Importance of Mandatory Neonatal Screening in Nigeria: A Comprehensive Review

International audience Background: Nigeria has the world's highest burden of sickle cell disease (SCD), with an estimated 150,000 affected newborns and 20–25% carrier prevalence annually, yet mandatory neonatal hemoglobin screening is not yet standard practice across all areas of Nigeria. Without early detection, about 50–90% of affected children die before the ages of five years, primarily from preventable diseases such as pneumococcal sepsis, severe malarial anaemia, and acute chest syndrome. Method: This review deeply appraised recent peer-reviewed studies, systematic reviews and pilot programme data from Nigeria and comparable sub-Saharan African settings, alongside relevant policy and epidemiological reports. The review studied the cases for adopting mandatory neonatal hemoglobin screening in Nigeria by examining the burden of hemoglobin disorders, evaluating available screening technologies, and identifying barriers to implementation. Results: Findings showed that mandatory neonatal screening is a feasible, cost-effective, and life-saving intervention for Nigeria, it also noted that point-of-care testing (POCT) devices such as HemoTypeSCTM, Sickle SCAN®, and GazelleTM offer rapid, low-cost are field-feasible alternatives to laboratory-based methods like HPLC and IEF achieving high acceptance and diagnostic accuracy in Nigerian and regional pilot studies in Africa. The review identified early diagnosis as an enabler for timely penicillin prophylaxis, vaccination, and hydroxyurea therapy, substantially reducing mortality and stroke risk. Conclusion: A total implementation of mandatory neonatal hemoglobin screening in Nigeria is constrained by infrastructural deficits, financial limitations, workforce shortages, and sociocultural barriers including stigma and low awareness. Legislative backing, POCT deployment through a hub- and-spoke model, and sustained public awareness campaigns are recommended to accelerate adoption and reduce preventable childhood mortality from hemoglobin disorders.