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Effect of Community-Based Anaemia Screening on Anaemia Detection among Pregnant Women in Nigeria

Abstract

Anaemia remains a major public health concern among pregnant women in Nigeria and is associated with increased risks of maternal morbidity, fatigue, reduced work capacity, poor pregnancy outcomes, preterm birth, low birth weight, and other complications. Pregnancy increases the body's requirements for iron and other essential nutrients, while factors such as inadequate dietary intake, malaria, parasitic infections, haemoglobin disorders, closely spaced pregnancies, and other health conditions may contribute to the development of anaemia. Many pregnant women may have anaemia without obvious symptoms, resulting in delayed identification and treatment. Early detection of anaemia during pregnancy is therefore essential for timely management, nutritional counselling, iron and folic acid supplementation where appropriate, investigation of underlying causes, and referral for further care. Community-based anaemia screening provides an opportunity to bring haemoglobin testing and related health services closer to pregnant women through community outreach programmes, primary healthcare centres, antenatal outreach services, maternal health programmes, and other community platforms. However, limited screening coverage, inadequate diagnostic equipment, shortages of trained healthcare personnel, financial barriers, low awareness, transportation difficulties, 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 pregnant women 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 pregnant women'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 maternal healthcare programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based anaemia screening may influence anaemia detection among pregnant women in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise pregnant women residing in selected communities and accessing antenatal or maternal healthcare services in Nigeria. A multistage sampling technique will be used to select states, local government areas, communities, primary healthcare centres, maternity facilities, and eligible pregnant women. Community-based anaemia screening will be measured using indicators such as availability of screening services, screening coverage, frequency of community screening activities, accessibility of screening locations, number of pregnant women screened, haemoglobin testing, availability of trained healthcare personnel, availability of screening equipment, screening procedures, health education, and referral arrangements. Anaemia detection will be assessed using indicators such as haemoglobin test results, number and proportion of pregnant women identified with anaemia, severity of anaemia, newly detected cases, confirmation of suspected cases where necessary, referral for further assessment, and initiation of appropriate management. Data will be collected using structured questionnaires, community screening registers, antenatal records, haemoglobin testing records, laboratory reports, maternal health records, 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 pregnant women in Nigeria. Pregnant women who have access to community-based anaemia screening are expected to have a higher likelihood of being screened and having anaemia identified than women without access to such services. Community-based screening may improve early identification of low haemoglobin levels and provide opportunities for timely treatment, iron and folic acid supplementation where appropriate, nutritional counselling, investigation of underlying causes, malaria management where indicated, and referral for further medical assessment. Bringing screening services closer to pregnant women may also reduce geographical and financial barriers and encourage greater utilization of maternal health services. Early detection may contribute to improved maternal health and support better pregnancy outcomes through timely management of identified anaemia. Conversely, inadequate screening coverage, limited diagnostic capacity, shortage of trained healthcare personnel, low 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 management of anaemia among pregnant women in Nigeria. The study is expected to contribute to the literature on community-based anaemia screening, anaemia detection, maternal health, antenatal care, nutritional health, pregnancy outcomes, 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, maternity hospitals, antenatal care providers, community health workers, maternal and child health programmes, development partners, and policymakers regarding strategies for improving anaemia prevention and detection during pregnancy. The study will also provide evidence-based recommendations for expanding community-based anaemia screening programmes, improving access to affordable haemoglobin testing, strengthening maternal health education, increasing availability of trained healthcare personnel and diagnostic equipment, integrating anaemia screening into community and antenatal care services, strengthening referral and follow-up systems, improving access to appropriate treatment and nutritional interventions, and promoting early detection and management of anaemia among pregnant women across Nigeria.

Keywords: Community-based anaemia screening, anaemia detection, pregnant women, maternal health, haemoglobin screening, antenatal care, iron deficiency, nutritional health, pregnancy, preventive healthcare, Nigeria, public health.