Abstract

Childhood arthritis, primarily chronic rheumatic conditions such as Juvenile Idiopathic Arthritis (JIA), poses 
significant challenges in low- and middle-income countries, particularly in sub-Saharan Africa. This review examines 
healthcare policies and service frameworks relevant to children with arthritis in Nigeria and Uganda, highlighting 
existing policy environments, specialist service availability, barriers to care, and enabling factors. Findings indicate 
that paediatric rheumatology remains underdeveloped, with a limited specialist workforce, inadequate diagnostic 
and therapeutic infrastructure, high out-of-pocket costs, and low policy prioritization. Awareness among healthcare 
providers and communities is also insufficient, contributing to delayed diagnosis and suboptimal management. 
Emerging initiatives, including regional guidelines from the Paediatric Society of the African League Against 
Rheumatism (PAFLAR), civil society advocacy, and integration within broader non-communicable disease 
frameworks, offer opportunities for improvement. Strengthening policy frameworks, expanding specialist training, 
enhancing service delivery, and promoting community awareness are essential to improve clinical outcomes, 
equitable access, and overall quality of life for children with arthritis in these low-resource settings.