{"doi":"10.1093/pubmed/fdaf147","title":"Barriers to sickle cell disease care: a biopsychosocial analysis mapped to the standards of care guidelines by the sickle pan African research consortium","abstract":"BACKGROUND: The SickleInAfrica consortium has developed multi-level Standards of Care (SoC) guidelines for SCD spanning primary, secondary, and tertiary services. However, their successful implementation may be hindered by health system limitations, patient-level factors, and social determinants of health. OBJECTIVES: To identify and categorise barriers to SCD care using the biopsychosocial framework and map the barriers to the SoC guidelines developed by the Sickle Pan-African Research Consortium (SPARCo). The goal was to identify public health, clinical, programmatic and research priorities for SCD care in Africa. METHODS: A scoping review was conducted to identify barriers to SCD care. The identified barriers were categorised into biopsychosocial domains and mapped to the SPARCo SoC guidelines. RESULTS: Fifty-four studies were included in the scoping review. Social barriers were the most frequent (85.2%), followed by operational (74.1%), psychological (40.7%), and biological (14.8%). Common barriers included the invisible nature of pain, medication stockouts, negative attitudes from clinical staff; inadequate mental health support; stigma, and low SCD literacy among healthcare workers. Most barriers clustered around three SPARCO SoC domains: health maintenance and preventive therapy, management of acute complications, and specialised protocols. Suggested priorities include integrating SCD care into existing vertical programmes, co-designing paediatric-to-adult care transition models with patient support groups, and workforce training. CONCLUSION: Leveraging existing, well established vertical programmes in healthcare systems, such as maternal health, immunisation and counselling services, could be a pragmatic pathway to scale up SCD services and minimising barriers to the implementation of the SPARCo SoC.","journal":"Journal of Public Health","year":2025,"id":515346,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9623,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1380165,"name":"Vhuthu Raphunga","orcid":null,"position":1,"is_corresponding":false},{"id":1380166,"name":"Achuma Mashalaba","orcid":null,"position":2,"is_corresponding":false},{"id":759217,"name":"Arthemon Nguweneza","orcid":null,"position":3,"is_corresponding":false},{"id":1380167,"name":"Kambe Banda","orcid":null,"position":4,"is_corresponding":false},{"id":758710,"name":"Vivian Paintsil","orcid":"0000-0002-8965-0549","position":5,"is_corresponding":false},{"id":310463,"name":"Obiageli Nnodu","orcid":"0000-0002-4801-3156","position":6,"is_corresponding":false},{"id":78669,"name":"Ambroise Wonkam","orcid":"0000-0003-1420-9051","position":7,"is_corresponding":false},{"id":341652,"name":"Nchangwi Syntia Munung","orcid":"0000-0003-1498-3602","position":0,"is_corresponding":true}],"reference_count":75,"raw_metadata":null,"created_at":"2026-07-19T02:48:39.436300Z","pmid":"41307557","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}