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Effect of Anaemia Screening on Anaemia Detection among Female Undergraduates in Nigeria

Abstract

Anaemia is a common public health problem that can affect women's physical health, cognitive functioning, academic performance, productivity, and overall wellbeing. Female undergraduates may be particularly vulnerable to anaemia because of menstrual blood loss, inadequate dietary iron intake, nutritional deficiencies, infections, and other health conditions. Mild or moderate anaemia may remain undetected because affected individuals may not recognize symptoms or may attribute fatigue, weakness, dizziness, and poor concentration to academic stress or other factors. Routine anaemia screening provides an opportunity for early identification of haemoglobin abnormalities and referral for appropriate investigation and management. However, limited awareness, inadequate screening programmes, financial barriers, and poor access to health services may reduce the likelihood of early detection among university students. Against this background, this study investigates the effect of anaemia screening on anaemia detection among female undergraduates in Nigeria. The study will be anchored on the Health Belief Model, Andersen's Behavioral Model of Health Services Use, and Social Cognitive Theory. The Health Belief Model explains how female undergraduates' perceptions of their susceptibility to anaemia, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in screening. Andersen's Behavioral Model explains how individual characteristics, enabling resources, and perceived health needs influence utilization of screening services. Social Cognitive Theory emphasizes knowledge, self-efficacy, social support, and environmental influences in the adoption of preventive health practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how anaemia screening may influence the detection of anaemia among female undergraduates in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise female undergraduate students enrolled in selected universities and other tertiary institutions across Nigeria. A multistage sampling technique will be used to select states, institutions, faculties, departments, and eligible female students. Anaemia screening will be assessed using indicators such as availability of screening services, screening coverage, frequency of screening, haemoglobin testing, availability of trained healthcare personnel, screening procedures, confidentiality, result communication, and referral arrangements. Anaemia detection will be assessed using indicators such as haemoglobin concentration, proportion of participants identified with anaemia, severity of anaemia, newly detected cases, referral for further investigation, and linkage to appropriate treatment or nutritional support. Data will be collected using structured questionnaires, screening records, haemoglobin testing results, healthcare records, and referral registers. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, haemoglobin findings, and patterns of anaemia detection. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of anaemia screening on anaemia detection. Where a quasi-experimental design is adopted, detection rates before and after implementation of an anaemia screening programme may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that anaemia screening has a significant positive effect on anaemia detection among female undergraduates in Nigeria. Female students who participate in systematic anaemia screening are expected to have a higher likelihood of previously undetected anaemia being identified than students without access to routine screening. Screening may identify women with mild or moderate anaemia who may not yet have sought healthcare because their symptoms are absent, mild, or attributed to other causes. Early detection may facilitate appropriate clinical evaluation, dietary counselling, iron or other indicated treatment, investigation of underlying causes, and follow-up monitoring. Screening programmes conducted within tertiary institutions may also reduce barriers related to distance, cost, time, and limited awareness. However, fear of testing, low awareness, financial constraints, limited healthcare resources, inadequate follow-up, and poor availability of screening personnel may reduce participation and the benefits of screening. The study therefore expects accessible, affordable, confidential, and well-organized anaemia screening services to contribute significantly to improved detection and early management of anaemia among female undergraduates in Nigeria. The study is expected to contribute to the literature on anaemia screening, anaemia detection, female undergraduates, women's health, nutritional health, preventive healthcare, university health services, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, Federal Ministry of Education, universities, tertiary institution health centres, healthcare providers, nutritionists, public health practitioners, women's health organizations, development partners, and policymakers regarding strategies for improving anaemia detection among young women. The study will also provide evidence-based recommendations for integrating routine anaemia screening into tertiary institution health programmes, improving access to haemoglobin testing, strengthening nutritional education and counselling, improving referral and follow-up systems, training healthcare personnel, and promoting early diagnosis and appropriate management of anaemia among female undergraduates across Nigeria.

Keywords: Anaemia screening, anaemia detection, female undergraduates, haemoglobin, women's health, nutritional health, preventive healthcare, university health services, early detection, Nigeria, public health.