Scoping review of interventions to improve continuity of postdischarge care for newborns in LMICs

Bibliographic Data

ID21879869
AuthorsGulraj Grewal (0000-0001-9299-4054, University of Oxford, corresponding author), Sebastian Fuller (0000-0002-9284-6630, University of Oxford), Asma Rababeh (0000-0002-1614-3896, University of Oxford), Michuki Maina (0000-0001-6874-8929, Kenya Medical Research Institute), Mike English (0000-0002-7427-0826, Kenya Medical Research Institute), Chris Paton (0000-0001-6952-9621, University of Oxford), Chrysanthi Papoutsi (0000-0003-1189-7100, University of Oxford)
Year2024
Volume9
Issue1
Pagese012894
Publication date2024-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMJ Global Health (JOURNAL)
Journal identifiersISSN: 2059-7908 • E-ISSN: 2059-7908
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2023-012894
PMID38199778
OpenAlexW4390708183
LanguageEN
Citations received3
References cited103

INTRODUCTION: Neonatal mortality remains significant in low-income and middle-income countries (LMICs) with in-hospital mortality rates similar to those following discharge from healthcare facilities. Care continuity interventions have been suggested as a way of reducing postdischarge mortality by better linking care between facilities and communities. This scoping review aims to map and describe interventions used in LMICs to improve care continuity for newborns after discharge and examine assumptions underpinning the design and delivery of continuity. METHODS: We searched seven databases (MEDLINE, CINAHL, Scopus, Web of Science, EMBASE, Cochrane library and (Ovid) Global health). Publications with primary data on interventions focused on continuity of care for newborns in LMICs were included. Extracted data included year of publication, study location, study design and type of intervention. Drawing on relevant theoretical frameworks and classifications, we assessed the extent to which interventions adopted participatory methods and how they attempted to establish continuity. RESULTS: A total of 65 papers were included in this review; 28 core articles with rich descriptions were prioritised for more in-depth analysis. Most articles adopted quantitative designs. Interventions focused on improving continuity and flow of information via education sessions led by community health workers during home visits. Extending previous frameworks, our findings highlight the importance of interpersonal continuity in LMICs where communication and relationships between family members, healthcare workers and members of the wider community play a vital role in creating support systems for postdischarge care. Only a small proportion of studies focused on high-risk babies. Some studies used participatory methods, although often without meaningful engagement in problem definition and intervention implementation. CONCLUSION: Efforts to reduce neonatal mortality and morbidity should draw across multiple continuity logics (informational, relational, interpersonal and managerial) to strengthen care after hospital discharge in LMIC settings and further focus on high-risk neonates, as they often have the worst outcomes

CINAHL · Cochrane Library · Health care · MEDLINE · Meta-analysis · Psychological intervention · Scopus · Global Maternal and Child Health · Infant Development and Preterm Care · Medicine · Neonatal Respiratory Health Research · Nursing

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