluation, particularly of more intensive nutrition adjuncts in diverse settings.
Source: IPS Journal of Public Health
DOI: 10.54117/p21ycd17
Authors: Ruqayyah Muhammad Ali, Abdu Bello Gololo
Institution: Ahmadu Bello University
Language: English
Subfield: Nutrition and Dietetics
Field: Nursing
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7164054652