Micronutrient deficiencies in Africa: an integrated review of determinants, health impacts, and intervention strategies

Abstract Micronutrient deficiencies, commonly referred to as “hidden hunger,” remain a major public health and developmental challenge across Africa, disproportionately affect women of reproductive age, infants, and children under five. This narrative review synthesizes current evidence on the prevalence, determinants, health consequences, and intervention strategies related to deficiencies in iron, vitamin A, iodine, zinc, and folate in African populations. The review highlights that inadequate dietary diversity, food insecurity, infectious disease burdens, environmental constraints, and socioeconomic inequities are the key drivers of micronutrient malnutrition across the continent. These deficiencies contribute substantially to anemia, stunting, impaired cognitive development, weakened immune function, adverse pregnancy outcomes, and reduced economic productivity. Existing interventions including food fortification, biofortification, micronutrient supplementation, dietary diversification, nutrition sensitive agriculture, and improved food processing technologies have demonstrated important benefits; however, their effectiveness remains constrained by weak health systems, poor policy implementation and limited coverage. The review further emphasizes that the importance of integrated, multisectoral strategies that combine food system transformation, public health interventions, nutrition education, and strong governance frameworks to sustainably reduce micronutrient deficiencies. Addressing these gaps in Africa is essential for improving maternal and child health, strengthening human capital development, and advancing progress toward the Sustainable Development Goals across Africa.