Abstract

Anemia remains a pervasive public health and clinical challenge across sub-Saharan Africa, driving substantial 
morbidity, mortality, and health-system costs. In hospital settings, anemia complicates obstetric, pediatric, surgical, 
and medical care, often interacting with malaria, helminth infections, nutritional deficiencies, hemoglobinopathies, 
chronic kidney disease, and inflammatory conditions. Non-governmental organizations (NGOs) have played a 
pivotal role in closing policy-practice gaps through program financing, technical assistance, supply-chain support, 
workforce training, patient blood management (PBM), and community engagement. This narrative review 
synthesizes the landscape of NGO contributions in Uganda and Nigeria, two countries with high anemia burdens 
and distinct health-system contexts. We summarize common intervention domains screening and diagnostics, blood 
safety and availability, iron and folate supplementation, infection control, peripartum hemorrhage prevention, 
pediatric and sickle-cell services, nutrition, and quality improvement-and discuss implementation strategies, 
health-system enablers, and barriers. We highlight promising models (integrated obstetric bundles, point-of-care 
testing, PBM pathways, and digital supply tracking) and outline a practice-oriented framework for hospital leaders 
and NGO partners. Finally, we identify research and policy priorities, including standardized hospital anemia 
indicators, cost-effectiveness of PBM and IV iron, equitable blood allocation, and stronger NGO-government 
compacts for sustainable scale-up.