<![CDATA[Background: Despite the availability of effective antimalarial medications, poor adherence remains a significant obstacle in malaria control, particularly in endemic areas. Numerous interventions have sought to enhance adherence; however, a clear understanding of their effectiveness is lacking. Objective: This systematic review aimed to evaluate the effectiveness of intervention strategies to improve adherence to antimalarial treatments and identify the contextual factors that influence them. Method: Following the PRISMA guidelines, studies published between 2020 and 2025 were systematically retrieved from PubMed, ScienceDirect, and Google Scholar databases. Ten studies that met the predefined inclusion criteria were analyzed using narrative thematic synthesis. The interventions were categorized into five groups: health education, digital reminders (mHealth), directly observed therapy (DOT), home visits, and family/community involvement. Results: Structured health education and mHealth strategies (e.g., SMS reminders) consistently improve medication adherence across diverse contexts. Directly observed therapy, particularly involving family supervision, significantly enhances adherence in community settings. Home visits and active community involvement promote adherence by addressing the sociocultural barriers. Multicomponent strategies that integrated educational, technological, and social elements had the highest and most sustained adherence rate. Key challenges include adverse drug reactions (ADRs), medication supply issues, complex treatment regimens, and limited health literacy. Discussion and conclusion: Improving antimalarial treatment adherence requires context-specific, multifaceted interventions that integrate education, technology, and community engagement while addressing systemic health challenges in the region. These findings provide valuable insights into the design of culturally sensitive and sustainable interventions for eliminating malaria.]]>
