Researchers looked at 32 studies from Sub-Saharan Africa to find out which programs help parents and caregivers keep young children healthy and alive. They discovered that talking to families one-on-one and visiting homes were the most effective ways to teach parents about keeping their kids safe. The studies mostly happened in Ethiopia and Kenya, and they measured success by looking at whether families used health services, how well children grew, and if families practiced good hygiene. This review helps health workers understand which strategies actually work best for saving children’s lives in African communities.

The Quick Take

  • What they studied: Which programs and teaching methods help parents and caregivers in Africa take better care of children under five years old to keep them healthy and alive
  • Who participated: 32 different research studies from Sub-Saharan African countries, mostly from Ethiopia and Kenya, involving mothers and caregivers of young children
  • Key finding: Talking directly with families and visiting their homes were the most popular and effective ways to teach parents about child health (used in 56% of studies), while other methods like radio, text messages, and farming programs were used less often
  • What it means for you: If you live in or work with communities in Africa, person-to-person conversations and home visits appear to be the best way to help families learn how to keep their children healthy. However, this review looked at many different studies with different methods, so results may vary by community

The Research Details

This was a scoping review, which means researchers looked at and organized 32 different studies about child health programs in Sub-Saharan Africa from 2010 to 2024. They searched through major medical databases like PubMed and Cochrane Library to find all relevant studies. The researchers followed strict guidelines called PRISMA-ScR to make sure they did the review carefully and fairly.

Most of the studies they found were cluster randomized controlled trials (31.3%), which means researchers divided communities into groups and tested programs in some groups but not others to see what worked. Some studies (18.8%) compared different types of interventions, and a smaller number (6.3%) were traditional randomized controlled trials where individual people were randomly assigned to different programs.

The researchers organized all the information they found about what programs were used, how they were tested, and what results they showed. This helps people understand the big picture of what’s being done to help children survive in Africa.

This type of review is important because it brings together information from many different studies in one place. Instead of reading 32 separate studies, health workers and program planners can read this review to understand what methods work best. This helps them decide which programs to use in their own communities and where to focus their efforts and money.

This review is strong because it looked at studies from multiple countries and used a clear, organized method. However, readers should know that only 5 out of 32 studies (15.6%) used a clear theory or framework to guide their work, which means many studies may not have been as well-planned as they could have been. The review looked at studies with different designs and measured different outcomes, which makes it harder to compare results directly. The review did not measure the overall quality of each individual study, so some studies may have been better done than others.

What the Results Show

The most common way to teach families about child health was through direct communication and home visits (56.3% of studies). This includes talking one-on-one with mothers and caregivers, either in their homes or in community settings. This approach was used much more often than other methods.

The second most common approaches were media-based (radio, mobile phones, text messages) and nutrition-sensitive farming programs, each used in about 19% of studies. Water, sanitation, and hygiene programs (WASH) were used in 16% of studies. Health facility-based programs and group-based programs were the least common, used in only 9% of studies.

When measuring success, researchers most often looked at whether families actually used health services like clinics and vaccinations (25% of studies). The second most common measure was how well children grew and developed (16% of studies), followed by whether families practiced good hygiene (12% of studies). Interestingly, only one study measured whether vaccination rates actually increased.

The studies were concentrated in just a few countries: Ethiopia and Kenya had the most studies (22% each), followed by Ghana and Malawi (13% each), and Tanzania (9%). This means we know less about what works in other African countries. Most studies used strong research designs like cluster randomized controlled trials, which is good for reliability. However, only a small number of studies (6%) used traditional randomized controlled trials with individual participants.

This review adds to what we already know by showing that simple, direct communication with families appears to be more commonly used and studied than high-tech approaches. Previous research has suggested that personal contact is important for changing health behaviors, and this review confirms that this approach is being used widely in Africa. The finding that vaccination rates are rarely measured as an outcome suggests this is an area where more research is needed.

This review only looked at studies published between 2014 and 2024, so older research wasn’t included. The studies came from only a few African countries, so results may not apply everywhere in Sub-Saharan Africa. The review didn’t rate the quality of each individual study, so some studies may have been done better than others. Different studies measured different things, making it hard to compare results directly. Finally, the review didn’t look at how much each program cost or how practical they were to run in real communities.

The Bottom Line

Based on this review, health programs should prioritize direct communication with families through home visits and one-on-one conversations (high confidence based on frequency of use). Programs should also consider using mobile phones and text messages as a way to reach families (moderate confidence). Communities should measure whether families actually use health services and practice good hygiene, not just whether they receive information (moderate confidence). More research is needed on vaccination rates and which programs work best in different types of communities (low confidence).

Health workers, community health volunteers, and program planners in Sub-Saharan Africa should pay attention to these findings. Government health departments and international health organizations working in Africa should consider these results when planning new programs. Parents and caregivers may find it helpful to know that direct communication and home visits are evidence-based approaches. People in other regions may find some ideas useful, but results may differ in different settings.

Changes in family health behaviors typically take 3-6 months to show up in studies, though some changes may happen faster. Improvements in child growth and health outcomes usually take 6-12 months to measure. Long-term benefits like reduced child deaths may take 1-2 years or longer to see clearly.

Want to Apply This Research?

  • Track weekly check-ins with family members or community members about child health practices: number of conversations held, topics discussed (vaccinations, hygiene, nutrition), and whether families report making changes
  • Use the app to schedule and log home visits or community conversations about child health. Set reminders for follow-up conversations and track which health topics are discussed most often. Record feedback from families about what messages are most helpful
  • Monitor trends over 3-month periods: increase in number of families reached, improvement in reported health behaviors (handwashing, vaccination attendance, nutrition practices), and feedback on which communication methods families prefer most

This review summarizes research about programs that help children stay healthy in Africa, but it is not medical advice. The findings are based on studies with different methods and quality levels. Results may vary depending on your specific community, culture, and resources. Always consult with local health professionals and your doctor before making decisions about your child’s health care. This information should not replace professional medical advice, diagnosis, or treatment. If you have concerns about your child’s health, please speak with a qualified healthcare provider.