Grant: Project Grant

Worldwide, most child deaths occur during the first few weeks of life. Many of these deaths are caused by severe infections. Babies who experience severe infections shortly after birth can receive life-saving care in neonatal hospital units but require ongoing care and follow-up visits after returning home to ensure their recovery and healthy development. However, some communities do not have enough health workers and money for all babies to receive the same number of in-person follow-up visits. Nurses can use a 'risk score' to make sure those most at risk receive the highest number of in-person visits. To create a risk score, we must know what happens to babies after they return home from the hospital. However, we do not have information for babies who experience severe infections in many countries. In Uganda, we have developed a risk score that allow healthcare workers to identify children who are most at risk of dying after discharge following a severe infection. We created a 'Smart Discharges' program with the Uganda Ministry of Health, where health workers use the risk score to guide delivery of care plans that include education and follow-up visits. We did not include young babies admitted to neonatal hospital units for a severe infection shortly after birth in our initial risk score. Including these babies is important to developing an evidence-based program that improves care and outcomes for children of all ages. Here, we will begin this process by understanding what happens to babies after they return home following treatment for severe infections. We will work in two East African countries. We will then develop our risk score to identify who is most at risk of death in the first few weeks after leaving the hospital. Finally, we will talk with families, health workers, and policy-makers to determine how the risk score and our findings can be used to guide decisions about care for babies to ensure their survival and healthy development.