Vitamin A deficiency remains a significant public health concern in Malawi, particularly among women of reproductive age. Biofortified orange-fleshed sweet potato (OFSP) is promoted as a sustainable, food-based strategy to improve vitamin A intake. However, comprehensive syntheses of evidence on its adoption and subsequent impact on diet and nutritional status in Central Malawi are limited. This systematic review aimed to synthesise existing evidence on the adoption of biofortified OFSP by smallholder women farmers in Central Malawi and to assess its association with dietary intake and vitamin A status across two agricultural seasons. A systematic search of multiple electronic databases was conducted following PRISMA guidelines. Peer-reviewed studies and relevant grey literature reporting on OFSP adoption, dietary intake, or biochemical/clinical indicators of vitamin A status among women farmers in Central Malawi were included. Study quality was assessed using appropriate critical appraisal tools. The review identified a limited number of studies. Adoption was influenced more by agronomic traits like drought tolerance than by nutritional knowledge. Where adoption occurred, a consistent finding was an increase in OFSP consumption frequency, contributing to dietary diversity. However, evidence directly linking adoption to improved vitamin A status, such as serum retinol levels, was insufficient and methodologically weak. While OFSP shows potential for improving dietary patterns, the current evidence base is inadequate to conclusively determine its efficacy in enhancing vitamin A status among the target population in Central Malawi. The primary barrier to nutritional impact appears to be adoption driven by non-nutritional factors. Future interventions should integrate nutrition education with agronomic support to promote adoption based on nutritional value. Robust, longitudinal studies with biochemical validation are required to measure the impact of OFSP consumption on vitamin A status. Biofortification, orange-fleshed sweet potato, vitamin A deficiency, adoption, dietary intake, Malawi, women farmers, systematic review. This review consolidates the available evidence on OFSP adoption and its nutritional associations in Central Malawi, highlighting critical evidence gaps and informing the design of future research and public health interventions.
Chikondi Mwale (Mon,) studied this question.
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