{
  "abstract": "Background\n\nSickle cell disease causes substantial childhood morbidity and premature mortality in sub-Saharan Africa, while access to essential services remains uneven. In Uganda, geographic variation in inherited SCD risk supports spatially targeted service planning.Methods\n\nWe conducted a national facility-linked ecological spatial planning analysis using 280 eligible higher-level public facilities. Populated cells were assigned to the nearest eligible facility within a modelled 60-minute travel-time boundary. Epidemiological context was represented by a study-specific co-risk index combining standardised haemoglobin S (HbS) allele frequency and Plasmodium falciparum parasite rate among children aged 2 to 10 years (PfPR2-10). Reported availability was assessed for newborn screening, hydroxyurea, blood transfusion, and specialised SCD clinic care. We derived service-deficit, structural-vulnerability, programme-priority, service-specific priority, and coverage-to-need measures and assessed sensitivity to alternative weighting specifications.Results\n\nAmong 280 planning zones, 122 (43.6%) had none of the four reported services and 205 (73.2%) had no more than one. Co-risk ranged from 0.003 to 0.934 and service-mediated SCD structural vulnerability from 0.000 to 0.905. Higher programme-priority scores were concentrated mainly in northern, north-eastern, eastern, and parts of central Uganda, while lower-priority tiers were more common in the south-west. Newborn-screening and hydroxyurea priorities were closely aligned, transfusion priorities extended more broadly into northern and central Uganda, and specialised-clinic priorities were more spatially mixed. The overall coverage-to-need gap had a mean of 0.190 and median of 0.205. The 56 zones comprising the national top 20% of programme priority contained approximately 7.0 million people, representing 17.3% of the population within the analytic framework. Priority concentration was strongest in Lango, Teso, Acholi, Karamoja, and Busoga.Conclusions\n\nThe framework identified a concentrated set of candidate service-strengthening nodes under the specified assumptions, mainly in northern, north-eastern, and eastern Uganda. The findings can support further programme assessment and stakeholder review for phased, regionally coordinated, and service-specific expansion of SCD care.",
  "abstract_shown": true,
  "affiliations": [
    "School of Medicine, College of Health Sciences, Makerere University, Upper Mulago Hill Road, P.O. Box 7062, Mulago, Kampala, Uganda. georgepaasi8@gmail.com.",
    "Mbale Clinical Research Institute, Mbale Regional Referral & Teaching Hospital Complex, P.O. Box 1966, Plot 29-33 Pallisa Road, Mbale, Uganda. georgepaasi8@gmail.com.",
    "School of Medicine, College of Health Sciences, Makerere University, Upper Mulago Hill Road, P.O. Box 7062, Mulago, Kampala, Uganda.",
    "Mbale Clinical Research Institute, Mbale Regional Referral & Teaching Hospital Complex, P.O. Box 1966, Plot 29-33 Pallisa Road, Mbale, Uganda.",
    "Faculty of Health Sciences, Busitema University, Mbale Campus, P.O. Box 1460, Mbale, Uganda."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "George Paasi",
      "orcid": "0000-0001-6360-0589"
    },
    {
      "affs": [
        2
      ],
      "name": "Grace Ndeezi"
    },
    {
      "affs": [
        2
      ],
      "name": "Ruth Namazzi"
    },
    {
      "affs": [
        2
      ],
      "name": "Ezekiel Mupere"
    },
    {
      "affs": [
        2
      ],
      "name": "Ian Guyton Munabi"
    },
    {
      "affs": [
        2
      ],
      "name": "Sarah Kiguli"
    },
    {
      "affs": [
        2
      ],
      "name": "Richard Idro"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Peter Olupot-Olupot"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e2c8nywdqwxrm.bib",
  "cited_by": 1,
  "doi": "10.1186/s44263-026-00338-y",
  "fulltext_url": "https://europepmc.org/articles/PMC13660151",
  "id": "e2c8nywdqwxrm",
  "issns": [
    "2731-913X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42864651",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2716|Hemoglobinopathies and Related Disorders"
    ]
  ],
  "openalex": "W7221520636",
  "pdf_url": "https://europepmc.org/articles/PMC13660151?pdf=render",
  "pmcid": "PMC13660151",
  "pmid": "42864651",
  "published": "2026-10-12",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/e2c8nywdqwxrm.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42864651",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42864651"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Hemoglobinopathies and Related Disorders",
      "subfield": "human-genetics"
    }
  ],
  "title": "A national spatial prioritisation framework for the targeted expansion of essential sickle cell disease services across health-facility catchments in Uganda.",
  "title_text": "A national spatial prioritisation framework for the targeted expansion of essential sickle cell disease services across health-facility catchments in Uganda.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:00Z",
  "url": "https://research.draconitic.com/paper/e2c8nywdqwxrm",
  "venue": "BMC global and public health",
  "versions": []
}