Malnutrition among children under five continues to be a persistent public‑health challenge across sub‑Saharan Africa, despite numerous nutrition programmes introduced by governments and development partners.

The review examined 50 studies published between 2015 and 2025 and identified under‑nutrition – especially stunting, wasting and under‑weight – as the predominant form of child malnutrition in the region.

Stunting was the most frequently reported condition, affecting more than a quarter of children under five in many countries such as Tanzania, Uganda, Ethiopia, Liberia and the Central African Republic.

Under‑weight prevalence averaged about 20 % across 12 surveyed countries, while wasting – an acute form of malnutrition linked to rapid weight loss – was also widely reported.

The review highlighted that malnutrition is not caused solely by food scarcity; disease, poor sanitation, climate pressures, limited health‑care access, caregiver knowledge gaps and socio‑cultural factors also drive poor nutrition outcomes.

Nutrition‑specific interventions that provide direct nutrient supplementation, promote exclusive breastfeeding and enable community‑based screening have shown positive impacts on acute malnutrition and child growth.

However, these measures alone do not address underlying drivers; nutrition‑sensitive approaches such as agricultural support, water‑sanitation improvements, cash transfers and maternal education are needed to influence broader determinants of child health.

Evidence suggests that integrated programmes combining direct nutrition support with poverty alleviation, food‑system resilience, health services and community engagement deliver the most sustainable results.

Strong community involvement, respecting local knowledge and cultural practices, is essential for programme acceptance and long‑term sustainability.

The authors conclude that coordinated action across governments, health systems, agriculture, development agencies and civil society is required, with policies that address immediate nutritional needs and broader drivers such as poverty, climate change and unequal service access.