Evaluation of Newborn Screening Practices for Sickle Cell Disease at Tertiary Hospitals in Kwara State, North Central Nigeria

Newborn screening (NBS) for sickle cell disease (SCD) enables early diagnosis, prophylactic penicillin initiation, and parental counselling before the onset of life-threatening complications. Despite advocacy, NBS programmes remain poorly implemented in most Nigerian states. This evaluative study assesses the current state of NBS practices for SCD at tertiary hospitals in Kwara State, North Central Nigeria. A mixed-methods approach was employed, including structured facility assessments, record reviews of 320 neonates born over a 12-month period, and in-depth interviews with 18 paediatricians, haematologists, and neonatal nurses. Formal NBS protocols for SCD were documented in only two of the five assessed facilities. Haemoglobin electrophoresis was performed on only 12.8% of neonates born during the review period, primarily on request rather than as routine screening. Counselling of parents regarding SCD results was described as adequate in 44.4% of cases by informants. Barriers included absence of institutional policy mandating screening, high reagent costs, equipment downtime, and lack of dedicated counselling staff. Only 28.3% of families of confirmed SCD neonates were linked to a specialist SCD clinic within three months. The study recommends developing and implementing a state-level NBS policy for SCD, subsidising screening costs, and establishing structured parent counselling and linkage protocols. Keywords: newborn screening, sickle cell disease, Kwara State, neonatal, North Central Nigeria.