Smart Discharges to improve post-discharge survival following admission for infection in young infants
Matthew Wiens, BSc, PharmD, PhD
BACKGROUND: In Uganda, infants treated for an infection in hospital are more likely to die during the first 6 months after discharge than during the period of hospitalization. We have developed and validated a risk prediction model for death after discharge in young infants, which can be used by frontline heath workers to guide delivery of low-cost interventions to improve transition from hospital to home. We have previously shown this ‘Smart Discharges’ approach is effective at improving outcomes among children 6 months to 5 years of age.
GAP: To our knowledge, there are no programs in Africa to address death after discharge in young infants. We do not know if our Smart Discharges approach, which we have implemented among older children, is effective in reducing death after discharge in young infants.
HYPOTHESIS: Use of Smart Discharges’s risk-guided counseling and post-discharge referral-based intervention will reduce post-discharge mortality in young infants who were treated in hospital for a proven or suspected infection.
METHODS: We will conduct a multisite, prospective before-and-after study at 6 hospitals in Uganda to evaluate an adaptive counseling and referral-based intervention in 5400 young infants aged 0-6 months who are admitted to the hospital for a proven or suspected infectious illness.
IMPACT: If the Smart Discharges approach reduces death among young infants, we will include young infants in our actively growing Smart Discharges Program currently being implemented by Walimu, our partner in Uganda, under the support of the Ministry of Health. The broader evidence base for Smart Discharges will ensure better integration into policies, guidelines, and other programs aimed at reducing child death in Uganda and across sub-Saharan Africa.