Evaluation of low birth weight infant post-discharge outcomes and development of community-based follow-up and monitoring strategies in Africa

Background: Every year 2.5 million newborns die worldwide. Low birth weight infants (birth weight< 2,500g, LBW) have the highest risk of dying in the newborn period and those who survive often suffer from poor growth and development, particularly in impoverished communities of sub-Saharan Africa and Southern Asia. However, the rate of progress in reducing newborn deaths in sub-Saharan Africa has been much slower than in other regions of the world. In addition, once discharged from hospital care, the follow-up of LBW infants is hampered by the weak linkage between the community and the health system. As a result, mothers may feel isolated when they return to the community with these infants whose care needs are often not prioritised due to community misconceptions of their potential to survive and thrive. Consequently, their problems are not addressed in a timely manner due to limited contact with health services and by the time they present to services they have established growth failure (commonly in the form of stunting, where they are too short for their age) and disabilities that can often not be adequately addressed or reversed. The mechanisms by which growth failure and disabilities co-exist in these LBW infants is not fully understood therefore limiting the design and timing of interventions. Empowering community health teams to provide support to these vulnerable babies and their mothers, particularly in impoverished communities where regular access to health facilities may not be possible due to financial constraints or physical distance, is a priority. Community-based mother-to-mother peer support is effective in improving breastfeeding practices in non-LBW infants in sub-Saharan Africa and Asia and could therefore improve feeding and care-giving practices for LBW infants.

Previous work: To test the feasibility and acceptability of mother-to-mother peer support (peer mothers) for LBW infants in Kenya, I recently completed a study in a rural community...