Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 2;11(3):e043773.
doi: 10.1136/bmjopen-2020-043773.

Mixed-method study to assess the feasibility, acceptability and early effectiveness of the Hospital to Home programme for follow-up of high-risk newborns in a rural district of Central Uganda: a study protocol

Daniel Kabugo #  1 , Heidi Nakamura #  2 , Brooke Magnusson #  2 , Madeline Vaughan #  3 , Beatrice Niyonshaba  1 , Cornety Nakiganda  1 , Christine Otai  1 , Kimber Haddix-McKay  2   4 , Margaret Seela  5 , Joyce Nankabala  5 , Josephine Nakakande  5 , Moses Ssekidde  5 , Cally J Tann  6   7   8 , Benjamin J S Al-Haddad  9 , James Nyonyintono  5 , Paul Mubiri  10 , Peter Waiswa  11   12   13 , Mohan Paudel #  14
Affiliations

Mixed-method study to assess the feasibility, acceptability and early effectiveness of the Hospital to Home programme for follow-up of high-risk newborns in a rural district of Central Uganda: a study protocol

Daniel Kabugo et al. BMJ Open. .

Abstract

Introduction: A follow-up programme designed for high-risk newborns discharged from inpatient newborn units in low-resource settings is imperative to ensure these newborns receive the healthiest possible start to life. We aim to assess the feasibility, acceptability and early outcomes of a discharge and follow-up programme, called Hospital to Home (H2H), in a neonatal unit in central Uganda.

Methods and analysis: We will use a mixed-methods study design comparing a historical cohort and an intervention cohort of newborns and their caregivers admitted to a neonatal unit in Uganda. The study design includes two main components. The first component includes qualitative interviews (n=60 or until reaching saturation) with caregivers, community health workers called Village Health Team (VHT) members and neonatal unit staff. The second component assesses and compares outcomes between a prospective intervention cohort (n=100, born between July 2019 and September 2019) and a historical cohort (n=100, born between July 2018 and September 2018) of infants. The historical cohort will receive standard care while the intervention cohort will receive standard care plus the H2H intervention. The H2H intervention comprises training for healthcare workers on lactation, breast feeding and neurodevelopmentally supportive care, including cue-based feeding, and training to caregivers on recognition of danger signs and care of their high-risk infants. Infants and their families receive home visits until 6 months of age, or longer if necessary, by specially trained VHTs. Quantitative data will be analysed using descriptive statistics and regression analysis. All results will be stratified by cohort group. Qualitative data will be analysed guided by Braun and Clarke's thematic analysis technique.

Ethics and dissemination: This study protocol was approved by the relevant Ugandan ethics committees. All participants will provide written informed consent. We will disseminate through peer-reviewed publications and key stakeholders and public engagement.

Trial registration number: ISRCTN51636372; Pre-result.

Keywords: community child health; health policy; neonatal intensive & critical care; quality in health care.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
H2H study flow chart. *Or until saturation has been reached. H2H, Hospital to Home; KH, Kiwoko Hospital; NU, neonatal unit, VHTs, Village Health Teams.
Figure 2
Figure 2
Map showing Hospital to Home study districts.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hug L, Sharrow D, Zhong K. Levels & trends in child mortality report 2018. New York: United Nations Children’s Fund, 2018.
    1. Lawn JE, Blencowe H, Oza S, et al. . Every newborn: progress, priorities, and potential beyond survival. Lancet 2014;384:189–205. 10.1016/S0140-6736(14)60496-7 - DOI - PubMed
    1. van den Boogaard W, Zuniga I, Manzi M, et al. . How do low-birthweight neonates fare 2 years after discharge from a low-technology neonatal care unit in a rural district hospital in Burundi? Trop Med Int Health 2017;22:423–30. 10.1111/tmi.12845 - DOI - PubMed
    1. Pickier RH, McGrath JM, Reyna BA, et al. . A model of neurodevelopmental risk and protection for preterm infants. Adv Neonatal Care 2013;13:S11–20. 10.1097/ANC.0000000000000022 - DOI - PMC - PubMed
    1. Cheong JL, Doyle LW, Burnett AC, et al. . Association between moderate and late preterm birth and neurodevelopment and social-emotional development at age 2 years. JAMA Pediatr 2017;171:e164805. 10.1001/jamapediatrics.2016.4805 - DOI - PubMed

Publication types

Associated data

LinkOut - more resources