Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Yusuf Ransome

Second Advisor

Elijah Paintsil



Almajirai are male children who leave the care of their parents to learn the Qur’an and study Islam under the tutelage of a Mallam or Imam at a Tsangaya. Almajiranci refers to the system of education based on this relationship between almajiri and mallam, and which was the dominant mode of education in precolonial Hausaland – Northern Nigeria and Southern Niger. This system remains widespread and popular in both countries. In recent years, discourse around almajirai has featured prominently in media from and about this region, and has associated almajiranci with non-participation in formal education, abuse, poverty, and underdevelopment. Despite this, the peer-reviewed literature around health among almajirai remains limited. Here, we conduct a scoping review of the academic literature as it concerns almajirai health to synthesize evidence for specific health problems, draw links between related findings, identify gaps in the literature, indicate areas for potential intervention, and assess if and how this literature has engaged almajirai as partners and participants in research.


We searched MEDLINE, Embase, OVID Global Health, Scopus, Web of Science and EBSCO’s Africa-Wide Information Database for articles that concerned almajiri heath as operationalized using a framework leveraging the biopsychosocial and socio-ecological models of health to integrate biological, social, and environmental factors that influence health. We included articles in English and French published between 2000 and 2022. For each study we collected information regarding (i) authorship (ii) study year and location(s), (iii) study design and aims, (iv) sample characteristics, (v) findings, and (vi) almajiri participation in research design, execution, interpretation and dissemination.


Of 1,944 identified studies, a final set of 17 were deemed relevant for data extraction. These included 14 cross-sectional studies, 2 descriptive articles, and one case-control study. All 17 were conducted in Nigeria, though one included almajirai from Niger. Just one study concerned an intervention to improve almajiri health, and no study engaged almajirai in participatory roles beyond acquiring their consent. Domains evaluated in this set of studies included infectious disease (10 studies), oral health (2 studies), workplace injury, nutrition, general health status, health determinants, and mental health (1 study each). The ages of almajirai represented in these studies ranged from as young as 3 years to as old as 28, though some studies did not clearly state participants’ ages. Included studies find high rates of malaria, intestinal parasitosis, urinary tract infection, and occupational injury among almajirai. Studies comparing almajirai to controls find significantly higher rates of cholera, urinary schistosomiasis, and psychiatric disorders, as well as lower levels of rabies awareness and poorer oral hygiene among almajirai than in controls (p


Our scoping review identifies several notable features of the literature around almajiri health. We find that this literature has concerned a wide range of domains, though the number of studies concerned with specific phenomena within each domain remains limited. We further note limitations in the geographic scope of the current literature around almajiri health, in the study of interventions meant to improve almajiri health, and in the consideration of demographic features, such as age, that may influence almajirai’s experiences and health. We stress the need for further study in all these areas, and for participatory approaches to this study, which, by involving almajirai in the research process, can help develop trust between almajirai and the research enterprise, build interventions tailored to their priorities and preferences, and may be more likely to sustainably and successfully improve almajiri health and wellbeing.


This is an Open Access Thesis.

Open Access

This Article is Open Access