R E S E A R C H Open Access © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit ​h​t​t​p​:​​​/​​/​c​r​e​a​t​i​​v​e​c​​o​m​m​​o​n​​s​​.​o​​r​​g​/​l​i​c​e​n​s​​e​s​/​​b​​y​/​4​.​0​/. Atobrah et al. International Journal for Equity in Health (2025) 24:211 https://doi.org/10.1186/s12939-025-02545-9 International Journal for Equity in Health *Correspondence: Benjamin K. Kwansa bkkwansa@ug.edu.gh 1Centre for Gender Studies and Advocacy, University of Ghana, Legon, Ghana 2Institute of African Studies, University of Ghana, Legon, Ghana 3Regional Institute of Population Studies, University of Ghana, Legon, Ghana 4School of Pharmacy, University of Ghana, Legon, Ghana Abstract Background  Malaria disproportionately affects vulnerable and marginalised population subgroups, including women and girls, migrants, and persons with disabilities. Gender roles expose men and women differently to malaria risks. Similarly, restrictive gender norms pose unique challenges to women and girls in accessing preventive treatment and care. Gender norms that perpetuate hegemonic masculinity also expose men and boys to malaria, resulting from occupational exposure and untimely access to malaria treatment and care. Unfortunately, the gender dimensions of malaria remain under-researched. This systematic descriptive review examines how gender has been conceptualised in published malaria and gender research over the last three decades. Methods  The keywords “malaria AND gender” were used to search for articles published in English from 1995 to 2024 in four databases (PubMed, Scopus, Science Direct, and Google Scholar). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was adopted for this review. The Rayyan intelligent systematic review software was used to collate, manage, and screen articles retrieved from the search engines. The gender analysis matrix advanced by Morgan and colleagues was used to analyse the conceptualisation of gender in published malaria and gender research. Results  A total of 57 published articles that met the inclusion criteria were included in the final review. We found that the majority of the published papers on malaria and gender have been biomedical in nature, consequently reducing gender analysis to only sex-disaggregated data. Moreover, most of the studies employed a quantitative research approach, with the majority being laboratory-based research, focussing on sub-Saharan Africa. Conclusion  There is a need for more social science research that employs qualitative, mixed-methods, and community-based approaches to malaria and gender research. These approaches extend gender analysis beyond sex and/or gender-disaggregated data, and includes other domains, such as access to resources; distribution of labour; practices and roles; norms, values and beliefs; and decision-making power. Keywords  Gender conceptualisation, Malaria research, Descriptive review, Sex-disaggregated data, Gender analysis, Malaria and gender Conceptualization of gender in published malaria and gender research: a systematic descriptive review Deborah Atobrah1,2, Benjamin K. Kwansa1,2*, Patience G. Okyere-Asante1, Abena Kyere1, Delali M. Badasu1,3 and Irene A. Kretchy4,1 http://creativecommons.org/licenses/by/4.0/ https://doi.org/10.1186/s12939-025-02545-9 http://crossmark.crossref.org/dialog/?doi=10.1186/s12939-025-02545-9&domain=pdf&date_stamp=2025-7-23 Page 2 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 Background Malaria remains a global health challenge, especially in low- and middle-income countries (LMICs). According to the 2024 World Malaria Report, there were 263 million cases of malaria in 2023 compared to 252  million cases in 2022 [1]. The estimated number of malaria deaths marginally declined from 600,000 in 2022 to 597,000 in 2023 [1]. Children under five years accounted for 80% of malaria deaths in the WHO African region [1]. Although malaria has important gender dimensions because preg- nant women [2, 3], children under five years [4], and adolescent girls [5, 6] suffer disproportionately from the malaria burden in the African region, malaria research has paid little attention to malaria and gender intersec- tion. Men and women have differential biological and sociocultural risks to and impacts from malaria. For instance, adolescent girls and women are more suscepti- ble to malaria infections during pregnancy [3, 6, 7]. They also carry the burden of caring for household members with malaria [1]. Restrictive gender norms pose unique challenges to women and girls in accessing preventive treatment and care [8]. Gender norms, which perpetuate hegemonic masculinity, on the other hand, expose men and boys to malaria, resulting from occupational expo- sure and delayed access to malaria treatment and care [1, 9, 10]. However, the gender dynamics of malaria, that is, how malaria affects women and men, and girls and boys, differently because of their socially assigned roles, responsibilities, and rights, are under-researched as gen- der remains a critical missing lens in malaria research. Unsurprisingly, it was the most recent World Malaria Report (WMR) that laid an overt emphasis on this rela- tionship between Malaria and Gender [1], highlighting how women and men, as well as girls and boys, are differ- entially vulnerable to malaria. However, understanding the gender dimensions of malaria and applying a gender lens to health research and programming can improve health outcomes while also enhancing gender equality [11]. Malaria and gender research have not sufficiently “integrated sex and gender analysis of the differences in exposure risks, disease susceptibilities, prevention and treatment behaviours, and preferences in product design” [12]. However, research that integrates a gender lens reveals the differential risks, presentation, effects, health- seeking behaviours, and social implications of diseases on men and women [13]. Most of the materials on malaria and gender have been largely policy documents and grey literature [12, 14–16]. Evidence from published academic research, however, remains crucial in contributing to the knowledge required for policy formulation and strategic investments in malaria control and elimination. There is also a tendency for researchers to use sex and gender interchangeably in malaria and gender research. While sex generally refers to the biological differences between males and females based on hormones, sex chromosomes, internal reproductive organs, and exter- nal genitalia, gender refers to the social construction of the roles, culturally prescribed responsibilities and rights, attitudes, and behaviours of males and females [14, 17]. Sex-disaggregated data remains an important starting point for gender analysis in malaria and gender research. Gender analysis, in addition, encompasses domains such as access to resources, distribution of labour, practices and roles, norms, values and beliefs, decision-making power and autonomy, policies, laws, and institutions [18]. Moreover, while the biomedical dimensions of malaria have received substantial attention, there is growing rec- ognition that social determinants, including gender, play a critical role in shaping malaria vulnerability, exposure, prevention, and treatment outcomes [19]. However, the conceptualization and operationalization of gender within malaria research remain uneven and, in many cases, underdeveloped or unexamined [20]. Addition- ally, little is known about the geographic distribution and methodological approaches used in malaria and gender research. Meanwhile, data on such geographic distribu- tion provides insight into the contexts in which gendered analyses of malaria occur, potentially revealing under- researched regions where gendered dynamics of malaria are nonetheless critical. Similarly, an understanding of methodological trends highlights prevailing approaches and reveals opportunities for innovation and more inclu- sive research frameworks [21]. This review examines the existing body of published research on malaria and gender to investigate how gen- der has been conceptualised and applied in these studies over the past three decades. It aims to show clearly how the research community has used the various domains of gender analysis in malaria and gender research. The review seeks to answer the following questions: 1. How has gender been conceptualized and applied in published malaria and gender research? 2. How have published malaria and gender research applied key gender concepts/gender analysis domains such as sex-disaggregated data, access to resources, distribution of labour, practices and roles, norms, values and beliefs, decision-making power and autonomy and policies, laws and institutions? 3. What disciplines and geographic regions have malaria and gender research been most published? 4. What have been the dominant methodological approaches in published malaria and gender research? Page 3 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 Methodology This study is a systematic descriptive review that describes how gender has been conceptualized or applied in published malaria and gender research. The purpose of descriptive reviews is to “determine the extent to which a body of knowledge in a particular research topic reveals any interpretable pattern or trend with respect to pre- existing propositions, theories, methodologies or find- ings” [22, 23]. The study examined how gender has been used in selected published studies on malaria and gen- der, specifically in terms of definitions, gender concepts, and terminologies applied. In line with the guidelines for descriptive reviews, structured methods were employed in selecting studies for the review and analysis [22, 23]. We paid attention to the fields or disciplines of study, the research methods used, the year of publication, the study findings, and the conclusions. We focused on published research only, excluding grey literature and unpublished research. This study, therefore, does not include theses, conference proceedings, policy documents, and reports. The review focused on available published research on malaria and gender over the last three decades (1995–2024). Inclusion criteria   • All existing published research (peer-reviewed articles) on malaria and gender over the last three decades (1995–2024) were included in the review.   • Only published social science papers with both malaria and gender in their titles were included in the review.   • Only articles in English were included.   • There was no geographical limitation in terms of the spread of publications. Exclusion criteria   • Articles that were not written in English were excluded.   • Articles with only malaria or gender in the title were not included.   • Unpublished manuscripts, policy documents and reports, thesis, conference proceedings, datasets, and presentations were excluded from the review. Search strategy The keywords “gender AND malaria” were exclusively used for article searches from Scopus, Science Direct, and Google Scholar. The search was limited to article titles only. The focus of the study was to examine how authors who sought to do a gender analysis of malaria conceptualised gender, hence the use of “gender” and not “women” or “men”. It is acknowledged that this approach may result in missing other studies that may have used women, men, or both, while applying a gender lens. A total of 156 records were identified: 99 from Google Scholar, 27 from Scopus, 23 from PubMed, and seven [7] from Science Direct. All these records were imported into the Rayyan Intelligent Systematic Review Software and screened for duplication. Seventy [70] duplications were detected and excluded, and full-text screening was conducted for the remaining 86 records, one of which could not be retrieved. Twenty-eight [28] records were excluded based on the inclusion and exclusion criteria: policy documents and reports [9], thesis [5], conference proceedings [5], unpublished manuscripts [4], datasets [2], presentation [1], non-English articles [2] were thus excluded. A total of 57 published articles were included in the final analysis. The review is registered in the open science framework (ref ID: https://osf.io/ve7ur/). The breakdown of the identification, screening, and inclusion of records is noted in the PRISMA flow chart in Fig. 1. Evidence screening and selection process The Rayyan intelligent systematic review software was used to collate, manage, and screen articles retrieved from the search engines. An initial screening was con- ducted by three independent reviewers (DA, BKK, and IAK), using article titles and abstracts, followed by a detailed review of the full-text articles selected for the review. Disagreements were resolved through discussions and consensus-building among the research team. Data extraction and analysis An Excel sheet was developed to capture key information from each study included in the review, including biblio- graphic details (paper title, author, year), methodology, study discipline, region of study, conceptualisations of gender, findings related to malaria and gender, and pol- icy implications or recommendations. Three researchers reviewed each article independently to ensure the consis- tency and reliability of data extraction. The researchers resolved discrepancies through discussions. A thematic analysis approach was employed to synthesise the find- ings across studies. Reviewers read each article multiple times to become deeply familiar with the content and context. Codes and themes related to gender conceptu- alisation were developed using the domains of gender analysis advanced by Morgan, Davies [18]. The themes were synthesised narratively, highlighting similarities, differences, and trends over time or by region, discipline, and methodological orientation. Data presentation The findings from the review were guided by the gen- der analysis matrix advanced by Morgan, Davies [18], https://osf.io/ve7ur/ Page 4 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 Fig. 1  PRISMA flow chart for the identification, screening, and inclusion of record Page 5 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 which highlights six gender analysis domains: sex and/ or gender-disaggregated data; access to resources; distri- bution of labour; practices and roles; norms, values and beliefs; decision-making power; and policies, laws, and institutions. Morgan, Davies [18] explored these gender analysis domains regarding how they influence vulner- ability to disease/illness exposure, response to illness/ treatment, health system facilities and infrastructure, and economic, social, and security impacts of illness. The Morgan, Davies [18] Gender Analysis Framework was chosen because it offers a robust, theoretically grounded, and empirically validated approach to analysing gender dynamics within global health research, making it par- ticularly well-suited for examining how gender has been conceptualised in malaria and gender research (see for instance, Kretchy et al. 2025). This framework adopts an intersectional, relational, and context-sensitive perspec- tive to uncover how power, resources, roles, and norms shape gendered experiences in health systems—com- ponents that are crucial for understanding the complex interplay between gender and malaria burden, preven- tion, and treatment [18]. Moreover, the framework is distinguished by its flexibility and adaptability to various health contexts and research designs, including quali- tative, quantitative, and mixed-methods studies. This makes it especially useful for synthesizing diverse types of malaria research while maintaining analytical coher- ence [18]. This review’s findings were restricted to the body of published peer-reviewed research on malaria and gender. Therefore, data from other sources that discuss works on the nexus of malaria and gender but are not published, such as grey literature, are excluded from this study. Furthermore, it’s possible that the included studies in the review did not explicitly explore gender aspects in their studies using the gender analysis matrix proposed initially by Morgan and colleagues for infectious dis- ease outbreaks. It is, therefore, acknowledged that the results may be limited due to the analytical approach employed. That is, a different framework may yield a dif- ferent outcome. However, since social, cultural, and insti- tutional gender disparities affect the gender dimensions of malaria activities, we decided to use Morgan and col- leagues’ framework for this study. It is worth noting that this gender matrix in our research was used solely as a comprehensive analytical framework to analyse how gen- der is applied in the studies reviewed. The data were categorised based on country/region, fields/disciplines, research method, and the key domains for gender analysis expounded by Morgan, Davies [18]. The data were colour-coded, sorted, and summarized using tables and charts. Results Country/ region of reviewed papers Most (66.7%) of the publications on malaria and gender focused on Africa, and only a few are on Asia (19.3%), South America (3.5%), North America (1.8%), the Carib- bean (1.8%), Australia (1.8%), Europe (1.8%) and global studies (3.5%). The majority of the documents on Africa were on Nigeria (42.1%), followed by Ghana (10.5%) and Kenya (7.9%). There were two papers (5.3%) each on Malawi and Ethiopia and one paper (2.6%) each from Mozambique, Mali, Equatorial Guinea, Cote d’Ivoire, Sudan, Uganda, and Tanzania. About (7.9%) of the pub- lished works focused on Sub-Saharan Africa as a unit. For Asia, the papers were from Pakistan (45.5%), India (18.1%), Indonesia (18.1%), Myanmar (9.1%), and Yemen (9.1%). Table 1 shows the regions and countries covered in the reviewed studies. Discipline of study Out of the 57 studies reviewed, 34 (59.6%) were biomedi- cal science papers, 4 (7.0%) were social science papers, and 19 (33.3%) were multi-disciplinary research. Out of the biomedical papers, 22 (64.7%) focused on microbiol- ogy and genetics, mostly involving laboratory research, while 12 (35.3%) were from the field of public health, mainly epidemiology. The multi-disciplinary studies combined social science (sociology, gender studies, and economics) with public health research (environmental science, vector control, and surveillance). Table 2 shows the breakdown of the reviewed studies by year of publica- tion, country, discipline, and research approach. Research approach/study type Most (77.2%, 44) of the studies reviewed employed a quantitative research approach. These studies were either hospital- or community-based and relied on primary or secondary data. Approximately 16% [9] of the reviewed studies employed a qualitative research methodology, relying mainly on primary data for their analysis. A few of the studies (7%, 4), however, employed a mixed-methods Table 1  Region/Country of reviewed papers Country/Region Frequency Percentage Africa (Nigeria, Ghana, Malawi, Ethiopia, Kenya, Sudan, Uganda, Tanzania, Mozam- bique, Burkina Faso, Mali, Cote d’Ivoire, Equatorial Guinea) 38 66.7 Asia (Yemen, India, Myanmar, Pakistan, Indonesia) 11 19.3 North America (US) 1 1.8 South America (Brazil) 2 3.5 Caribbean (Jamaica) 1 1.8 Australia 1 1.8 Europe (UK) 1 1.8 Global/General 2 3.5 Grand Total 57 100 Page 6 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 Article Title and Author(s) Year of Publication Country/ Region Discipline Of Study Research Method/Study Type Edstein, Nasveld [24] 2007 Australia Biomedical Science / Laboratory Research Quantitative / Hospital-Based Study Maraka, Akala [25] 2020 Kenya Biomedical Science / Laboratory Research Quantitative / Hospital-Based Study Vieira, Mello [26] 2020 Brazil Biomedical Science / Laboratory Research Quantitative / Hospital-Based Study Dhangadamajhi, Kar [27] 2009 India Biomedical Science / Laboratory Research Quantitative / Hospital-Based Study Morris, Tan [28] 2013 US Biomedical Science / Laboratory Research Quantitative / Clinical Trial Maiga, Opondo [29] 2022 Mali Biomedical Science / Laboratory Research Quantitative / Randomized Con- trolled Trial Segata, Baldini [30] 2016 Burkina Faso Biomedical Science / Laboratory Research Laboratory Experiment Ogbonna, Ezeoru [31] 2021 Nigeria Biomedical Science / Laboratory Research Quantitative (A Cross-Sectional Study) Ezenwa [32] 2023 Nigeria Biomedical Science / Laboratory Research Quantitative (Community-Based Study) Jeremiah, Eze [33] 2021 Nigeria Biomedical Science / Laboratory Research Quantitative/Randomized Con- trolled Trial Rafique, Hussain [34] 2022 Pakistan Biomedical Science / Laboratory Research Quantitative (Cross-Sectional Study) Sansan [35] 2016 Cote d’Ivoire Biomedical Science / Laboratory Research Quantitative (Hospital- Based Study) Zeb, Irshad [36] 2022 Pakistan Biomedical Science / Laboratory Research Quantitative (Hospital- Based Study) Raasti, Nasir [37] 2024 Pakistan Biomedical Science / Laboratory Research Descriptive Cross-Sectional Study Neboh and Okaka [38] 2019 Nigeria Biomedical Science / Laboratory Research Quantitative Onwuzurike, Nkpeh [39] 2023 Nigeria Biomedical Science / Laboratory Research Quantitative (Hospital- Based Study) Esan, Omisakin [40] 2014 Nigeria Biomedical Science / Laboratory Research Quantitative (Hospital- Based Study) ur Rehman, Khan [41] 2022 Pakistan Biomedical Science / Laboratory Research Quantitative (Observational / Cross- Sectional Study) Ojo, Jonathan [42] 2022 Nigeria Biomedical Science / Laboratory Research Quantitative/Retrospective Study Esan, Omisakin [43] 2014 Nigeria Biomedical Science / Laboratory Research Quantitative (Hospital- Based Study) Ayodele [44] 2014 Nigeria Biomedical Science / Laboratory Research Quantitative (Hospital- Based Study) Wedekind, Walker [45] 2006 UK Biomedical Science / Laboratory Research Laboratory Experiment Quaresima, Agbenyega [46] 2019 Ghana Epidemiology Mixed Methods (Primary Data) DeBoer, Vaz [47] 2023 Equatorial Guinea Social Science / Public Health (Vector Control & Surveillance, Gender Studies) Quantitative / Secondary Data Olapeju, Choiriyyah [48] 2018 SubSaharan Africa Epidemiology Quantitative / Secondary Data Rose, Ashfaq [49] 2018 Pakistan Social Science (Agric-Economics) Quantitative / Secondary Data Quaresima, Agbenyega [9] 2021 Ghana Social Science / Public Health (Sociology, Gen- der Studies) Mixed Method/Hospital and Community-Based Data Emmanuel Okoro, Ifeany- ichukwu Romanus [50] 2023 Nigeria Epidemiology Quantitative / Hospital-Based Study Willis and Hamon [51] 2018 Africa Social Science / Public Health (Agric- Economics, Sociology, Gender Studies) Quantitative / Secondary Data Mohamedani, Mirgani [52] 1996 Sudan Social Science / Public Health (Gender Studies) Quantitative / Community-Based Study Wai [53] 2001 Myanmar Social Science / Public Health (Sociology, Gen- der Studies) Qualitative / Community-Based Study Rawlings [54] 2016 Brazil Social Science / Public Health (Sociology, Health Economics) Quantitative / Secondary Data Okiring, Epstein [55] 2022 Uganda Epidemiology Quantitative / Hospital-Based Study Onyango and Maguire [56] 2022 Kenya Social Science / Public Health (Environmental / Sociology, Gender Studies) Qualitative/Community- Based Study Austin, Noble [57] 2014 90 less-devel- oped countries Social Science / Public Health (Health Econom- ics, Sociology, Gender Studies) Quantitative / Secondary Data Tolhurst, Amekudzi [58] 2008 Ghana Social Science / Public Health (Sociology, Gen- der Studies) Qualitative / Community- Based Study Diiro, Kassie [59] 2022 Ethiopia Social Science (Agric-Economics) Quantitative / Community Level Study / Primary Data Table 2  Breakdown of the reviewed studies by year of publication, country, discipline, and research approach Page 7 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 research approach, utilising primary data collected at the community level. Figure  2 shows the research method/ approach used in the reviewed studies. Year of publication of reviewed studies Although the article search focused on all existing pub- lished research on malaria and gender, the articles retrieved and reviewed were those published between 1995 and 2024. The majority of the papers were published after 2012, and no papers were published in 1995. Table 3 shows the year of publication of the reviewed studies. Application of gender analysis domains in the reviewed studies Regarding the number of gender analysis domains applied, only 7.0% of the reviewed papers have all the six [6] gender analysis domains proposed by Morgan, Davies [18]. About 16% of the papers applied five [5] of the domains, 8.8% applied four [4] of the domains, and another 8.8% of the papers applied only three [3] domains. About 11% of the reviewed papers applied two [2] of the domains, while 47.3% of the papers applied only one [1] domain. All the reviewed studies applied the sex-/ gender disaggregated data domain; 49.1% applied the domain covering the distribution of labour, practices, and roles, while 40.4% of the studies applied the domain covering norms, values, and beliefs. However, only 31.6% discussed access to resources, 26.3% applied the deci- sion-making power and autonomy domain, and 12.3% applied the domain covering policies, laws, and institu- tions. Table 4 shows the gender analysis domains applied in the reviewed study. Discussion The review reveals a paucity of published research stud- ies on malaria and gender. Most existing research has focused on Africa, which is not surprising, given that the African region bears the highest malaria burden, with Article Title and Author(s) Year of Publication Country/ Region Discipline Of Study Research Method/Study Type Alubabari and Aborlo [60] 2011 Nigeria Social Science / Public Health (Sociology, Gen- der Studies) Qualitative / Literature Review Woldu and Haile [10] 2015 Kenya Social Science (Anthropology) Mixed Method / Community-Based Data Klein, Barham [61] 2019 Malawi Social Science (Agric-Economics) Quantitative / Secondary Data Minja, Tanner [62] 2001 Tanzania Social Science / Public Health (Anthropology, Gender Studies) Quantitative / Community Level Study / Primary Data Tanner and Vlassoff [63] 1998 General/Global Social Science / Public Health (Sociology / Gender Studies) Qualitative / Conceptual Hildon, Escorcio-Ymayo [64] 2022 Mozambique Social Science / Public Health (Sociology, Gen- der Studies) Qualitative / Community-Based Study Diiro, Affognon [8] 2016 Kenya Social Science / Public Health (Sociology / Gender Studies) Quantitative / Community-Based Study Sumriati, Tosepu [65] 2022 Indonesia Epidemiology Quantitative / Secondary Data Willis and Hamon [66] 2005 Sub-Saharan Africa Social Science / Public Health (Agric-Economics, Sociology/Gender Studies) Qualitative / Literature Review Tolhurst and Nyonator [67] 2005 Ghana Social Science / Public Health (Sociology, Gen- der Studies) Qualitative / Hospital-Based Study Kunihya, Samaila [68] 2016 Nigeria Epidemiology Quantitative / Hospital- Based Study Garley, Ivanovich [69] 2013 Nigeria Social Science / Public Health (Epidemiology, Gender Studies) Quantitative / Community Level Study / Primary Data Xing, Zhang [70] 2024 Nigeria Epidemiology Quantitative/Secondary Data Gray [71] 2013 Jamaica Social Science / Public Health (Sociology, Gen- der Studies) Advocacy Piece / Quantitative Nas, Yahaya [72] 2017 Nigeria Epidemiology Quantitative / Hospital-Based Study Al-Taiar, Chandler [73] 2009 Yemen Social Science / Public Health (Sociology/Gen- der Studies) Mixed-Method / Community-Based Study Ayele, Zewotir [74] 2012 Ethiopia Epidemiology Quantitative / Secondary Data Simwaka, Makwiza [75] 2006 Malawi Epidemiology Qualitative / Community- Based Study Tripathy, Mohanty [76] 2016 India Epidemiology Quantitative / Community-Based Study Oktafandi and Sungkar [77] 2015 Indonesia Epidemiology Quantitative / Hospital-Based Study Table 2  (continued) Page 8 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 Nigeria recording the highest number of cases [1]. The majority of the published papers on malaria and gen- der have been biomedical, reducing gender analysis to only sex-disaggregated data and using sex and gender interchangeably. There is a notable lack of social science research on malaria and gender. Meanwhile, social sci- ence research offers an avenue for conducting a thorough gender analysis using all six gender analysis domains advanced by Morgan, Davies [18]. Moreover, most exist- ing published work on malaria and gender employed a quantitative research approach, with the majority of the studies being laboratory-based. There were very few community-based studies that employed qualitative research methodologies and data collection strategies such as focus group discussions (FGDs) and in-depth interviews. There were also very few studies that used a mixed-methods research approach. The dominance of biomedical and epidemiological approaches, often at the expense of qualitative and participatory methodologies, limits the depth of gender analysis. Integrating feminist, anthropological, and community-based research meth- ods could enrich the understanding of how gender norms and power relations shape malaria experiences and outcomes. Regarding the application of gender analysis domains, it was found that all the reviewed studies have applied the basic domain of gender analysis, which is sex-disag- gregated data. The sex-disaggregated data showed the gender differences in malaria incidence, knowledge, pre- vention, treatment, and impact. For instance, malaria incidence was higher among women of childbearing age compared to their male counterparts [55, 68, 72]. Based on household circumstances, more females and children used insecticide-treated nets than males [48, 69]. Additionally, males demonstrated significantly bet- ter knowledge about malaria despite being less involved in caring for the sick members of their household [8, 50, 76]. Malaria has a greater impact on women’s agricultural productivity than on men’s, mainly due to caregiving roles [10, 59, 66]. Gender norms, values, and beliefs were primarily dis- cussed in conjunction with the distribution of labour, practices, and roles in the reviewed studies [9, 10, 53, 56]. These studies highlight how gender roles and gen- der division of labour based on gender norms and beliefs expose men and women differently to malaria infections and malaria prevention activities. For instance, women who mostly trade in the night had higher malaria infec- tion rates than men while household chores that are per- formed in the evening or night expose women to malaria bites [9, 56, 73]. Regarding malaria prevention activities, women are responsible for carrying out tasks to prevent Table 3  Year of publication of reviewed studies Year of publication Frequency Percentage Year of publica- tion Fre- quen- cy Per- cent- age 1996 1 1.8 2014 4 7.0 1998 1 1.8 2015 2 3.5 2001 2 3.5 2016 6 10.5 2005 2 3.5 2017 2 3.5 2006 2 3.5 2018 2 3.5 2007 1 1.8 2019 3 5.3 2008 1 1.8 2020 2 3.5 2009 2 3.5 2021 3 5.3 2011 1 1.8 2022 10 17.5 2012 1 1.8 2023 4 7.0 2013 3 5.3 2024 2 3.5 Fig. 2  Research method/approach used Page 9 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 Reviewed Papers Gender analysis domains Sex-/gender disaggre- gated data Access to resources Distribution of labour, practices, roles Norms, values, beliefs Decision- making power, autonomy Policies, laws, institutions Number of domains applied in each paper Onwuzurike, Nkpeh [39] x 1 DeBoer, Vaz [47] x x x x x x 6 Edstein, Nasveld [24] x 1 Quaresima, Agbenyega [9] x x 2 Esan, Omisakin [43] x 1 Mohamedani, Mirgani [52] x x x x x x 6 Maraka, Akala [25] x 1 Wai [53] x x x 3 Neboh and Okaka [38] x 1 Oktafandi and Sungkar [77] x x 2 Sumriati, Tosepu [65] x x x x 4 Rawlings [54] x x 2 Ayele, Zewotir [74] x x x x 4 Okiring, Epstein [55] x x 2 Kunihya, Samaila [68] x 1 Simwaka, Makwiza [75] x x x x x 5 Garley, Ivanovich [69] x 1 [76] x x x 3 Onyango and Maguire [56] x x x x 4 Vieira, Mello [26] x 1 Austin, Noble [57] x x x x x x 6 Dhangadamajhi, Kar [27] x 1 Tolhurst, Amekudzi [58] x x x x x x 6 Morris, Tan [28] x 1 Quaresima, Agbenyega [46] x x 2 Emmanuel Okoro, Ifeanyichukwu Romanus [50] x 1 Rose, Ashfaq [49] x x x 3 Diiro, Kassie [59] x x x x 4 Minja, Tanner [62] x 1 Alubabari and Aborlo [60] x x x x x 5 Maiga, Opondo [29] x 1 Woldu and Haile [10] x x x x 4 Klein, Barham [61] x x x 3 [62] x x x x x 5 Segata, Baldini [30] x 1 Tanner and Vlassoff [63] x x x x x 5 Ogbonna, Ezeoru [31] x 1 Olapeju, Choiriyyah [48] x x 2 Nas, Yahaya [72] x 1 Hildon, Escorcio-Ymayo [64] x x x x x 5 Ezenwa [32] x 1 Wedekind, Walker [45] x 1 Diiro, Affognon [8] x x x x x 5 Ayodele [44] x 1 Jeremiah, Eze [33] x 1 Willis and Hamon [66] x x x x x 5 Esan, Omisakin [40] x 1 Rafique, Hussain [34] x 1 Tolhurst and Nyonator [67] x x x x x 5 Table 4  Gender analysis domains applied in the reviewed study Page 10 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 malaria, such as burning mosquito coils at night and washing and hanging bed nets [53]. Culturally prescribed gender roles in agricultural communities play important roles in explaining the disparity in reported malaria inci- dence among men and women [10]. Gender roles also determine who is responsible for providing care for sick relatives. At the same time, gender norms and beliefs place decision-making power and authority as well as the control of family resources in the hands of men, leaving women to rely on men for decisions and resources to seek treatment for sick members of the household [70, 73]. Access to resources, decision-making power and autonomy were discussed together in relation to prevail- ing gender norms [56, 59]. Gender norms generally place family resources in men’s care, which also influences the prerogative to make decisions regarding where and when to seek treatment for sick members of the house- hold [56, 59]. However, where women have access to personal resources, they can decide when and where to seek treatment, especially for their sick children. Wom- en’s access to resources also impacts how they prevent and cope with malaria [57]. Women’s increased eco- nomic autonomy has been linked to their access to social and health resources that reduce malaria transmission, such as acquiring preventive devices like mosquito nets and repellent [57]. Increased empowerment in terms of decision-making autonomy also decreases the likelihood of contracting malaria within the household [61]. Malaria also has direct and indirect effects on agricultural pro- ductivity among smallholder farmers, especially female farmers, due to time spent caring for sick relatives, which further reduces their access to resources [56, 59]. Discussions around policies, institutions, and laws centred on equipping women to function effectively in malaria prevention, treatment, and control [47, 52, 58, 61]. For instance, the importance of women’s role in vec- tor control has been emphasized. There is advocacy for the participation of women in indoor residual spraying (IRS) campaigns, as well as a renewed effort to imple- ment equitable policies and practices that intentionally engage women in vector control activities [47]. This systematic descriptive review reveals significant gaps and trends in the conceptualization and application of gender in malaria research, offering critical implica- tions for theory and practice. Theoretically, the findings demonstrate the persistent conflation of “sex” and “gen- der” in much of the literature, underscoring the need for a more nuanced and intersectional approach to gender analysis. Practically, the underutilization of comprehen- sive gender analysis impedes the development of equi- table and effective malaria interventions. For instance, overlooking gendered patterns in labour, mobility, and healthcare access may lead to interventions that fail to reach vulnerable populations like women, adolescent girls, and other marginalized groups. Conclusion This systematic descriptive review provides a timely and in-depth analysis of how gender is addressed in malaria research, examining its conceptualization, operational- ization, and methodological use across various disciplines and regions. Despite increased awareness of gender’s impact on health outcomes, few studies have critically explored how it is framed within malaria-related litera- ture. Meanwhile, the majority of the published papers on malaria and gender have been biomedical in nature, reducing gender analysis to only sex-disaggregated data. Moreover, most studies employed a quantitative research approach, with the majority being laboratory-based. The existing published research on malaria and gender has paid little attention to women in malaria control such as community health workers and the impact of malaria on adolescent girls. Reviewed Papers Gender analysis domains Sex-/gender disaggre- gated data Access to resources Distribution of labour, practices, roles Norms, values, beliefs Decision- making power, autonomy Policies, laws, institutions Number of domains applied in each paper Sansan [35] x 1 Xing, Zhang [70] x x x x x 5 Zeb, Irshad [36] x 1 Ojo, Jonathan [42] x 1 Gray [71] x x x 3 Raasti, Nasir [37] x 1 ur Rehman, Khan [41] x 1 Al-Taiar, Chandler [73] x x x x x 5 Total number of papers applying the vari- ous domains 57 18 28 23 15 7 x indicates the presence of a specified gender analysis domain for the article Table 4  (continued) Page 11 of 13Atobrah et al. International Journal for Equity in Health (2025) 24:211 More social science research that employs qualitative, mixed-methods and community-based approaches to gender and malaria research is needed. Increased effort is recommended towards academic research and evidence production on malaria and gender, employing detailed gender analysis. These approaches extend gender analy- sis beyond sex and/or gender-disaggregated data, and includes other domains, such as access to resources; dis- tribution of labour; practices and roles; norms, values and beliefs; and decision-making power. Increased evi- dence on the gender dimensions of malaria, coupled with the right policies and advocacy, will lead to gains in con- trolling and eventual eradication of malaria and achiev- ing gender equality. Abbreviations FGD � Focus Group Discussion LMIC � Low- and Middle-Income Countries PRISMA � Preferred Reporting Items for Systematic Reviews and Meta-Analyses SSA � sub-Saharan Africa WHO � World Health Organisation WMR � World Malaria Report Author contributions DA, BKK, AK, DMB and IAK conceptualised the paper. AK searched for and downloaded the articles. DA, BKK, PGOA and IAK reviewed and completed the title and abstract screening, full-text review and data extraction. DA, BKK, PGOA, AK, and IAK analysed the data and prepared the manuscript. DMB and AK edited the manuscript. All six authors (DA, BKK, PGOA, AK, DMB and IAK) read and approved the final manuscript. Funding This research is a product of the Evidence Generation component of the ‘Africa-based Gender Tech Platform for Gender Responsive Malaria Advocacy and Policy’ Project funded by the Bill and Melinda Gates Foundation. Data availability All the relevant data used in the analysis have been included in this paper by providing the search strategy used, the list of the included studies, the data extraction procedure and analysis, and the criteria for the selection of studies. Declarations Ethics approval and consent to participate This study used a systematic descriptive review to do secondary analyses. Ethics approval and consent to participate were obtained from all the research studies that were part of this analysis. 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Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Conceptualization of gender in published malaria and gender research: a systematic descriptive review Abstract Background Methodology Inclusion criteria Exclusion criteria Search strategy Evidence screening and selection process Data extraction and analysis Data presentation Results Country/ region of reviewed papers Discipline of study Research approach/study type Year of publication of reviewed studies Application of gender analysis domains in the reviewed studies Discussion Conclusion References