Transforming Hematology Care in Africa: Strategies for Enhanced Diagnosis and Treatment.

[BACKGROUND] Hematologic disorders contribute significantly to morbidity and mortality across Africa. Challenges include delayed diagnosis, limited access to essential therapies, workforce shortages, and fragmented blood transfusion services. Although global advances in diagnostics and therapeutics exist, their translation into African contexts remains inconsistent.

[OBJECTIVE] To provide a comprehensive narrative review of the current state of hematology care in Africa, highlighting diagnostic and treatment gaps, country-level experiences, and evidence-informed strategies for improving patient outcomes.

[METHODS] A structured literature search was conducted using PubMed, Scopus, and Web of Science for publications from 2018 to 2025. Search terms included "hematology Africa," "sickle cell disease," "blood disorders," "diagnostics," "blood transfusion," and "hematologic malignancies." Studies were selected based on relevance to diagnostic strategies, treatment interventions, health system strengthening, and country-level programs. Thematic synthesis was used to identify recurrent challenges and strategic interventions.

[RESULTS] Key challenges in hematology care include limited access to advanced diagnostics, insufficient laboratory and clinical workforce, inconsistent availability of essential medicines, and weak blood transfusion infrastructure. Country-level examples illustrate both successes and gaps: Rwanda has implemented neonatal sickle cell screening and drone-assisted blood delivery; Nigeria has regional sickle cell centers, but uneven coverage; Uganda and Kenya have improved diagnostic capacity through regional referral laboratories and point-of-care testing; Ghana has expanded access to targeted therapies for chronic myeloid leukemia via national health insurance programs. Strategic interventions include decentralizing diagnostics, expanding point-of-care testing, strengthening blood services, enhancing workforce training and CME, leveraging digital health and teleconsultation, and promoting regional centers of excellence. Collaborative initiatives and context-adapted policies are critical for sustainability.

[CONCLUSION] Transforming hematology care in Africa requires integrated, evidence-informed strategies combining technological innovation with health system strengthening. Country-specific experiences highlight actionable pathways, while persistent gaps underscore the need for scalable, equitable, and sustainable approaches. Coordinated efforts in diagnostics, therapeutics, workforce development, and service delivery can improve outcomes for patients with hematologic disorders across the continent.