Management of Haemophilia Patients in a Resource-Constrained Setting at Aminu Kano Teaching Hospital, North West Nigeria

This study evaluates the management of haemophilia patients at Aminu Kano Teaching Hospital (AKTH), Kano State, North West Nigeria, assessing the adequacy of current clinical care against international standards. Haemophilia care in Nigeria faces severe resource constraints including limited factor concentrate availability, inadequate laboratory monitoring, and insufficient specialist haematology support, resulting in preventable morbidity and mortality. A mixed-methods professional evaluation was conducted, combining retrospective review of 80 haemophilia patient records from 2020 to 2023, structured interviews with the haematology team, and patient and caregiver focus group discussions. Data were assessed against the World Federation of Hemophilia (WFH) standards for haemophilia care. Findings revealed that factor VIII concentrates were consistently available for only 4 months of each year due to supply chain disruptions. Sixty-eight percent of patients had experienced joint bleeds requiring hospital admission, with 41 percent developing at least one target joint. Inhibitor testing was performed in only 22 percent of patients despite clinical indications. Physiotherapy was accessed by 14 percent of eligible patients. Prophylactic factor replacement was used in only 7 percent of patients, compared to the WFH recommendation of universal prophylaxis in severe haemophilia. The study recommends sustained government funding for factor concentrate procurement, inhibitor surveillance protocols, physiotherapy integration, and a national haemophilia patient registry accessible at AKTH. Keywords: haemophilia, factor concentrate, bleeding disorder, Kano, resource-constrained haematology.