AWARENESS OF SICKLE CELL DISEASE AMONG UNIVERSITY STUDENTS IN NIGERIA: AN ECOLOGICAL MODEL STUDY IN A LOW- AND MIDDLE-INCOME COUNTRY SETTING

Abstract

Sickle Cell Disease (SCD) poses a significant yet underexplored challenge in public health among

students in higher education, particularly in low- and middle-income countries (LMICs). Despite its

prevalence, limited research has examined the lived experiences of affected students within institutional

contexts. This study aimed to explore the level of awareness of SCD, the nature of social relationships

among students living with SCD, and the presence or absence of university policies or guidelines

addressing their needs. Grounded in Bronfenbrenner’s Ecological Systems Theory and guided by

interpretivist epistemology, the study adopted a qualitative case study design. Semi-structured

interviews were conducted with 13 undergraduate students at Kaduna State University, Nigeria.

Thematic analysis of 127 narratives yielded 12 categories, which were further synthesized into four

ecological constructs: intrapersonal factors, interpersonal relationships, community perceptions, and

societal policy awareness. Findings revealed basic awareness of SCD among students, diverse social

experiences ranging from inclusion to stigmatization, and a critical absence of institutional policy

support. The study concludes that these gaps hinder effective health outcomes for students with SCD.

It recommends the establishment of inclusive, culturally sensitive support systems, targeted awareness

programs, and enforceable policy frameworks. These findings have practical implications for

universities, policymakers, NGOs, and development partners seeking to promote health equity and

inclusive education in LMICs.