Genetic and dietary influences
Researchers in Nigeria, particularly in the Yoruba-speaking regions, have long investigated the high rate of multiple births, the highest in the world. 

• Genetic predisposition: Studies, like those by Percy Nylander, suggest that the high incidence of dizygotic (fraternal) twins among the Yoruba is due to a genetic predisposition. These women may have naturally higher levels of the Follicle-Stimulating Hormone (FSH).
• Dietary factors: While some traditions attribute the high twinning rate to local foods like yams, research from McGill University and other institutions has not found concrete scientific evidence to support this claim. The chemical compounds in yams used to manufacture hormones are not converted into hormones in the body.
• Nigerian Twin and Sibling Registry (NTSR): Created in 2010, the NTSR aims to study the genetic and environmental factors affecting the psychological and mental health development of Nigerian children and adolescents. 

Clinical and maternal health Research

A significant portion of African research focuses on clinical outcomes for both mother and child during multiple pregnancies, which are considered high-risk. 

• Morbidity and mortality rates: Studies throughout Nigeria and other countries have documented the increased risk of complications such as anaemia, hypertension, pre-term delivery, and caesarean sections. These pregnancies are also associated with higher perinatal and neonatal mortality rates compared to single births.
• Importance of antenatal care: Research consistently shows that mothers who receive adequate antenatal care have better outcomes for themselves and their twins. The importance of early diagnosis through ultrasound is also highlighted as a critical intervention.
• Addressing poor outcomes: In Ethiopia, research at institutions like Dessie Referral Hospital has explored specific risk factors, such as maternal hypertension and lack of antenatal care, to develop targeted healthcare education and strategies. 

Public health and socioeconomic research

Research using large datasets provides a broader view of the challenges faced by multiple births across the continent.

• Population data analysis: The Demographic and Health Surveys (DHS) have been used to track twinning rates and mortality in multiple sub-Saharan African countries from 1986–2016. The average twinning rate remained high but stable during this period, with significant regional and ethnic variations.
• Survival disparities: Multiple studies have found a growing disparity in under-five mortality rates between multiples and singletons in sub-Saharan Africa. This suggests that advances in child mortality have benefited twins less, making them an especially vulnerable population.
• Historic practices: A University of Warwick study found that historic practices like twin infanticide do not predict higher twin mortality today, suggesting that suppressive efforts by colonial powers and missionaries were effective.