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Effect of Community-Based Anaemia Screening on Anaemia Detection among School-Age Children in Nigeria

Abstract

Anaemia remains an important public health concern among school-age children in Nigeria and may adversely affect physical growth, cognitive development, learning ability, school attendance, concentration, and overall well-being. Anaemia among children may result from nutritional deficiencies, particularly iron deficiency, malaria, intestinal parasitic infections, haemoglobin disorders, chronic diseases, inadequate dietary intake, and other health conditions. Many children with anaemia may not exhibit obvious symptoms during the early stages, resulting in delayed detection and treatment. Early identification of anaemia is therefore essential for timely nutritional assessment, appropriate treatment, management of underlying causes, and prevention of complications. Community-based anaemia screening provides an opportunity to bring haemoglobin assessment and related health services closer to children through schools, primary healthcare centres, community outreach programmes, child health campaigns, and other community platforms. However, inadequate screening coverage, limited diagnostic equipment, shortages of trained healthcare personnel, financial constraints, low parental awareness, geographical barriers, and weak referral systems may limit the effectiveness of community-based anaemia screening programmes in Nigeria. Against this background, this study investigates the effect of community-based anaemia screening on anaemia detection among school-age children in Nigeria. The study will be anchored on the Health Belief Model, Community Health Theory, and the Health Systems Framework. The Health Belief Model explains how parents', caregivers', and children's perceptions of susceptibility to anaemia, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in anaemia screening. Community Health Theory emphasizes the delivery of accessible health services through community structures and the involvement of communities in disease prevention, health promotion, and early detection activities. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective screening and child healthcare programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based anaemia screening may influence anaemia detection among school-age children in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise school-age children residing in selected communities and enrolled in selected primary and lower secondary schools across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, schools, classes, and eligible children. Community-based anaemia screening will be measured using indicators such as availability of screening services, screening coverage, frequency of screening activities, accessibility of screening locations, number of children screened, haemoglobin testing, availability of trained healthcare personnel, availability of screening equipment, nutritional health education, parental participation, and referral arrangements. Anaemia detection will be assessed using indicators such as haemoglobin test results, number and proportion of children identified with anaemia, severity of anaemia, newly detected cases, suspected nutritional or other causes where assessed, confirmation of cases following appropriate clinical evaluation, referral for further assessment, and initiation of appropriate management. Data will be collected using structured questionnaires, community screening registers, school health records, haemoglobin testing records, laboratory reports, referral registers, and relevant programme documents. 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, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of community-based anaemia screening on anaemia detection. Where appropriate, anaemia detection rates before and after implementation of community-based screening activities 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 community-based anaemia screening has a significant positive effect on anaemia detection among school-age children in Nigeria. Children who participate in community-based anaemia screening are expected to have a higher likelihood of having previously undetected anaemia identified than children without access to such services. Community-based screening may facilitate early identification of low haemoglobin levels and provide opportunities for timely nutritional assessment, iron supplementation where appropriate, treatment of underlying conditions, malaria management where indicated, and referral for further medical assessment. Bringing screening services closer to schools and communities may reduce geographical and financial barriers and encourage greater participation in child health services. Early detection and management of anaemia may contribute to improved concentration, learning, physical development, school attendance, and overall child well-being. Conversely, inadequate screening coverage, limited diagnostic capacity, shortage of trained healthcare personnel, low parental awareness, financial constraints, and weak referral and follow-up systems may reduce the effectiveness of community-based anaemia screening. The study therefore expects accessible and well-organized community-based anaemia screening to contribute significantly to improved detection and early management of anaemia among school-age children in Nigeria. The study is expected to contribute to the literature on community-based anaemia screening, anaemia detection, child health, nutritional health, school health services, preventive healthcare, community health services, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, state ministries of health and education, primary healthcare centres, schools, child health programmes, community health workers, development partners, and policymakers regarding strategies for improving anaemia prevention and detection among children. The study will also provide evidence-based recommendations for expanding community-based anaemia screening programmes, improving access to affordable haemoglobin testing, strengthening school and community health education, increasing availability of trained healthcare personnel and diagnostic equipment, integrating anaemia screening into school and primary healthcare services, strengthening referral and follow-up systems, improving access to appropriate nutritional and medical interventions, and promoting early detection and management of anaemia among school-age children across Nigeria.

Keywords: Community-based anaemia screening, anaemia detection, school-age children, haemoglobin screening, iron deficiency, nutritional health, child health, school health services, preventive healthcare, community health, Nigeria, public health.