Factors and determinants of malnutrition among under-five children in internally displaced persons (IDP) camps in Africa: a systematic review

Abstract

Background

Internal displacement due to conflict or crises has led to millions, including children under five, residing in precarious internally displaced persons (IDP) camps. Malnutrition, predominantly undernutrition in Sub-Saharan Africa, is a significant concern in these contexts. This review aimed to assess the factors and determinants of malnutrition among under-five children in IDP Camps in Africa.

Method

The review was conducted according to the PRISMA guidelines, and the research protocol was registered in PROSPERO (CRD42023460266). Embase, MEDLINE, CINAHL, Web of Science, CABI Abstracts, Scopus and Google Scholar were searched methodically. The AXIS Critical Appraisal of Cross-sectional Studies Tool was utilized to evaluate the quality and risk of bias of each included study.

Result

After screening full-text articles, eight studies meeting eligibility criteria were included in the review. Factors influencing nutritional status of under-five children were summarized into 11 themes: Age, Gender, Caregiver’s Educational Status, Family Planning, Antenatal Care, Displacement Status, Access to Safe Water and Handwashing, Dietary Diversity, Disease History, Caregiver’s Occupation, and Household Income.

Conclusion

This review examined the factors contributing to malnutrition among under-five children in IDP camps in Africa, and sheds light on neglected crises. It adds to existing knowledge in this area. The findings underscore the need for future research to explore variations in malnutrition determinants across different IDP contexts and to focus on multi-sector collaboration for effective policy implementation in addressing malnutrition in African IDP camps.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-025-01131-0.

Introduction

The phenomenon of internal displacement due to conflict, natural disasters, or other crises has become a global concern, with millions of people, including children under the age of five, finding themselves in precarious situations within internally displaced persons (IDP) camps [1]. One of the significant challenges faced by these displaced populations is malnutrition among children. Malnutrition includes undernutrition and overnutrition, however, in developing regions’ context like in Sub-Saharan Africa, malnutrition usually refers to undernutrition [2]. Stunting, wasting, and underweight are indicators of childhood undernutrition. Malnutrition’s global economic, social, and medical effects on people, families, communities, and nations are severe and long-lasting [3]. According to the World Health Organisation (WHO), 149 million children under the age of five were stunted, 85 million were underweight, and an estimated 45 million children under the age of five were wasting globally in 2022 [4]. Millions of children under the age of five die from malnutrition every year across nations of the world [5, 6]. About half of the global burden of childhood malnutrition is from low and middle-income countries [7].

There is an increased risk of malnutrition among children under the age of five during migrations and war, making it a major public health issue [8, 9]. Sub-Saharan Africa (SSA) accounts for a large proportion of these as the top ten neglected crises occur in SSA, cutting across Ethiopia, Nigeria, Burkina Faso, DR Congo, South Sudan, Sudan, Cameroon, Chad, Mali and Burundi [10]. Across Europe and the Middle East, children in IDP and refugee camps face a huge burden of malnutrition [11]. The war in Ukraine and Russia has further contributed to the burden of malnutrition with a reduction in the supply of foods with the greatest need for food, particularly IDP and refugee camps [12].

Several factors are associated with malnutrition among children in IDP camps. Socioeconomic factors are predominantly the most reported predictors of malnutrition [2, 13]. Physiological and sociodemographic characteristics of children under five years such as age and sex of the child, history of illness, birth order, anaemic status of the child, and level of displacement have been shown to be predictors of malnutrition [2, 5, 14]. Other predictors significantly associated with malnutrition among children under five years of age in IDP camps are the educational and occupational status of caregivers, access to water, sanitation and hygiene (WASH), household size and age of caregiver [2, 5, 14]. Currently, there is a lack of a comprehensive systematic review that summarises the existing evidence on malnutrition with a focus on Africa considering the neglected crises. Thus, this review aimed to assess the factors and determinants of malnutrition among under-five children in IDP Camps in Africa.

Methods

Eligibility criteria

The review was conducted according to the 2020 Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and the research protocol was registered in PROSPERO with registration number CRD42023460266 [15]. The eligibility criteria followed the SPIDER Search format and can be found in Table 1 [16].

Table 1.

Inclusion and exclusion criteria

SPIDER	Inclusion Criteria	Exclusion Criteria
Sample/Population	Children under five years of age in IDP Camps in Africa and their caregivers	1. Economic migrants, nomadic populations. 2. Children over five years of age 3. Other geographical location than Africa
Phenomenon of interest	Factors and determinants of malnutrition. Wasting, stunting and underweight were considered	Overweight and overnutrition
Research type and Design	Cross-sectional studies (Qualitative, quantitative, and mixed studies)	Reviews (systematic or narrative), cohort, case-control, randomized control trials (RCTs)
Publication type and language	Full text research papers published in peer-reviewed journals between 2019 and 2023 in English language.	Editorials, commentaries, dissertations, correspondences, theses, preprints, books, reports, government documents, and book chapters. Non-English language.

Information sources

A total of seven databases were used to search for relevant literature. A literature search of Embase (via Ovid), MEDLINE (via Ovid), CINAHL (via EBSCO), Web of Science, CABI Abstracts, Scopus and Google Scholar. Grey literature was also searched for relevant literature.

Search strategy

A search strategy was developed and guided by a scoping review conducted on MEDLINE. Seven databases were searched using keywords, appropriate search terms and truncations such as malnutrition, undernutrition, children, wasting and malnourishment, as shown in Additional File 1. The search was conducted in accordance with the eligibility criteria for the review. The search terms were merged using the Boolean operators “AND” or “OR,” the explosion function was employed whenever it was possible, and truncation was used to identify all of the alternate spellings of the search terms. Searches were conducted between August 30, 2023 and September 20, 2023. Citation searches were also conducted to find relevant literature. The reviewer however did not contact the authors for other relevant information.

Limits

The date of publication was limited from 1st January 2019 to the period the search was undertaken. The study type was limited to cross-sectional studies. Cross-sectional studies are suitable for the review as it provides a snapshot of a wide range of factors contributing to malnutrition among under-five children at a specific point in time. Geographical location was limited to Africa and only studies published in English were eligible.

Study selection

The selection of the studies was conducted after the database search. All search results were exported into the reference manager EndNote for screening. The titles were first screened at the initial stage and the abstracts of all of the papers were screened. Full-text papers of screened records were obtained and after carefully reading through all of the full-text papers, four independent reviewers (EEA, AON, NSG and HL) made a selection of studies based on the eligibility criteria. After the conclusion of this stage, studies that met the eligibility criteria were incorporated into the review.

Data extraction

The data extraction process was rigorously conducted by three reviewers (EEA, NSG, TMA) with a data extraction form adapted from Terry and colleagues [17], and information was extracted into an Excel spreadsheet. The form was piloted before use and can be found in Additional File 2. Data extracted include publication details, study setting, study design, participants’ characteristics, sampling method, and results.

Quality assessment of included studies

The AXIS Critical Appraisal of Cross-sectional Studies Tool was utilised to evaluate the quality and risk of bias of each included study. The instrument is a questionnaire consisting of 20 questions that cover study quality and reporting [18]. Study Design, Sample Size Justification, Target Population, Sampling Frame, Sample Selection, Measurement Validity & Reliability, and Overall, Methods are some of the key areas that are discussed in the AXIS tool [18]. AXIS is a great tool for evaluating the quality of cross-sectional studies as it was developed through a consensus of a multidisciplinary group, and has outstanding rigour and effectiveness [18]. Three independent reviewers (EEA, BEE, EOO) solely used the AXIS tool and journal articles of included studies to assess study quality. The risk of bias for each question of the tool for the selected study was rated as Yes, No, or Unsure.

Summary measures and synthesis of results

A systematic narrative synthesis was conducted. Tables and narrative summaries were used to present the characteristics and findings of included studies in accordance with the Synthesis without meta-analysis (SWiM) in systematic review reporting guidelines [19]. This guidance provides a framework for the execution of narrative synthesis using both broad and specific techniques and tools. It has been used widely in several systematic reviews.

Results

Study selection

The PRISMA diagram of the study search process and the number of citations/records and studies found at each stage is shown in Fig. 1 (See Fig. 1). The database search strategy yielded 1048 records. All records were screened and 406 duplicates were removed. The titles of 642 records were then screened and 586 records were removed. 56 records were screened at the abstract stage and eight full-text articles were then assessed for eligibility. After screening the full-text articles, eight studies which met the eligibility criteria were then included in the systematic review [20–27].

Fig. 1.

PRISMA flow diagram showing the search results

Study characteristics

Study design

All included studies utilised a cross-sectional study design and quantitative data was collected from participants [20–27]. The sampling method varied among the included studies as two studies used probabilistic sampling methods [23, 25], and two studies did not report on the sampling method utilised [20, 22]. Six of the studies were reported to be conducted between 2016 and 2022 [20–22, 24, 25, 27]. More details are provided on Table 2.

Table 2.

Study design

Authors/Year of publication	Study Design	Study Type	Sampling Method	Data collection method/tool	Date Conducted
Ajakaye and Ibukunoluwa (2020) [20]	Cross-sectional	Quantitative	No information provided	Questionnaire	2018
Akeh et al. (2022) [21]	Community-based Cross-sectional study	Quantitative	Snowball sampling technique	Structured questionnaire	May - June 2021
Iacoella and Tirivayi (2020) [22]	Cross-sectional	Quantitative	NA	Survey	January - July 2016
Idowu et al. (2020) [23]	Cross-sectional	Quantitative	Simple Random Sampling	Semi-structured questionnaire	NA
Mandre et al. (2022) [24]	Comparative analytical Cross-sectional	Quantitative	Multistage sampling method (random and purposive)	ODK (questionnaires)	19th June − 9th July 2019
Mela et al. (2021) [25]	Cross-sectional	Quantitative	Probability proportionate to size sampling (PPSS)	Questionnaire	Sept 2018 - January 2019
Oyinwola et al. (2022) [27]	Cross-sectional	Quantitative	Multistage probability proportional to size sampling	Semi-structured questionnaire	April - May 2019
Omer et al. (2020) [26]	Cross-sectional	Quantitative	Systematic sampling technique	Structured questionnaire	NA

NA = No information provided

Population

The number of children under five years of age in each study ranged from 75 [20], to 1179 [27], and the total sample size in the eight studies was 3880. Five studies were conducted in Nigeria [20, 22, 23, 25, 27], one was conducted in Cameroon [21], one in Uganda [24], and one in Somalia [26]. From six studies that reported statistics on gender, male participants were significantly dominant in the studies [21–24, 26, 27]. More details are in Table 3.

Table 3.

Population characteristics

Authors/Year of publication	Study Location	Sample Size	Gender
Ajakaye and Ibukunoluwa (2020) [20]	Nigeria	75	No information
Akeh et al. (2022) [21]	Cameroon	395	M = 233; F = 41
Iacoella and Tirivayi (2020) [22]	Nigeria	531	M = 361; F = 170
Idowu et al. (2020) [23]	Nigeria	317	M = 161; F = 156
Mandre et al. (2022) [24]	Uganda	170	M = 108; F = 62
Mela et al. (2021) [25]	Nigeria	807	No information
Oyinwola et al. (2022) [27]	Nigeria	1179	M = 608; F = 571
Omer et al. (2020) [26]	Somalia	406	M = 209; F = 197

M = Male; F = Female

Factors and determinants of under-five malnutrition

A wide range of factors and determinants contributes to malnutrition among under-five children in IDP camps in Africa. These factors are shown in Table 4.

Table 4.

Outcomes

Authors/Year of publication	Forms of Malnutrition	Outcomes
Ajakaye and Ibukunoluwa (2020) [20]	Wasting; Underweight; Stunting	Factor - Being in the 0–5 years age group
Akeh et al. (2022) [21]	Wasting; Underweight; Stunting	Risk factors: Displacement more than four times Deworming and frequency of deworming Occupational status of caregivers Childhood diarrhoea Gender -males are more wasted and underweight than females Distance to the source of potable water
Iacoella and Tirivayi (2020) [22]	Wasting; Underweight; Stunting	Negative predictors - Child age and household head age; number of female households members Positive predictors - larger household size, improved facilities, access to safe water, and longer displacement period
Idowu et al. (2020) [23]	Wasting; Underweight; Stunting	Negative Predictors: Birth order Gender - females have a better nutrition index Deworming History of morbidity/child illness
Mandre et al. (2022) [24]	Wasting; Underweight; Stunting	Predictors: Deworming; Child illness; Medium household size; Having monthly income less than USD 54/month; Lack of handwashing; Immunisation status
Mela et al. (2021) [25]	Wasting; Underweight; Stunting	Risk factors of stunting: mother’s level of education and family planning usage Risk factors of wasting: Mother’s level of education, family planning usage, family planning interest, mother’s visit to the antenatal clinic, and the number of mother’s visits to the antenatal clinic Risk factors of underweight: Mother’s level of education, family planning usage, family planning interest, mother’s visit to the antenatal clinic, and household income
Oyinwola et al. (2022) [27]	Wasting; Underweight	Negative predictors: History of morbidity; Age below 24 months Low birth weight (< 2500 g)
Omer et al., 2020 [26]	Wasting; Underweight; Stunting	Risk factors: Sex of the child, age of the child and employment of the caretaker; Dietary diversity; Diarrhoea and immunisation

Sociodemographic factors

In the review, being of the age group, 0–5 years was a determinant of malnutrition in one of the included studies [20]. The age of the child coupled with low birth weight was considered a negative predictor of malnutrition and younger children were more likely to be malnourished in two studies [22, 27]. Taking a gender disaggregation, males were more likely to have malnutrition than females as reported in three studies [21, 23, 26]. Males were also reported to be more wasted and underweight than females in one study [21]. Similarly, females had a better nutrition index and status as reported in another study [23]. More so, birth order was reported to be a significant predictor of under-five malnutrition. Children of first birth order were less likely to be malnourished than the children who came after them [23]. The educational status of caregivers was a significant determinant of under-five malnutrition. Caregivers with lower education status were more likely to have under five children with malnutrition as reported in one of the included studies [25]. Mothers’ level of education was a significant predictor of stunting, wasting and underweight among under-five children in IDP camps [25]. However, Omer and colleagues reported that the educational status of caregivers was not significantly associated with malnutrition [26]. More so, the occupational status of caregivers was reported by Akeh and colleagues to be a determinant of under-five malnutrition [21]. Families with better occupational status were less likely to have malnourished children. In addition, having a monthly income of less than USD 54/month was considered to be a predictor of under-five malnutrition in one of the studies [24]. This indicates that families in low employment with less income have lower access to food and thus predispose children to malnutrition [26]. However, in contrast, larger household size was considered a positive predictor of malnutrition in one of the studies [22].

History of disease and dietary diversity

Under-five children in IDP camps with a disease history were more likely than others to have malnutrition as reported in five of the included studies [21, 23, 24, 26, 27]. Children with diarrhoea were significantly more likely to have malnutrition than other children [21, 26, 27]. Children who were dewormed were less likely than others to have malnutrition as noted in three of the included studies [21, 23, 24]. Dietary diversity was another significant factor, revealing that under-five children who had none or less access to different food groups were more vulnerable to malnutrition. Under-five children with low dietary diversity were more likely to be wasted, stunted or underweight than other children [26].

Accessibility to safe water and handwashing

Access to safe drinking water is considered a positive predictor of malnutrition among under-five children in one of the studies [22]. Access to safe drinking water reduces the risk of malnutrition among under-five children in IDP camps. The distance to the source of potable drinking water is a factor influencing under-five malnutrition and households with shorter distances had children who were less likely to be malnourished [21]. Households with a lack of handwashing were more likely to have malnourished children as reported in one of the included studies [24].

Displacement status

Displacement was more than four times a negative predictor of under-five malnutrition, and children who were displaced were more than four times more likely to have malnutrition than others in one of the studies [21]. Children who stayed in IDP camps for a long duration of time (6 months and above) had the same risk of malnutrition as others with shorter stays [26]. Conversely, a longer displacement period was considered a positive predictor of malnutrition among under-five children in IDP camps as reported in one included study [22].

Antenatal care and immunisation

Antenatal care and immunisation were considered factors influencing under-five malnutrition in two of the included studies [24, 25]. Mothers’ visit to antenatal clinics was a significant predictor of wasting, and underweight among under-five children in IDP camps [25]. Children who were immunised or with better immunisation status were less likely to have malnutrition [24, 26]. Thus, these results reveal the utmost importance of ensuring access and uptake of childhood vaccination.

Family planning interest and utilisation

Under-five children of mothers who had family planning interest or utilised family planning were less likely to be stunted, wasted or underweight as compared to other children [25].

Quality of included studies

All included studies had clear aims and objectives; appropriate study design for aims, clearly defined target population, appropriate outcomes for the aims; pre-determined statistical significance level, description of basic data, internally consistent results; description of all presented analyses in methods, justification of discussions and conclusions by results; and ethical approval or consent [20–27]. One of the included studies lacked a justification for sample size [22]. Five of the included studies had clearly repeatable methods [21, 23, 24, 26, 27] None of the included studies addressed and categorised non-responders, or raised concerns over non-response bias. However, only one of the included studies reported on funding sources or conflicts of interest [27]. Four of the included studies had better quality than other studies with responses to over 15 criteria [21, 23, 24, 26]. The quality of the included studies is shown in Table 5.

Table 5.

Quality assessment using AXIS checklist

	Oyinwola et al. (2022) [27]	Ajakaye & Ibukunoluwa (2020) [20]	Iacoella & Tirivayi (2020) [22]	Idowu et al. (2020) [23]	Mela et al. (2021) [25]	Akeh et al. (2022) [21]	Mandre et al. (2022) [24]	Omer et al. (2020) [26]
Clear Aims and Objectives?	✔	✔	✔	✔	✔	✔	✔	✔
Appropriate Study Design for the Aims?	✔	✔	✔	✔	✔	✔	✔	✔
Justified Sample Size?	✔	✔	X	✔	✔	✔	✔	✔
Target population clearly defined?	✔	✔	✔	✔	✔	✔	✔	✔
Appropriate sample frame for the representative sample?	✔	✔	✔	✔	✔	✔	✔	✔
Selection Process to select representative subjects?	✔	X	?	✔	?	✔	✔	✔
Addressed and categorised non-responders?	X	X	X	X	X	X	X	X
Appropriate outcomes for the aims?	✔	✔	✔	✔	✔	✔	✔	✔
Trialled/ piloted/ published survey instruments?	X	X	X	✔	✔	✔	✔	✔
Pre-determined statistical significance level?	✔	✔	✔	✔	✔	✔	✔	✔
Repeatable methods?	✔	X	?	✔	?	✔	✔	✔
Basic data described?	✔	✔	✔	✔	✔	✔	✔	✔
Response rate raises concerns over non-response bias?	X	X	X	X	X	X	X	X
Non-responders described?	X	X	X	X	X	X	X	X
Are results internally consistent?	✔	✔	✔	✔	✔	✔	✔	✔
All analyses presented were described in methods?	✔	✔	✔	✔	✔	✔	✔	✔
Discussions and conclusions justified by results?	✔	✔	✔	✔	✔	✔	✔	✔
Limitations discussed?	X	X	✔	X	X	✔	✔	✔
Funding sources or conflicts of interest?	✔	X	X	X	X	X	X	X
Ethical approval or consent attained?	✔	✔	✔	✔	✔	✔	✔	✔

✔ =Yes, X = No,?= Unsure

Discussion

This present review aims to consolidate the latest peer-reviewed literature on the variables and determinants of malnutrition among children under the age of five residing in internally displaced persons (IDP) camps in Africa. This particular group is highly susceptible to malnutrition and has been largely overlooked in the context of global health policy with the frequency of displacement increasing the likelihood [21]. Four of the included studies had better quality than others considering the AXIS checklist utilised [21, 23, 24, 26]. From the included studies, sociodemographic characteristics such as age, gender, birth order, educational status of the caregiver, occupational status of caregivers, household income and medium household size are factors and determinants of malnutrition among children under five years of age in IDP camps. Being a child under five years of age in an IDP camp is a significant predictor of malnutrition and reveals the extent of the vulnerability of this age group [20, 22, 27]. Using a gender lens, males are more at risk of malnutrition and are more likely to be stunted than females [21, 23, 26]. Beyond the estimates, however, country contexts could differ and there may be variations in malnutrition among males and females [28].

In line with previous research, socioeconomic factors predominantly predispose children in IDP camps to malnutrition [2, 13]. Caregivers’ employment status and level of income particularly affect access to food and households with low income are more likely to have under-five children who are malnourished [21, 24]. More studies conducted in Venezuela, India and Australia have shown that caregivers with higher income or who are employed have children with a low risk of malnutrition [29–31]. Lower household income then contributes to lower access to food [32]. More so, the educational status of caregivers influenced dietary diversity as caregivers with little or no form of education were more likely to have children who consumed less than four food groups, further increasing the risk of malnutrition [26]. Thus, under-five children with low dietary diversity were more likely to be wasted, stunted or underweight and this is consistent with a study conducted in Myanmar [14]. Beyond sociodemographic determinants, structural determinants significantly shape malnutrition risks in IDP settings. Conflict dynamics play a crucial role, as displacement often disrupts agricultural production, limits access to arable land, and undermines local food systems, exacerbating food insecurity [22]. Governance failures, including weak institutional responses, corruption in aid distribution, and lack of coordinated policies, further heighten the vulnerability of children in IDP camps. In many cases, ineffective humanitarian response mechanisms result in inconsistent food aid distribution, lack of access to healthcare, and poor sanitation conditions, all of which contribute to the high burden of malnutrition [22, 26].

A history of diseases can significantly impact and increase the risk of malnutrition among children under five in IDP camps [4]. In this review, children in IDP camps with a history of diseases like diarrhoea, helminth infections and fever were more likely to have malnutrition [21, 23, 24, 26, 27]. More so, immunisation and deworming are positive predictors of malnutrition as children who are fully immunised or dewormed are less likely to have malnutrition [24, 26]. This is consistent with a study conducted in Ethiopia [5], and highlights the importance of childhood immunisation and access to essential medicines for children in preventing childhood illnesses, particularly drawing on the integrated management of childhood illnesses (IMCI) guidelines. Increased access to WASH is a critical factor as it reduces the risk of malnutrition among under-five children in IDP camps [22, 24].

The results of this review show that several factors influence malnutrition among under-five children in IDP camps in Africa. This has implications for sustainable development especially in light of the SDGs aimed at leaving no one behind. The factors and determinants of malnutrition among under-five children in IDP camps are diverse and interconnected. Addressing this complex issue requires a comprehensive and multisectoral approach spanning individual, community, institutional, and policy levels involving international organisations, governments, and humanitarian agencies collaborating to implement sustainable solutions that prioritise the nutritional needs of children in IDP camps, ensuring their right to a healthy and fulfilling childhood is upheld despite the challenges they face. Measures include enhancing healthcare access, sanitation, food security, and nutritional interventions like breastfeeding promotion and complementary feeding. Also, other vital components include supplementary feeding programs, caregiver education, stakeholder coordination, and strengthened healthcare services. Government and NGOs should allocate funds for Infant and Young Child Feeding in Emergency Practice (IYCF-E) programs and food distribution in IDP camps, alongside improving socioeconomic conditions and providing targeted medical facilities for IDPs to safeguard children under five in crises. Moreover, humanitarian agencies and governments should focus on enhancing the effectiveness of response mechanisms by ensuring better coordination, reducing bureaucratic inefficiencies, and integrating evidence-based strategies. Potential interventions include scaling up cash-transfer programs to enable IDP families to purchase nutritious food, food fortification initiatives to improve micronutrient intake, and mobile health interventions to provide direct healthcare access within IDP settlements. Additionally, mobile health interventions should be expanded to enhance access to healthcare services, including immunization, deworming, and nutritional counselling. Governments, NGOs, and international organizations must collaborate to develop long-term, sustainable strategies that not only address immediate food insecurity but also build resilience against malnutrition in these vulnerable populations.

Limitations

In the review, only information reported on journal articles was extracted and authors were not contacted about some missing information which may have likely been due to word limits in publications where the studies were published. A lack of detail does not necessarily indicate inappropriate methodology; however, it may have impacted the quality assessment of the included studies. More so, the review was limited due to limits on databases in which the papers were published and thus operational and grey literature sources which may contain crucial information on malnutrition in IDP camps were not included. Thus, this limits the generalisability of this review.

Conclusion

This review presents evidence on the determinants of malnutrition among under-five children in IDP camps in Africa as a result of the neglected crises in Africa. The data presented in this systematic review contributes to the existing body of knowledge in this field. The results of the review emphasise the necessity for future research to not only the variations in the determinants of malnutrition in different IDP contexts but also concentrate on how various sectors may collaborate to effectively implement policies and activities that address malnutrition in IDP camps in Africa. Addressing malnutrition in these contexts requires a holistic approach, including improving healthcare access, promoting proper sanitation and hygiene, ensuring food security, and implementing nutritional interventions. Governments, NGOs, and humanitarian agencies must move beyond generic policy recommendations and adopt targeted, evidence-based strategies. Implementing cash-transfer programs could empower IDP families to afford nutritious foods, while food fortification programs could address micronutrient deficiencies. Strengthening governance frameworks to improve the efficiency of humanitarian responses and ensuring better coordination among stakeholders are crucial steps toward reducing malnutrition among displaced children. These interventions, if effectively implemented, could play a significant role in improving child health outcomes and advancing the Sustainable Development Goals (SDGs) by ensuring no child in crisis settings is left behind.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Abbreviations

IDPs

Internally displaced persons

IMCI

Integrated management of childhood illnesses

IYCF-E

Infant and young child feeding in emergency practice

PRISMA

Preferred reporting items for systematic reviews

SDGs

Sustainable development goals

SWiM

Synthesis without meta-analysis

WASH

Water, sanitation and hygiene

Author contributions

E.E. Abua and A.O. Ndep conceptualized the review and developed the protocol. All authors read and approved the final and the revision of the manuscript. Full-text screening and data extraction were completed by E.E. Abua, A.O. Ndep, N.S. George, H. Lonn, and T.M. Awa. Quality Assessment of the included studies were conducted by E.E. Abua, B.E. Edet and E.O. Okoi. Interpretation of the data was performed by E.E. Abua, N.S. George and M.U. Ugbe. The first draft of the manuscript was written by E.E. Abua, N.S. George, B.E. Edet, and E.O. Okoi, and supervised by A.O. Ndep, G.H. Forge and C. Asibi-Ogben. All authors read and approved the final and the revision of the manuscript.

Funding

Authors state no external funding involved.

Data availability

No datasets were generated or analysed during the current study.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.