Stewart, KearsleyKitts, Madison2025-07-022025-07-022025https://hdl.handle.net/10161/32912<p>Background: Sickle cell disease is a threat to public health and contributes significantly to morbidity and early childhood mortality in sub-Saharan Africa. Uganda has the 5th highest sickle cell disease burden, and an estimated 40,000 babies are born each year in Uganda, of which 80% die before the age of 5 years. Newborn screening has proven to reduce the risks and complications associated with sickle cell disease in high-resource settings by allowing early enrollment in treatment and management. In February 2024, Kalangala Health Center IV, the largest health center in the Kalangala District, initiated universal newborn screening for sickle cell disease. In low-resource settings, implementation of such interventions is almost impossible due to constrained systems and capacity challenges. Understanding all factors that may influence the uptake and implementation of newborn screening in Kalangala is essential for….(explain). Methods: This study used a mixed-methods approach with data collection deriving from Kalangala Health Center IV, Bwendero Health Center III, and Mulabana Health Center II. Survey data collected from parents was analyzed using descriptive statistics in RStudio. Qualitative data from interviews with parents and healthcare workers were transcribed, de-identified, and thematically analyzed in NVivo 14. Results: Findings identified various social, cultural, systemic, structural, and physical barriers and facilitators to universal newborn screening uptake. Parent surveys revealed a greater need for health education, as most participants knew of sickle cell disease (n= 227, 83.8%), but most were unable to correctly identify key aspects of the disease (n=117, 43.2%). Additionally, parent in-depth interviews covered concerns of stigmatization for sickle cell disease patients and screening, attitudes regarding NBS process, and community outreaches to remote villages. Lastly, healthcare worker in-depth interviews identified health system and policy gaps such as little government support, healthcare worker burnout, and inconsistent access to medications. Healthcare worker interviews also emphasized current facilitators like KHCIV laboratory capabilities, readiness to learn, and overall support for the newborn screening program. Conclusions: While early stages of universal newborn screening for sickle cell disease in Kalangala showcases healthcare worker commitment to increasing access to healthcare, challenges in awareness, accessibility, and health infrastructure must be addressed. Strengthening existing infrastructure, conducting standardized medical training, and improving community awareness should be integrated into the newborn screening program, enhancing uptake and sustainability in the long-run. </p>https://creativecommons.org/licenses/by-nc-nd/4.0/Public healthMaster's thesis