Optimising health of at-risk infants in Eswatini: Developing a post-discharge healthcare model

Abstract Introduction: At-risk infants between zero to one year of age are those with an increased risk of morbidity and/or mortality, are currently maintaining homeostasis and do not require a special or intensive care level of monitoring or medical intervention. Advancements in the management of at-risk infants make it possible to have more of them surviving and being discharged home, even though they will still need close monitoring and follow-up. Upon discharge, primary caregivers must assume responsibility for the care of the at-risk infants. The care of the at-risk infants at home may entail multi-layered challenges. Among the challenges are a lack of skills and confidence due to insufficient preparation before discharge from the hospital, a lack of support from family and significant others, and economic challenges stemming from job loss and increased financial demands for caring for the at-risk infant. The at-risk infant may be at risk of experiencing adverse outcomes and poor health. The researcher observed a lack of comprehensive healthcare model for the care of at-risk infants post-discharge in Eswatini. Aim: To develop a healthcare model for post-discharge care to optimise the health of at-risk infants in Eswatini. Design, data collection and analysis: A multi-method design will be used. The study is planned in 3 phases. Phase 1 will be a theoretical phase during which the current healthcare models for post-discharge care of at-risk infants will be explored through a scoping review. Phase 2 will describe the Eswatini healthcare landscape in terms of Eswatini legislation, policies, guidelines and systems by conducting and interpreting a situation analysis of post-discharge systems for at-risk infants, and conducting focus group discussions to describe the perceptions of primary post-discharge caregivers of at-risk infants. Phase 3 will focus on consensus, formulation and verification of a healthcare model for post-discharge care of at-risk infants in Eswatini, using a nominal group technique and an e-Delphi to verify the applicability and comprehensiveness of the healthcare model. Significance: To ensure continuity and prevent complications that may arise post-discharge, this study seeks to establish a healthcare model to optimise the care of at-risk infants post-discharge in Eswatini.