REConneCteD: Risk-Enhanced Community Care After Discharge

Children returning home after hospitalization for severe infectious illnesses suffer high mortality rates, especially in sub-Saharan Africa (SSA). After returning home, continued engagement with the health system can improve recovery and reduce post-discharge deaths. Yet, it is not feasible for every child to return to the hospital for follow-up care post-discharge. Community health workers (CHWs) can facilitate safer transitions in care by engaging with families after they return home and providing re-referrals back to higher levels of care if needed. Risk-enhanced care uses digital algorithms to provide the most appropriate intensity of care to each child depending on the estimated risk of an outcome. Embedding risk-enhanced care in SSA’s increasingly digitized health system provides an opportunity to increase the efficiency and effectiveness of health services provided by CHWs. However, digital health platforms used by CHWs in SSA do not currently communicate with digital health platforms used by facilities, creating a missed opportunity for ensuring continuity of care for vulnerable families. Here, we aim to embed our clinically-validated, risk-enhanced care approach into an existing electronic community health information system used by CHWs to create Risk-Enhanced Community Care after Discharge (REConneCteD). We will initially conduct formative research to develop and optimize the usability and accessibility of REConneCteD and then evaluate the impact of REConneCteD on post-discharge mortality in a clinical trial at 8 hospitals in Uganda and Kenya. We will also conduct a thorough economic evaluation. Our teams combines expertise and experience from community partners and researchers in Uganda, Kenya, and Canada (Walimu, KEMRI/Wellcome Trust, UBC, Brock University). We will engage with governments and healthcare providers throughout the project to ensure our findings contribute to national and regional priorities and policies.