Prevalence of Overweight and Obesity and Its Associated Factors among Preschool Children in Sub-Saharan Africa: a Systematic Review and Meta-analysis

TL;DR

This study finds that 15% of preschool children in sub-Saharan Africa are overweight or obese, with factors like screen time and maternal weight playing a role.

Contribution

This is the first systematic review and meta-analysis quantifying overweight/obesity prevalence and its drivers in preschool children across sub-Saharan Africa.

Findings

The pooled prevalence of overweight/obesity among preschool children in sub-Saharan Africa is 14.77%.

Children aged 2–3 years and those spending over 2 hours on screen activities are significantly more likely to be overweight or obese.

Having an overweight mother is strongly associated with increased odds of childhood overweight/obesity.

Abstract

Overweight and obesity among preschool children have become significant public health concerns in sub-Saharan Africa (SSA), driven by rapid urbanization, economic growth, and dietary shifts. This systematic review and meta-analysis assessed the prevalence of overweight and obesity and its associated factors among preschool children in SSA. A comprehensive search of peer-reviewed and gray literature was conducted up to 29 January, 2025, using databases such as MEDLINE, ScienceDirect, Research4Life, and African Journals of Online. The study followed Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Due to significant heterogeneity (I2 = 99.4%, P < 0.001) identified through Cochran’s Q statistic, a random-effects model was used to estimate the pooled prevalence. Publication bias was assessed with funnel plots and Egger’s test. A total of 27 studies (n = 30,805) were included; 77.78% of studies showed a low risk of bias per the Joanna Briggs Institute appraisal tool. The pooled prevalence of overweight/obesity was 14.77% [95% confidence interval (CI): 11.94%, 17.60%]. Key factors associated with overweight/obesity included being aged 2–3 y [odds ratio (OR) = 2.65; 95% CI: 1.73, 4.05] and 48–60 mo (OR = 1.99; 95% CI: 1.33, 2.98), spending over 2 h on screen activities (OR = 3.33; 95% CI: 1.89, 5.84), consuming sweet foods (OR = 2.55; 95% CI: 1.86, 3.48), and having an overweight mother (OR = 3.72; 95% CI: 1.30, 10.65). Given the high prevalence, interventions should focus on promoting healthy diets, reducing screen time, encouraging physical activity, and supporting maternal health and nutrition. The review was registered in PROSPERO as CRD42024560996.

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