Application of Genetic Counselling Protocols in the Management of Sickle Cell Disease in Primary Healthcare Settings in Ogun State

Genetic counselling is a cornerstone of sickle cell disease (SCD) management, enabling affected families to understand inheritance patterns and make informed reproductive choices. However, the consistent application of formal counselling protocols at primary healthcare facilities in South West Nigeria remains limited. This professional study evaluated the application of established genetic counselling protocols for SCD management at selected primary healthcare centres (PHCs) in Ogun State. A programme assessment design was employed, involving structured observation of 80 counselling sessions across 20 PHCs and in-depth interviews with 20 genetic counsellors and trained nurses. Sessions were assessed against the American Board of Genetic Counseling competency framework adapted for Nigerian contexts. Common deficiencies included incomplete pedigree construction, inadequate recurrence risk communication, and limited post-test psychological support. Facilities in urban local government areas demonstrated higher protocol adherence than rural counterparts, largely attributable to differences in workforce training and resource availability. Qualitative findings identified time pressure and inadequate supervision as key barriers. These results inform targeted capacity-building interventions for PHC-level SCD counselling in Ogun State and provide a model for programme evaluation replicable across South West Nigeria. Keywords: genetic counselling, sickle cell disease, primary healthcare, protocol adherence, Ogun State