Anemia in Women of Reproductive Age (15–49 years) in West Africa: A Scoping Review of Etiologic Factors and Programmatic Implications

Anemia affects about a third of the world population, and in regions like West Africa it is estimated that about half the women of reproductive age are affected by anemia. Despite bold commitments made as part of the 2012 World Health Assembly targets, little progress has been observed over the last decade. This review sought to map the evidence on the etiologic factors of anemia among pregnant and nonpregnant women of reproductive age in West Africa and to identify implications for targeted prevention strategies. English-language studies (January 1, 2000-November 30, 2024) were systematically searched in the Web of Science Core Collection, Medline, and PubMed using keywords related to anemia outcomes, etiologic factors, West African countries, and women of reproductive age. The searches were guided by an adapted conceptual framework focusing on the immediate determinants of anemia. Titles, abstracts, and full texts were screened for studies conducted in West Africa among women aged 15-49 years (pregnant or nonpregnant) that assessed anemia and at least 1 causal factor. Of 729 papers (post-duplicate removal) identified in the search, 84 were included in the final review. The articles were categorized by risk factor, prevalence, and associations with anemia. The study characteristics were tabulated and the 2010-2019 trends were benchmarked against World Health Assembly 2025 targets using WHO data. Evidence gaps and intervention implications were qualitatively assessed, including through geographic and population subgroup analyses. Effective prevention of anemia in the region would require widening the scope of interventions beyond nutrition to include those delivered in the health, environment, agriculture, social protection, and water, sanitation, and hygiene (WASH) sectors. More comprehensive investigations are needed to understand the role of each factor and their overlap to support the design of more effective interventions. Without a renewed and holistic approach to anemia prevention and control, the global targets are unlikely to be met in this region.