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Effect of Community-Based Anaemia Screening on Anaemia Detection among Adolescent Girls in Nigeria

Abstract

Anaemia remains an important public health problem among adolescent girls in Nigeria, particularly because of increased nutritional requirements during adolescence, menstrual blood loss, inadequate dietary intake, parasitic infections, malaria, and other health conditions that may contribute to reduced haemoglobin levels. Undetected anaemia may result in fatigue, weakness, poor concentration, reduced school performance, impaired physical development, and other adverse health consequences. Early detection of anaemia is essential for identifying affected adolescent girls and providing timely treatment, nutritional counselling, supplementation, further investigation, and appropriate referral. Community-based anaemia screening provides an opportunity to bring screening services closer to adolescent girls through schools, community health centres, youth programmes, outreach activities, and other community platforms. Such screening may improve access to haemoglobin testing and facilitate identification of girls with anaemia who may not otherwise seek healthcare services. However, limited screening coverage, inadequate diagnostic equipment, shortage of trained healthcare personnel, low awareness, fear of testing, financial barriers, and weak referral systems may reduce 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 adolescent girls 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 adolescent girls' perceptions of susceptibility to anaemia, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence their participation in anaemia screening. Community Health Theory emphasizes the delivery of health services through accessible 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 healthcare programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based anaemia screening may influence anaemia detection among adolescent girls in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adolescent girls aged approximately 10–19 years residing in selected communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, schools or youth centres, and eligible adolescent girls. 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 adolescent girls screened, availability of trained screening personnel, availability of haemoglobin testing equipment, screening procedures, and referral arrangements. Anaemia detection will be assessed using indicators such as haemoglobin test results, number of girls identified with anaemia, severity of anaemia, proportion of screened girls with low haemoglobin levels, confirmation of suspected cases where necessary, referral for further assessment, and initiation of appropriate management. Data will be collected using structured questionnaires, screening registers, haemoglobin testing records, school health records, community health records, healthcare facility records, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, screening coverage, 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 adolescent girls in Nigeria. Adolescent girls who have access to community-based screening are expected to have a higher likelihood of being screened and having anaemia identified than girls without access to such services. Community-based screening may improve accessibility by bringing haemoglobin testing closer to adolescent girls through schools, community health centres, outreach programmes, and youth-focused health activities. Early detection may provide opportunities for timely treatment, iron and folic acid supplementation where appropriate, nutritional counselling, investigation of underlying causes, and referral for further medical assessment. Community screening may also improve awareness of anaemia and encourage adolescent girls and their caregivers to seek appropriate healthcare when symptoms occur. Conversely, inadequate screening coverage, limited diagnostic capacity, shortage of trained personnel, low awareness, concerns about testing, 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 of anaemia among adolescent girls in Nigeria. The study is expected to contribute to the literature on community-based anaemia screening, anaemia detection, adolescent health, nutritional health, reproductive health, 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, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, schools, adolescent health programmes, nutrition programmes, healthcare providers, community health workers, development partners, and policymakers regarding strategies for improving anaemia prevention and detection among adolescent girls. The study will also provide evidence-based recommendations for expanding community-based anaemia screening programmes, improving access to affordable haemoglobin testing, strengthening training of healthcare and community health workers, increasing adolescent health and nutrition education, integrating anaemia screening into school and primary healthcare services, strengthening referral and follow-up systems, and improving access to appropriate treatment and nutritional interventions for adolescent girls across Nigeria.

Keywords: Community-based anaemia screening, anaemia detection, adolescent girls, haemoglobin screening, adolescent health, nutritional health, iron deficiency, community health, preventive healthcare, Nigeria, primary healthcare, public health.