Mobile money, and the welfare of women and youths in fragile states: Evidence from Mozambique.

Sickle Cell Disease (SCD) is a hereditary blood disorder characterised by the production of abnormal haemoglobin, leading to the deformation of red blood cells into a sickle shape. This condition presents significant health challenges, especially during pregnancy, when physiological changes can exacerbate complications associated with SCD. Globally, SCD affects approximately 5% of the population, with the highest prevalence found in sub-Saharan Africa, India, and the Middle East []. The World Health Organisation (WHO) has recognised the need for improved healthcare strategies for SCD management, particularly in regions where the disease is endemic []. The Lancet Haematology Commission has made specific recommendations aimed at enhancing care for individuals with SCD, emphasising the importance of integrating disease management into primary healthcare systems []. These recommendations underscore the necessity of a multidisciplinary approach that includes healthcare providers, social support systems, and patient education to mitigate the risks associated with SCD, particularly during pregnancy. Pregnancy in women with SCD presents significant risks, including heightened rates of maternal morbidity and mortality, preterm birth, and fetal complications []. The physiological changes that occur during pregnancy, such as increased blood volume and alterations in blood viscosity, can trigger Vaso-occlusive crises and other complications related to SCD. Therefore, it is essential to understand the unique challenges faced by healthcare providers in managing SCD during pregnancy and the implications of these challenges on maternal and fetal outcomes. In Uganda, SCD is a significant public health issue, affecting an estimated 1.5% of the population, with a higher prevalence observed in the Eastern and Northern regions of the country []. The healthcare delivery in Uganda is constrained by inadequate resources, limited access to specialised care, and a lack of comprehensive SCD management protocols. These challenges are compounded for pregnant women with SCD, who require specialised care to navigate the complexities of their condition during pregnancy.