Table 1

Showing features of key interventions by the perspectives that underpin their design

InterventionsBiomedical and biopsychosocial approachesSocial determinants of health
Estimating prevalenceMagnitude of SCDs is seen as a burden, that potentially stigmatises people with SCDs and carrier status.Prevalence is seen as part of holistic policies that combine life-course approach and universal access to healthcare for people with SCDs and general population.
Screening servicesIdentify children with SCDs to ensure care. This can cause stigmatisation of women carrying children with SCDs and people with SCDs.Screen to ensure timely treatment to save lives of those born with SCDs and also ensure family planning, reproductive choices and maternal health policy exists in society.
Medical careSCDs often seen as a specialised issue in health services with need for particular training. Under-invested and neglected. Payment expected for treatment. Research focuses on development of cures and new therapies neglected for years.SCD is considered specialised but it incorporates duty of care and is linked to other parts of healthcare and investments made in therapies. Universal health coverage is implemented alongside investments in cures. Recognition of pluralistic health belief systems and importance of patient support groups.
Mental healthIdentify mental health issues such as depression and stress as triggers for SCD crisis. The condition is viewed as stigmatised.Health and social care focus on strengthening friendships, relationships and community connections that support persons with SCDs to cope better and understand psychological stressors.
LifestyleCare and nutrition viewed as family and individual management usually targeted to mothers as part of early intervention programmes.Care and nutrition as part of a country’s policies for general population taught in schools, universities and public communication programmes. The contribution of the extended family and community in care of those with SCDs is recognised.
SchoolInformation about SCDs is seen as biomedical education with no policies in schools for inclusion.SCDs integrated in all aspects of education and inclusive disability policies in schools and higher education institutions.
EmploymentPeople with SCDs are unable to work due to invisible disabilities or require special provisions to work.Work is made accessible for those with invisible disabilities with reasonable adjustments, welfare (or a basic universal income) and pension plans for people with chronic conditions exist in society.
Housing and sanitationHousing and sanitation excluded from these approaches.Housing and sanitation should be safe and accessible. Hygiene taught in schools.
EnvironmentEnvironmental conditions viewed as ‘trigger’ for disease, warnings about extremes in temperature but no policies to support improvements in environmental conditions.Environmental policies focused on housing conditions, access to heating and/or air conditioning to support a stable body temperature. Climate change and reduction of pollution. Disability and chronic conditions included in pandemic preparedness and planning throughout.
  • SCD, sickle cell disorders.